What to eat? How should I change my diet if I have lactose intolerance?

You will need to speak to your doctor or a dietitian about making changes in your diet to manage lactose intolerance symptoms while making sure you get enough nutrients. 

Despite being lactose intolerant some people are able to have some lactose without getting symptoms. To control your symptoms, you need to reduce the amount of lactose you consume. 

What foods and drinks contain lactose?

You may not need to completely avoid foods and beverages that contain lactose.

Lactose contains in all milk and milk products and can be found in other drinks or foods. Besides that lactose is often added to prepared foods. such as boxed, canned, frozen, packaged, and prepared foods. You should always read all the labels, especially If you have any symptoms after consuming a small amount of lactose.

Some common products that have lactose are:

• bread and other baked goods, such as pancakes, biscuits, cookies, and cakes or mixes for those products
• processed foods, including breakfast cereals, instant potatoes, soups, margarine, flavored chips and other snack foods(candies, milk cholocate etc)
• Lunch meats (other than kosher)
• Salad dressings
• processed meats, such as bacon, sausage, hot dogs, and powdered meal-replacement supplements
• milk-based meal replacement liquids and powders, smoothies, and protein powders and bars
• nondairy liquid and powdered coffee creamers, and nondairy whipped toppings, they also can have parts of milk or be derived from milk and therefore have lactose.
• some medications(used in more than 20 percent of medications and about 6 percent of over-the-counter (OTC) drugs)
• birth-control pills, tablets for stomach acid and gas. Ask your pharmacist about lactose amounts in medications

Carefully read product labels, if any of these ingredients are listed on package, it means that that product contains lactose:

• milk
• lactose
• whey
• curds
• milk by-products
• dry milk solids
• non-fat dry milk powder

Lactose-free and lactose-reduced milk and milk products

Using lactose-free and lactose-reduced milk and milk products may help you lower the amount of lactose in your diet. These products are available in many grocery stores and are just as healthy for you as regular milk and milk products. Such as (link)

• try eating yogurt and hard cheeses, like cheddar or Swiss, which are lower in lactose than other milk products
• use lactase products(link) to help digest the lactose in milk and milk products

There are also some dairy products that are low in lactose and have a good amount of calcium, they still contain some lactose, but can easily be digest by someone with lactose intolerance:

• Plain, low-fat yogurt or greek yougrt
• Reduced-fat milk
• Swiss cheese or other hard cheeses that are low in fat
• Ice cream
• Cottage cheese 
• Any milk or dairy product with big amount of fat in it
• sour-cream with big amount of fat
• Any plant milk
• lactose-free cows’ milk
• soya milks, yoghurts and some cheeses
• rice, oat, almond, hazelnut, coconut, banana, quinoa and potato milks

Can I still eat a little lactose?

And still people with lactose intolerance can handle different amounts of lactose. Some researchers suggest that there are people who could have 12 grams of lactose (about 1 cup of milk) without any symptoms or with only mild symptoms.

You may be able to tolerate milk and milk products if you

• drink small amounts of milk at a time and have it with meals
• add milk and milk products to your diet a little at a time and see how you feel

Getting appropriate nutrition

When avoiding all milk and milk-containing products, you may get less calcium and vitamin D than you need. All dairy products are a major source of nutrients, like calcium and vitamin D. Calcium is needed for the growth and repair of bones during your life. When you remove milk and dairy products from your diet, be sure to make up for it in other ways.  This table shows how much calcium you should be getting every day and some ideas on where to get it. 

Age	Male (mg of calcium/day)	Female (mg of calcium/day)
1 to 3	500	500
4 to 8	800	800
9 to 13	1,100	1,100
14 to 18	1,000	1,000
19 to 30	800	800
31 to 50	800	800
51 to 70	800	800
>70	1,000	1,000

Food and Nutrition Board, Institute of Medicine, National Academics Dietary Reference Intakes: Estimated Average Requirement of Calcium Intake Per Day (in mg)

You should include in your diet products with enough calcium. There a lot of foods that don’t contain lactose, but are high in calcium:

• Firm tofu with calcium sulfate (3.5 oz: 683 mg calcium).
• Soy milk (1 cup: 200–300 mg calcium).
• Broccoli (1 cup: 90 mg calcium) and leafy green vegetables
• Oranges (1 medium: 50 mg calcium).
• Pinto beans (1/2 cup: 40 mg calcium).
• Tuna, canned (3 oz.: 10 mg calcium).
• Lettuce greens (1/2 cup: 10 mg calcium).
• Chinese cabbage, collard greens and kale
• fish with soft bones, such as canned salmon, canned with edible bones or sardines, with edible bones(3 oz: 198 mg calcium and 3 oz: 382 mg calcium)
• almonds, Brazil nuts, and dried beans
• products with labels that show they have added calcium, such as some cereals, fruit juices, and soy milk

Products describe above as dairy low lactose products still contains a good amount of calcium and can easily be digest by someone with lactose intolerance::

• Plain, low-fat yogurt (1 cup: 415 mg calcium, 5 g lactose).
• Reduced-fat milk (1 cup: 295 mg calcium, 11 g lactose).
• Swiss cheese or other hard cheeses that are low in fat (1 oz.: 279 mg calcium, 1 g lactose).
• Ice cream (1/2 cup: 85 mg calcium, 6 g lactose).
• Cottage cheese (1/2 cup: 75 mg calcium, 2–3 g lactose).

Also don’t forget about Vitamin D which helps your body absorb and use calcium. Be sure to eat products that contain vitamin D, such as eggs and fish. Some cereals and orange juice have added vitamin D. And the mean way to get enough vitamin D is to take subath for at least 10 to 15 minutes  or just being outside in the sunlight helps your body