Foods with lactose: What you should know

If you are lactose intolerant or need to follow a lactose-free diet, you may be wondering what foods you can tolerate and what foods you need to avoid. There are a number of foods that contain lactose.

Lactose is a type of sugar that is found naturally in milk and other dairy products. This sugar is usually broken down by an enzyme called lactase. People with lactose intolerance do not make enough of this enzyme and may suffer from digestive issues like gas, bloating or diarrhea after eating foods containing lactose.

Lactose is naturally found in dairy products, including:

• Milk
• Cream
• Yogurt 
• Ice cream
• Butter
• Cheese
• Dry powdered milk 
• Evaporated and condensed milk

It should be noted that all low-fat milk, such as 2% milk, 1% milk or fat-free skim milk, contains lactose.

Food made with dairy products may also contain lactose, so it's important to read ingredient lists and food labels. Baked goods and packaged foods often have milk as one of the ingredients. If whey, curds, milk powder, milk solids or caseinate are listed as ingredients, it may indicate that the product contains lactose.

There are plenty of dairy-free foods that do not contain lactose. Fruits and vegetables, whole grains, meat, poultry, fish and healthy fats like oils, nuts and seeds are all lactose-free foods.

There are also many lactose-free versions of popular dairy products. Lactose-free milk, ice cream, cottage cheese and sour cream can be found in many grocery stores.

Plant-based drinks, such as those made from soy, almonds and coconuts, are another great choice for people who need to follow a lactose-free diet. Yogurt, ice cream and cheese made from plant-based milk make it easy for people to enjoy some of their favorite foods without worrying about lactose.

If you are lactose intolerant, you may find that you can consume small quantities of lactose without experiencing symptoms. Dairy foods have varying levels of lactose, and some foods in this group may be better tolerated than others. For example, yogurt and hard cheeses, such as Swiss or cheddar, have low amounts of lactose and tend to be well-tolerated. You may also consider taking an over-the counter lactase enzyme supplement, to help prevent symptoms when eating foods with lactose. Make sure that your diet includes enough calcium and vitamin D, which most people get from dairy. Calcium can be found in many lactose-free foods, including broccoli, leafy greens, and tofu.

Yes, butter contains small amounts of lactose. The low-lactose content means that many people who are lactose intolerant can eat butter and not suffer any symptoms. Margarine may also contain dairy ingredients, so be sure to check the label.

Yes, yogurt does contain lactose; however, the amount varies. Many people with lactose intolerance find that they can eat yogurt without symptoms, even if they can't drink milk.

Yes, cheese has lactose. The lactose content in cheese varies by type. For example, cream cheese, cottage cheese, mozzarella and cheddar cheese are relatively low in lactose, and many people who are lactose intolerant can enjoy these foods without experiencing symptoms.

Traditionally, lactose-free milk is milk that has had the enzyme lactase added to it. The addition of this enzyme breaks down the lactose, making it easier to digest for people with lactose intolerance. Other manufacturers may filter out the lactose from milk. Lactose-free milk can then be used to make other lactose-free dairy products, like ice cream and cottage cheese.

There are plenty of healthy and delicious foods that can be enjoyed if you can't tolerate lactose. Your healthcare provider can help you determine if you should follow a lactose-free diet and give you further guidance on what foods you should avoid. Your provider may also recommend lactose intolerance supplements.

Updated by Julie McDaniel, MSN, RN, CRNI, August 2024.