Bayside Dietetics
Tummy troubles associated with milk? Is it best to avoid milk altogether or try lactose free? Why is lactose free milk so sweet and does that mean it’s high in sugar?
By Sarah Smith of Bayside Dietetics
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Irritable bowel syndrome (IBS) is not life-threatening, but it is consistently associated with reduced quality of life. When I share that information with a long-suffering client, I get nods and sighs of recognition. Difficulties toilet training in little clients to embarrassment going out for older clients. The impact can be significant.
Mim (not her real name), stands out to me as she was a delightful and social lady who came to see me after years of her tummy problems stopping her from going out. She told me that every time she was invited out, she would check where the toilets were, and how far she may get from a toilet. Any long event without a nearby toilet, well Mim just said “no” to. Her IBS was having a significant impact on her life.
Symptoms of IBS can be managed with an adjustment to foods eaten in most (but not all) people. The trouble is, that, in my experience, changing foods is complicated and can bring on new stress. It should only be done in certain situations and definitely under the advice of both a medical doctor and dietitian. Changing diet in children is particularly risky.
If you’ve checked with your doctor and you or your child have been advised to trial a lactose free diet, in my experience, you are about to try a change that can be both simple and significantly helpful. However, you can inadvertently put you or your child at nutritional risk unless it is done properly. So here are the keys when eating low lactose.
Choose lactose free dairy products rather than changing to soy, rice, almond or coconut products.
If you are exploring whether milk products contribute to tummy troubles in IBS, it is important to continue dairy in the diet in the usual way, but to use low lactose alternatives rather than skipping dairy products altogether. The reason for this is nutrition. Dairy products have calcium in abundance and in the form that is easy to use for the human body. Alternatives like soy, coconut, rice and almond products, don’t naturally have the calcium. It may be added to products like soy milk, and that helps, but the form of this added calcium is a little harder for the human body to use than the natural form in dairy. Calcium is rarely added to rice milk, almond milk and coconut yoghurt in Australia.
Lactose free dairy products that are readily available in Australia are lactose free milk, ice cream and yoghurt. The way these products are made is in the same way as regular products, however with an added enzyme called lactase which does the job of getting rid of the lactose for you. The result is a very similar product, just without the lactose.
There are some dairy products that are naturally low in lactose and you can continue to use in the regular way. These are hard cheeses such as cheddar, parmesan, swiss and even fetta cheese, cream, sour cream, cream cheese and butter. Some people need to avoid large amounts of cheese, and lactose free cheese is a good alternative in those cases. So you can keep up that homemade cheesy pizza.
Dark chocolate is usually better tolerated than milk chocolate…sorry!
The only dairy products that aren’t tolerated in large amounts on the low lactose diet and don’t have readily available lactose free alternatives are soft cheeses such as ricotta and cottage cheese, custard and cheesecake.
Please note that this advice applies to IBS-related removal of lactose and is not appropriate for anyone who has been advised to remove dairy for other reasons.
It hasn’t got the same ring, but it’s more of a “low and spread out” lactose diet rather than lactose free diet.
You can order a kids milkshake at a café and then a shake seemingly the size of a bucket arrives! Kids may tolerate this fine, but not many adults can tolerate such a large amount of milk at once. However, even if feels like you can’t tolerate much at all, almost everyone can tolerate small amounts of lactose spread over the day. For example, you might be fine if you have regular milk in your cups of tea that are spread over the day. This is particularly helpful to try if that’s the only option available at work. If you only have a dollop of yoghurt on your cereal, then regular yoghurt is probably going to be fine.
Why does lactose free milk taste so sweet? Does that mean it’s “bad” for me?
No! It’s just a change in taste that happens when long chains of lactose are cut up into smaller pieces that you can tolerate better. Smaller pieces just happen to be sweeter.
Part of the changes Mim tried included moving to a lactose free diet. The change for her was monumental and helping people like her is why I love my job so much.
If you’ve got tummy troubles, check in with your GP first. The change that is possible for some people through diet, is a significant one.
Sarah
