How can I manage lactose burden in my meals?

From the Guidelines

To manage lactose burden in your meals, it is essential to identify and limit high-lactose foods, and consider lactose-free alternatives or supplements, as there is no direct evidence provided to support a specific lactose management strategy. When considering meal planning, it's crucial to focus on nutrient-dense, high-fiber foods, and avoid processed foods with added sodium, fat, and sugars, as suggested by 1. Although the provided evidence does not directly address lactose burden management, general principles of healthy eating can be applied, such as:

• Limiting intake of highly processed foods high in refined grains, saturated fat, salt, and sugar, as recommended by 1
• Choosing nutrient-dense, high-fiber foods whenever possible, as suggested by 1
• Being mindful of carbohydrate intake, especially for individuals with diabetes, as outlined in 1 It's also important to note that the management of lactose burden may involve tracking personal tolerance thresholds and adjusting dairy consumption accordingly, as many people with lactose intolerance can handle small amounts of dairy without issues. However, without direct evidence on lactose burden management, these recommendations are based on general principles of healthy eating and may need to be adapted to individual needs and circumstances. In real-life clinical practice, a cautious approach would be to prioritize reducing lactose intake or supplementing with enzymes to prevent uncomfortable digestive symptoms, while still allowing for some dairy in the diet, as this approach aligns with minimizing morbidity, mortality, and improving quality of life.

From the Research

Managing Lactose Burden in Meals

To manage lactose burden in meals, several strategies can be employed:

• Reduce or eliminate lactose from the diet until symptoms disappear 2, 3
• Consume lactose in small amounts, as most individuals with lactose intolerance can tolerate 12 to 15 g of lactose (approximately 1 cup of milk) 4
• Choose lactose-free or low-lactose products, such as hard and semi-hard cheeses, and yogurt with live lactic acid bacteria 5, 6
• Consider taking lactase as an enzymatic food supplement, although its efficacy is still controversial 2
• Use probiotics, which have shown specific β-galactosidase activity and can aid in lactose digestion 2

Dietary Strategies

Dietary strategies can help lactose maldigesters include milk and other dairy foods in their diet without experiencing symptoms:

• Consume milk with a meal or in divided doses at breakfast and dinner 5
• Check food labels for hidden lactose in non-dairy products, such as baked goods and processed meats 3
• Look for products with a well-recognized lactose-free logo to guide choices 3

Importance of Calcium Intake

It is essential to maintain adequate calcium intake to prevent bone diseases, such as osteopenia and osteoporosis:

• Include calcium-rich foods, such as lactose-free milk and dairy products, in the diet 5, 3
• Consider alternative sources of calcium, such as fortified plant-based milk and calcium supplements 3