A Tolerance Kitchen article.
The below content has been created with the input of a range of dietitians and sources. Managing a lactose-reduced diet should always be done alongside a qualified dietitian. Lactose tolerance varies significantly between individuals, and long-term avoidance of dairy without guidance can lead to calcium and other nutrient deficiencies. Please speak to a qualified healthcare professional before making significant changes to your diet.
Rethinking Dairy with Lactose Intolerance
Lactose intolerance is often simplified to a single rule: avoid all dairy. While this is a safe starting point when you first find out you have lactose intolerance, it isn’t the full story for a lot of people. Understanding the ‘why’ behind your symptoms can open up a world of food possibilities you may have thought were lost to you.
Lactose intolerance is caused by a shortage of an enzyme called lactase in your small intestine. Lactase is needed to break down lactose, the natural sugar found in milk and dairy products. When lactose isn’t broken down it travels to the large intestine where gut bacteria ferments it, leading to uncomfortable reactions like gas, bloating, and pain.
It's crucial to remember lactose intolerance is an enzyme deficiency and not a food allergy. A dairy allergy involves an immune system reaction and requires the strict avoidance of all milk proteins. Because it’s an enzyme issue, most people with lactose intolerance have an individual threshold that will differ from other people with lactose intolerance. A key element is knowing which dairy foods are naturally lower in lactose to begin with, that you might be able to tolerate more of. Let’s explore some of the most common ones.
Why Hard Cheeses Are Often Tolerable
While thinking of giving up cheese can feel like a tragedy, the good news is that you may not need to say goodbye to the cheeseboard entirely. Many hard, aged cheeses contain very little to no lactose.
The reason for this is in the cheesemaking process. First, milk is separated into solid curds and liquid whey. Most of the lactose is found in the watery whey, which is drained off during production. The small amount of lactose left in the curds is then broken down by bacteria and enzymes as the cheese matures or ages. This process converts the lactose into more easily digestible lactic acid.
As a general rule, the longer a cheese has been aged the less lactose it will contain. This is why many people with lactose intolerance find they can comfortably eat cheeses like:
- Parmesan: Aged for 12 months or more, it is virtually lactose-free
- Mature Cheddar: A well-aged cheddar has minimal lactose
- Swiss and Gruyère: These hard, aged cheeses are also very low in lactose
In contrast, fresh, soft cheeses like ricotta, cottage cheese, and cream cheese have not undergone this ageing process, so they retain a much higher lactose content and are more likely to cause symptoms.
As we explore in our article comparing lactose intolerance and histamine intolerance, these cheeses that are tolerated here are the least likely to be tolerated with histamine intolerance. Whereas the aging process removes lactose from cheeses, it adds histamine at the same time.
Yoghurt and Kefir
Yoghurt might seem on the outset like a definite ‘no’, but it has a secret weapon. Traditional yoghurt and other fermented milk drinks like kefir are made using live bacterial cultures. These bacteria, which are often called probiotics, do something that can be a game changer for people with lactose intolerance: they produce their own lactase enzyme (called beta-galactosidase).
What this means is that when you eat a yoghurt that contains ‘live and active cultures’ you are also consuming the lactase enzyme produced by those cultures. This helps your body break down the lactose within the yoghurt itself, essentially giving your digestive system a helping hand. Research from the British Dietetic Association supports that live yoghurt is often well-tolerated by individuals with lactose intolerance.
You may find that Greek yoghurt is an even better choice. During its production, much of the liquid whey is strained out to create its thick texture. As with cheese, removing the whey also removes a significant amount of the lactose. A full-fat Greek yoghurt with live cultures is often the most comfortable option to start with. Of course, as with anything here, it's crucial to find your own tolerance levels.
Butter and Ghee
Butter is another dairy product that is surprisingly low in lactose. Butter is made by churning cream, which separates the high-fat component (butterfat) from the liquid part (buttermilk). Since lactose is a sugar that dissolves in water, most of it is left behind in the buttermilk.
The final product is mostly fat which only trace amounts of lactose. Most people with lactose intolerance find that the amount of butter used in cooking or spread on toast is well below their personal threshold.
If you are particularly sensitive then you might consider ghee as an alternative. Ghee is a type of clarified butter where all the milk solids and water have been removed, leaving behind pure butterfat. This process removes what little lactose remains, making it an excellent option for even very sensitive individuals.
Finding Your Personal Threshold
This information isn’t a licence to eat an entire block of aged cheese in one sitting. The concept of an individual threshold is key, and the only way to find out what works for you is through careful, gradual experimentation, ideally with the support of a professional.
We encourage a ‘start low and go slow’ approach. Try a very small amount of a low-lactose food, like a sprinkle of Parmesan on pasta or a spoonful of live yoghurt with your breakfast. It is best to eat this alongside other foods, as this can slow digestion and improve tolerance. Pay attention to how your body feels. Over time, you can build a clear picture of which dairy foods, and in what quantities, your body is comfortable with.
Living with lactose intolerance doesn’t have to mean a lifetime of strict avoidance. By understanding how different dairy products are made, you can make informed choices that empower you to enjoy food without fear. Always remember to listen to your body and seek professional guidance to ensure your diet remains balanced and nutritious.
This article is for informational purposes only and does not constitute medical advice. Please consult a qualified healthcare professional for advice specific to your situation.