If you can't tolerate dairy products, don't feel bad…you're not alone. Nearly one in four Americans has difficulty digesting milk products, according to the American Dietetic Association. And about 70 percent of the world's adult population is in the same boat.
The culprit is lactose, the sugar found naturally in milk and milk products. If your doctor says you are lactose intolerant, it means your body can't digest this sugar, which leads to discomfort in varying degrees.
Luckily, this condition doesn't always mean that you have to give up milk and milk products. Many people find that, through trial and error, they can tolerate small amounts of dairy items as long as they're consumed with other foods.
It does mean you have to adjust your diet, and that includes finding substitutions for dairy items in recipes.
- "What can I use for cheese in lasagna?"
- "What can I substitute for milk in scrambled eggs?"
- "Do you have a suggestion for substituting sour cream?"
These are just a few of the questions our readers have asked us in their letters and E-mails. There are many alternatives to traditional milk products on the market. You don't have to visit a "health food" store to find lactose-free milk, soy milk, rice milk, silken tofu and even soy cheese (for that lasagna). Plus, organic food chains offer everything from soy cream cheese to frozen dairy-free pizzas.
Plain yogurt makes a great alternative to sour cream in recipes, and many people who are lactose intolerant can tolerate this dairy product. (Choose brands that say "live active cultures.") If you can stomach aged cheeses such as Swiss or cheddar, which are lower in lactose, use these in place of other varieties.
Read the Labels
Whether buying ingredients for a recipe, or a boxed mix or frozen food, always check these labels:
- List of ingredients—If this list includes butter, cheese, cream (sweet or sour), curds, dried milk, margarine, milk, milk solids, whey or whey protein concentrate, the product contains lactose. Some foods with "hidden lactose" include breakfast cereals, lunch meats, salad dressings, cookie mixes, cream soups and instant potatoes. Even some products labeled "non-dairy" might include ingredients derived from milk.
- Nutrition label—Milk substitutes may not be nutritionally comparable to cow's milk products. If you are not getting enough calcium from substitutes, especially if you are at risk for osteoporosis, add other calcium-rich foods to your diet, such as cooked greens, canned salmon and calcium-fortified orange juice.
- Processed and prepared foods that may contain lactose—bread, baked goods, candy, cookies, breakfast drinks, chocolate drink mixes, sauces and gravies, frosting, frozen dinners, pancake and biscuit mixes, coffee creamer and snack foods.
- Lactose-free ingredients—casein, lactate, lactic acid, lactalbumin (lactoglubulin) and lactylates. (Some may contain trace amounts of lactose. Check nutrition labels.)
- Kosher foods—if they are labeled "parve" or "pareve," it means they are milk-free.
- Buttermilk—like yogurt, buttermilk is made with active cultures.
- Prescription and over-the-counter medications—may contain lactose. Talk to your doctor or pharmacist before buying.
Cooking and Dining
- Usually, you can make substitutions in recipes measure for measure (1 cup soy milk for 1 cup regular milk, 1 ounce soy cream cheese or 1 ounce regular cream cheese).
- Eat smaller servings of lactose-containing foods throughout the day. Instead of an 8-ounce glass of milk for breakfast, drink 1/3 cup three times during the day.
- Dairy products made with whole milk, like ice cream and pudding, may be easier to digest. Make sure you round out your daily diet with lower-fat foods to balance these higher-fat choices.
- To aid digestion, ask your doctor about taking over-the-counter lactase enzyme caplets before eating or adding lactase enzyme drops to milk.
- When eating out, be sure to ask your server if dishes are made with butter, milk or cheese. Ask for dry toast instead of buttered, egg substitute instead of eggs and salads without cheese or creamy dressings.
American Dietetic Association
International Foundation for Functional Gastrointestinal Disorders
National Institute of Diabetes and Digestive and Kidney Diseases
Lactose-Free Food Brands
- Lactaid—lactose-free milk
- Rice Dream—milk substitute, frozen desserts
- Soy Dream—milk substitute, frozen desserts
- Westsoy—soy milk
- Tofutti—sour cream, cream cheese, non-dairy desserts
- Amy's Kitchen—labels its products "dairy-free," "non-dairy" or "vegan" if they contain no lactose or milk proteins.