The amount of lactose that causes symptoms varies from person to person. Many individuals can tolerate up to 10g of lactose (i.e.: a glass of milk) without any symptoms.

Lactose is found in the milk of all mammals, with the exception of some marine mammals.

Therefore, there is no advantage to substituting cow’s milk with milk from a different mammal (goat, sheep).

Dairy products contain varying amounts of lactose, depending on the processing methods used. Apart from the obvious sources, lactose is also often found in many hidden forms. For example, whey is often used in the food industry as a browning or fixing agent, or to enhance the sweetness and taste of foods and beverages. Sauces, soups and salad dressings often contain powdered milk products. Lactose is also used as a filler in at least 20% of medicines. Whey and casein are common components used in body-building energy drinks. Neither heat nor the level of the milk’s fat content (skim vs. whole) affects its lactose content. However, consuming milk in combination with other products (such as chocolate, cereal) could significantly improve tolerance. Yogurt may not cause symptoms, as many of the bacterial strains in yogurt produce lactase, which helps break down the lactose. It is worth experimenting to compare one’s tolerance to different brands of yoghurt. Hard cheeses are generally low in lactose and are usually well tolerated.

Lactose content may be indicated through the following components used in food labels – declaring lactose content is not mandatory in all countries:

Artificial butter flavour, butter, colour or caramel flavour, casein or caseinate, cheese, cream, powdered milk, high-protein flour, lactalbumin, lactitol (E966), lactose, lactoferrin, lactoglobulin, milk derivatives or powders or milk solids, natural flavours, fat-free milk solids, whey, milk protein and concentrated milk solids.

Completely excluding lactose is not usually necessary for lactose intolerance, although it is required in the case of a milk allergy.

Completely avoiding lactose may lead to increased sensitivity over time. Continuing to consume small amounts of lactose appears to have beneficial effects on the gut flora (microbiome).

Read the labels on the following foods since they may contain lactose.

Pastries (e.g.: cakes, cookies, crackers, donuts, waffles, pancakes), butter, buttermilk chocolate, cream, cream soups, curd products, custard/flan, cold cuts, desserts (e.g.: caramel, flan, mixes, mousse, soufflé), egg substitutes, energy drinks and concentrates, frozen yoghurt, ghee juice (made from butter), semi-skimmed milk, diet and granola bars, hot dogs, ice cream, instant drinks (e.g.: iced tea, coffee, chocolate drinks/Ovaltine) and foods and mixes, kefir, margarine (not all), milk (whole, 2%, 1%, skim, condensed, chocolate, cocoa, evaporated, powdered, lactose-reduced), pizza, processed meats, cold cuts, puddings, salad dressings, sausages, condiments, sorbet, sour cream, whipped cream topping, and yoghurt.