Avoiding lactose intolerance

Cows’ milk is used to make the dairy products we know and love: butter, cream, ice cream, chocolate, custard, flavoured milk, frozen desserts, buttermilk, yoghurt, cheese, and the myriad of processed milks created to satisfy our desire for low-fat, high calcium, lactose-free or long-life convenience.

When we talk about ‘milk’, we usually mean cows’ milk, but I remember drinking goats’ milk as a child too. There was a small farm just outside Brisbane with a herd of goats; they sold fresh raw milk directly to anyone who showed up to the house. The goats’ milk had a distinctly different flavour to commercially pasteurised cows’ milk, and it was supposed to be better for my asthmatic sister. I don’t know if it helped her, but for me it was a rare treat and I loved the taste. I’d like to try fresh camel milk one day too, but for now I’m sticking to plant-based alternatives, because, like so many other grown-ups, I’ve become lactose intolerant.

Dairy decadence (Photo by Anna Tukhfatullina on Pexels.com)

Milk is a rich source of macro- (proteins, fats, carbs) and micro-nutrients (vitamins, minerals). Most of the carbohydrates are natural sugars such as lactose. But we can’t digest lactose; we can only digest its component parts, two simple sugars called glucose and galactose.

However, the lactose can only be broken down in the presence of adequate quantities of a specialised enzyme called lactase. If we don’t produce enough of this enzyme, we can’t digest the milk properly. This indigestion can cause bloating, abdominal pain, diarrhoea and even vomiting. This adverse reaction is called lactose intolerance.

In Western countries like Australia, milk is a normal part of childhood, and most of us begin a life-long love affair with dairy products. Flavoured milk, smoothies, thick-shakes, ice cream, chocolate, cream and all sorts of yummy gooey cheeses. The list goes on and on. But as we age, an estimated 75% of the world’s population can’t produce enough lactase.

The other 25% are thought to be descendents of northern European and middle-eastern pastoral populations who have relied on the milk of farm animals for centuries. For this reason, the most likely explanation is a genetic adaptation that allows them to continue producing lactase throughout their lives. It makes sense.

The literature data mainly concerns cow milk, which represents 85% of the milk consumed in the world and, to a lesser extent, goat and sheep milk. Studies on other dairy animals (buffalo, yak, mare, camel) are rather scarce, in spite of their nutritional interest.

(Konuspayeva, Faye, & Loiseau, 2009).

Photo by Pixabay on Pexels.com

For most of us, we either suffer the consequences of an unruly gut, or we make changes to our diet. We can reduce the severity of attacks by limiting ourselves to very small servings, or we can find another way. And here are a few alternatives:

  • lactose-free milk: Like regular milk, lactose-free milk is a good source of protein, calcium, phosphorus, vitamin B12, riboflavin and vitamin D. Many manufacturers produce at least one type of lactose-free milk by adding lactase to regular cow’s milk. Most supermarkets will stock at least one brand of ‘long-life’ lactose-free milk in tetra packs on their pantry shelves.
  • goat or camel milks: dairy products from these animals could be worth a try, especially for anyone with low levels of lactose intolerance. More expensive than cows’ milk, but definitely an interesting alternative with lots of natural nutritional benefits.
  • fermented or cultured dairy products, such as cheese and yoghurt
  • plant-based milk substitutes fortified with nutrients similar to those found in cows’ milk. Popular milk-alternatives include those made from soy beans, almonds, or rice. If look hard enough in the freezer aisle, you will probably find a few soy-based alternatives for our beloved ice-cream too. The flavour and texture might be a bit different, but not too bad once you get used to them.

Fermented or cultured dairy

Naturally fermented Greek-style yoghurt is made from whole milk that has undergone fermentation with a lactobacillus starter culture that feeds on the lactose sugars in the milk. Because the amount of lactose has been reduced in naturally fermented yoghurt, it should be much more easily digested than other dairy products. Yoghurt is readily accessible in most supermarkets, quite inexpensive, and an excellent source of calcium and probiotic bacteria.

Photo by Jenna Hamra on Pexels.com

Natural yoghurt can be added to breakfast muesli or fruit desserts, but is equally at home with savoury foods, substituting for sour cream in dips and easily made into a creamy salad dressing, e.g.

  • Creamy Greek Yoghurt Dressing: Greek yoghurt, lemon juice, white wine vinegar, olive oil, garlic, salt, ground black pepper, sugar, dill
  • Sunshine Salad Dressing: Greek yoghurt, olive oil, Dijon mustard, honey, lemon juice, apple cider vinegar, garlic, sea salt, ground black pepper.
  • 5 of the best salad dressings: Starting with Greek yoghurt, you can make a quick and easy 2-minute creamy dressing or something a little more exotic, such as Green Goddess, Ranch, Poppy Seed, or Avocado. You are limited only by your imagination.

Cultured cheese

Lactose is water-soluble. When making cheese, milk is separated into liquid and solids. Most of the lactose stays in the liquid whey, while the solid curd becomes cheese. Firmer cheese varieties contain very little whey, and very little lactose.

Parmesan, pecorino, provolone, cheddar, Swiss, blue and fresh mozzarella cheeses often contain less than 1g of lactose per ounce. Other low-lactose cheese options include cottage cheese or feta cheese made from goat or sheep’s milk. By comparison, a cup of plain yoghurt can contain 4-6g of lactose; whereas milk and ice cream can contain 11g per cup. The hard cheeses are clearly an excellent option for the lactose intolerant, but all cheeses are calorie-dense, so don’t overdo it.

Photo by Polina Tankilevitch on Pexels.com

Q & A

Q. Should I switch to drinking milk from goats or even camels?

A. Goats’ milk contains slightly less lactose (4.2%) compared to cows’ milk (5%), but anecdotal reports suggest that many people find goats’ milk much easier to digest. Similarly, reports suggest that people can tolerate camel milk better than cows’ milk too. Interestingly, camel milk may have a healthier nutrient profile, with insulin-like proteins, long-chain fatty acids, less saturated fat, more unsaturated fats, and lots of essential vitamins. (Thanks to Fred from Nouq Camel Milk in the UAE for your interest.)


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