Good Sense Eating | Lactose intolerance is less common than thought

The inability to digest lactose-a sugar found in milk-can cause children to miss out on favorites such as pizza, ice cream and cheese. But a new study published in Nutrition Today found that the rate of lactose intolerance is lower than previously thought.

Dear Good Sense Eating, are “Non-Dairy,” “Dairy-Free” and “Parve” foods lactose-free?

Not necessarily since Food and Drug Administration regulations do not define these terms for food labels. A product labeled “Non-Dairy” or “Dairy-Free” may mean that the milk fat has been replaced by a vegetable fat but may still contain other ingredients, such as whey or casein. “Pareve” or “Parve” labeled foods contain no dairy-based ingredients and are free of lactose.

Theresa Nicklas, DrPh, of the USDA/ARS Children’s Nutrition Research Center at Baylor College of Medicine, and her team found the incidence of lactose intolerance was 12 percent (7.7 percent of European Americans, 10 percent of Hispanic Americans and 19.5 percent of African Americans) based on a phone survey of 1,084 individuals. The study, sponsored by the National Dairy Council, differs greatly from previous studies reporting that 15 percent of European Americans, 50 percent of Mexican-Americans and 80 percent of African Americans suffer from lactose maldigestion.

Few experience symptoms

During normal digestion, lactose is broken down by lactase, an enzyme in the small intestine. While babies are born with plenty of it, lactase production drops off between the ages of 3 and 5. The result? Certain people develop the classic symptoms of gas, bloating and abdominal pain due to their inability to break down lactose.

However, symptoms are not experienced by all. In fact, research suggests that regardless of ethnic background, only a minority of people actually experience effects. Several studies found the number of symptoms reported by maldigesters after drinking regular milk were no different than after a lactose-free placebo.

Some children develop lactose intolerance after being hit by a viral infection like the flu. While most of these occurrences are temporary, lasting several days to weeks, kids are able to ease back into normal dairy food consumption gradually.

What if you suspect your child is intolerant of lactose? He can be tested by an elimination diet, where he is taken off all dairy foods for two weeks. In addition to milk and its products, ingredient lists must be scoured to ensure hidden lactose doesn’t appear. If your child’s symptoms disappear while on the lactose-free diet, yet return when they’re reintroduced into the diet, it’s lactose intolerance. More formal diagnostic tests include a hydrogen breath test or an intestinal biopsy.

Where lactose tends to hide

Foods where dairy ingredients are added may include baked goods, cereals, instant soups, salad dressings, breakfast drinks, margarine and pancake, biscuit and cookie mixes. Search the food label ingredient lists for whey, curds, milk byproducts and dry milk solids.

Even if your child is unable to digest lactose, he should consume some dairy products to ensure he receives enough calcium and vitamin D, according to a 2006 report by the American Academy of Pediatrics Committee on Nutrition. Many affected children are able to tolerate small amounts, especially if they’re paired with some non-dairy foods. It also takes time to build lactase production.

Dairy foods that include live cultures that pre-digest some of the sugar-such as yogurt, buttermilk or kefir-may be well tolerated. Although yogurt is high in lactose, its bacterial cultures produce lactase, which allows for easy digestion. Aged cheeses also tend to be low in lactose. Finally, lactose-treated milk, such as Lactaid, or the over-the-counter lactase enzyme pills can also be used.

Bottom line: Most children are still able to enjoy nutrient-rich foods and beverages containing lactose.

Lactose content of common foods

Food Milk, 1 cup Yogurt, plain, 1 cup Ice cream, vanilla, ½ cup Sherbet Cottage cheese, creamed, 1 cup Cheese, cheddar 1 ounce Swiss cheese, 1 ounce Lactaid® lactose-free, lowfat milk
Lactose (in grams) 12 8.4 4.9 4 1.4 0.07 0.02 0

Sources: USDA national nutrient database for standard reference,

Egg Salad Twist

Prep Time: 5 minutes
Cook Time:20 minutes


  • 4 Large eggs
  • 3 Tbsp. chopped celery
  • 2 Tbsp plain low fat yogurt
  • 1 Tbsp fresh lemon juice
  • 1 ½ tsp Dijon mustard
  • ⅛ tsp black pepper
  • ⅛ tsp kosher or sea salt

Fill medium saucepan with cold water. Add pinch of salt and eggs, bringing to a boil over high heat. Once water is boiling, remove from heat and cover. Let rest for 20 minutes. Drain and rinse with cold water. Submerge the eggs in cold water and let set for 10 minutes to stop further cooking.
Remove shells and chop egg to desired consistency. Mix remaining ingredients into eggs. Serve in butter lettuce, similar to a taco.
Variation: Mix in chopped tomato, avocado, cucumber, scallions or dill pickle.
Serves: 2

Nutrition facts:
157 calories, 9 g fat, 3 g saturated fat, 430 mg cholesterol, 357 mg sodium, 5 g carbohydrates, 0 g fiber, 1 g sugar, 13 g protein, 13% DV vitamin A, 0% DV vitamin C, 7% DV calcium, 8% DV iron.

Printed with permission from A Recipe for Life by the Doctor’s Dietitian by Susan Dopart, M.S., R.D.


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