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Lactose Intolerance / Low Lactose Diet o milk solids non fat, milk solids, milk powder, whey protein, milk, casein, curd What is lactose? Lactose is a sugar found in milk and milk products. It is also added to some processed and prepared foods. An enzyme called lactase is needed for your body to break down (digest) lactose What is lactose intolerance? Lactose intolerance happens when your body does not have enough lactase to break down all the lactose into smaller parts for digestion and absorption. What are the signs of lactose intolerance? You may be lactose intolerant if after consuming milk based products you experience some of the following symptoms: bloating diarrhoea wind pain cramping urgency to go to the toilet What can I eat? Most people with lactose intolerance can tolerate some lactose in their diet. If you do get symptoms, you can manage them by: Choose lactose-free or foods low in lactose, preferably fortified with calcium Check labels on foods and drinks for added milk or milk products. The closer to the beginning it is listed the higher the amounts. On the ingredients list, added milk (or lactose) can be described as: Your lactose tolerance may be improved if you: o eat small amounts of lactose containing foods daily o include lactose-containing foods as part of meal o drink lactose containing beverages (or milk) with food What about calcium? Many foods that contain lactose are also important sources of calcium. Not enough calcium might make your bones more easily broken. This is called Osteoporosis. If you avoid lactose-containing foods, you will need to find other sources of this important nutrient including: 40g hard cheese 250ml soy or lactose-free milks 200g soy yoghurts with added calcium or yoghurts with active and live bacterial cultures* ½ cup fish with edible bones (eg. salmon and sardines) * The bacterial cultures found in some yoghurts break down the lactose, so it is usually better tolerated due to a lower lactose content than yoghurt without live cultures. Can I take something to digest lactose? There are medications available in the form of lactase enzyme drops and tablets that can reduce the lactose in milk and milk products. Discuss the use and where you can get these with your Pharmacist. This is a consensus document by Queensland Dietitians. Disclaimer: http://www.health.qld.gov.au/masters/copyright.asp Revised: May 2015 Review: May 2017 The table lists some of the foods you can eat safely. They contain no or small amounts of lactose. It is not a complete list and therefore for further details please discuss with your Dietitian. Milk, Milk Products and Alternatives Aim for 2 ½ serves per day (Women over 50 years: 4 serves) 1 serve = 40g hard cheese = 200g yoghurt = 250ml of Low lactose milk = 250ml calcium enriched soy or rice milk Safe Low lactose or lactosefree milks Soy milk Rice milk Soy based nutritional supplements Soy yoghurt Yoghurt with live cultures (depending on tolerance) Soy Ice creams Block/ hard cheeses: Mature, semi-mature and mild Foods to Limit/ Avoid Cow’s milk (all types) Goats milk Milk powders Malted milk Some powdered Chocolate drinks (depending on tolerance) Milk based nutritional supplements Milk based ice cream Dairy desserts Custards soft Cheese cake Cheeses: processed cheese, cottage cheese, cheese spreads Breads and Cereals Aim for 6 serves per day (70+ years: 3-4 serves) 1 serve = 1 slice of bread = ½ medium bread roll = ½ cup cooked rice, pasta or noodles = 2/3 cup breakfast flakes = ½ cup porridge Safe Most should be fine, check the label to confirm This is a consensus document by Queensland Dietitians. Disclaimer: http://www.health.qld.gov.au/masters/copyright.asp Foods to Limit/ Avoid Those containing custard or dairy based filling or coatings. For example: Yoghurt coated muesli bars Custard Danish Bee-sting cake Milk rice pudding Revised: May 2015 Review: May 2017 Meat and Meat Alternatives Aim for 2 - 3 serves per day 1 serve = 65-100g cooked meat, chicken or fish = 1 cup cooked or canned legumes/ beans such as lentils, chick peas or split peas = 2 eggs = 1/3 cup nuts or seeds Vegetables Aim for 5 - 6 serves of vegetables 1 serve = ½ cup cooked vegetables = cup raw vegetables (eg. salad) = ½ cup of vegetable Juice = ½ medium potato Fruit Aim for 2 serves per day 1 serve = 1 piece of fruit = ½ cup tinned/cooked fruit = ½ cup fruit juice Miscellaneous Safe Most should be fine, check the label to confirm: Check labels of processed, canned marinated and frozen meat/ meat alternatives and those in sauces. Foods to Limit/ Avoid Those in milk based sauces. Safe Fresh, frozen or tinned vegetables, vegetable juice. Foods to Limit/ Avoid Those containing milk or milk based sauces. Check labels of processed vegetables and those in sauces. For example: Cauliflower in white sauce Mashed potato Safe All fresh fruit, dried fruit Fruit Juice Foods to Limit/ Avoid Those in milk based drinks, sauces or yoghurt. Check labels of processed fruits and those in sauces. Safe Meringues, jellies, fruit or cordial ices, soft drinks, cordials, wine, beer, spirits* For example: Fruit smoothies with milk, yoghurt, whey. Foods to Limit/ Avoid Sweets containing milk* Cocoa, oils, margarine*, ghee, butter*, jam, honey, golden syrup, peanut butter Yeast extract, nuts, plain potato crisps, plain popcorn, confectionary, dark chocolate* Medicines For example: Quiche Frittata Lasagne Fish Mornay Check labels to confirm suitability Check with your pharmacist Milk or dairy based liqueurs Milk chocolate, foods with yoghurt coatings (i.e. muslei bars) Some salad dressings*, mayonnaises* and commercial gravy mixes* Protein powders* and powdered meal replacement supplements* Those containing lactose or milk products. For example artificial sweeteners * Denotes that label needs to be checked to see if contains added milk or milk products This is a consensus document by Queensland Dietitians. Disclaimer: http://www.health.qld.gov.au/masters/copyright.asp Revised: May 2015 Review: May 2017 What does a low lactose diet look like? Sample Meal Plan Breakfast Toast with margarine and spread (e.g. jam or honey) Breakfast cereal with calcium enriched soy milk or low lactose milk Coffee with low lactose milk Morning Tea Piece of fruit Lunch Sandwich with hard block cheese, lean meat and salad Glass of Water Afternoon Tea Soy yoghurt Dinner Grilled steak, chicken breast or fish with mashed potato (made using low lactose milk) and vegetables or salad Tinned peaches with lactose free fruit ice Supper Fruit toast with margarine Cup of tea with sugar and low lactose milk This is a consensus document by Queensland Dietitians. Disclaimer: http://www.health.qld.gov.au/masters/copyright.asp Revised: May 2015 Review: May 2017 Sources for Additional Reading and Recipes Dairy Australia, www.dairyaustralia.com.au Osteporosis Association of Australia, http://www.osteoporosis.org.au Sanitarium Health Food Co., www.sanitarium.com.au Eat For Health - Australian Dietary Guidelines, http://www.eatforhealth.gov.au Better Health Channel – Lactose Intolerance, http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Lactose_intolerance Important points to remember! Dietitian: Contact Details: _______ This is a consensus document by Queensland Dietitians. Disclaimer: http://www.health.qld.gov.au/masters/copyright.asp Revised: May 2015 Review: May 2017