While we might all be curious about the best plunger or probiotic tampon or cold-sore remedy, it can be difficult to discuss these more personal items. That’s why we’re tackling Things We Don’t Talk About, a series in which we track down the best hygiene-, sex-, and bodily function-related things we all need but might be too embarrassed to ask about. In this installment, we consult experts on what adjustments you can make to your diet if you’re lactose intolerant.
If the thought of a thick milkshake or whipped cream inspires more apprehension than delight, you may be one of the roughly 65 percent of post-adolescents who is lactose intolerant. In short, it means you lack the enzyme lactase, which helps you digest lactose (i.e., the sugars found in dairy products). Any combination of diarrhea, bloating, flatulence, abdominal pain, and nausea can sideline your day if you get too overzealous with dairy.
But there could be some other food-related allergy or gastrointestinal problem to blame, which is why Lisa Stollman — a registered New York dietitian and nutritionist (she earned the title of Dietitian of the Year in 2015 from the Academy of Nutrition and Dietetics) — tells me it’s worth seeing a physician for a hydrogen breath test to narrow down the cause. From there, an elimination diet can help zero in on foods that are causing sensitivities, functional nutritionist Angela T. Russo says. Thankfully, for the lactose intolerant, there are a multitude of dairy alternatives (we are living in the golden age of oat milk, after all) and supplements that can help. Below, both experts share their recommendations for preventing an upset stomach if you’re lactose intolerant.
Since lactase is at the root of lactose intolerance (the majority of lactose intolerance cases occur when people experience a drop in lactase production as adults), the quickest way to prevent an upset stomach is to increase the amount of lactase in your system. Lactase supplements come in many forms these days, the most popular one being Lactaid. Stollman says that tablets can be taken just before a meal or snack containing lactose. “The enzyme supplement will act just like the enzyme lactase, which we naturally produce, but may not have enough of.”
There’s also this slightly cheaper lactase supplement that throws in proteases and lipases which specifically aid in the digestion of milk proteins and fat.
Both experts also suggest probiotics — the healthy bacteria in your gut which maintain a healthy digestive system — for helping your body process lactose. Probiotics are naturally found in fermented foods like pickles, yogurt, and sauerkraut, but you can also purchase them in supplement form. The Align probiotics, which we’ve covered before, are the top choice that gastroenterologists recommend to patients with IBS.
Or, you could try out lactase supplements with additional probiotics in them, like these Digestive Advantage capsules, which contain the BC30 probiotic.
Russo says she also likes to make sure that people are healing their stomach lining with L-glutamine, which is a protein that helps prevent infection and inflammation in the gut, plus soothes the intestinal region (so it’s often recommended for IBS-sufferers).
Choosing smaller servings of dairy can help prevent symptoms (“the smaller the serving, the less likely it is to cause intestinal issues,” says Stollman) but you don’t have to cut milk from your diet entirely. She says that drinking milk in combination with other food can slow digestion and may decrease symptoms of lactose intolerance. (She doesn’t recommend more than four ounces of milk per meal, though.) There are even types of dairy that are low in lactose: “For example, hard cheeses, such as Swiss or cheddar. Cultured milk products, such as yogurt, may also be well-tolerated, since the bacteria utilized in the culturing process naturally produce lactase.”
Of course, with the variety of milks at your disposal these days, you could just make the transition to a nut milk or the hypertrendy oat milk. If you’re dabbling in plant-based alternatives, Stollman says coconut yogurt and vegan cheeses are also worth a try.
Editor’s Note: While this Oatly oat milk is available to purchase online, you’ll have an easier time finding a reasonably priced version in person somewhere.
Because reducing your dairy intake can mean losing a good source of calcium, Russo also recommends adding some high-calcium, non-dairy foods to your diet. Chia seeds, raw almonds, and sunflower seeds are good snack-sized options, but she says you can also add more leafy greens like broccoli rabe, kale, and arugula, or sweet potato to your meals.
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