What is lactose?

Lactose is a milk sugar that occurs naturally in milk and dairy products. In order for it to be digested and absorbed in the intestine, it must first be broken down into two parts. This is done by the enzyme lactase. If this enzyme is completely or partially lacking, the milk sugar cannot be absorbed through the intestinal wall, but instead binds water, resulting in diarrhea. Further down in the intestinal system, the milk sugar is broken down by bacteria, forming lactic acid and gas. This causes rumbling in the stomach an colic-like pains. The condition can be uncomfortable but is harmless.

Low-lactose diet

The treatment consists of completely or partially excluding lactose from the diet. It is only rarely necessary to completely avoid lactose. Most people can tolerate 5-10 grams per meal, equivalent to 1-2 deciliters of milk. Individual sensitivity to lactose may vary, so it is recommended to experiment to find out how much can be tolerated.

Where is lactose found?

Lactose occurs naturally in milk an dairy products. Milk is often processed and added to a wide range of finished foods, so it is necessary to read the label on finished products, as lactose may be present in these. Milk and lactose may be listed under the following names on product labels:

• Milk powder
• Dry milk
• Whey, whey powder, whey protein
• Caseinate, casein
• Milk sugar
• Milk components
• Various from of milk and dairy products (whole milk, skim milk, cultured milk products, cream, buttermilk, yoghurt, sour cream).

Note! Despite their names, lactic acid and lactic acid culture have nothing to do with milk.

Lactose per 100 grams:

• Skimmed, mini, light and whole milk: 4.8
• Coffee cream 13%, Cheasy Cream 13%: 4.1
• Buttermilk, sour milk, A48: 3.7
• Fresh cheese, Fromage Blanc, Cheasy Natural: 3.5
• Yoghurt and ylette: 3.4
• Whipping cream 38%: 3.2
• Creme Fraiche 18%, Cheasy Fraiche 9%: 2.8
• Cultura with fruit and Gaio: 2.6
• Feta chesse in cubes: 1.0
• Butter: 0.6
• Kærgården: 0.4
• Hard cheeses, blue cheeses: 0.1

Hard cheeses and blue cheeses are virtually lactose-free as it breaks down during storage. Arla has published a brochure with lists of lactose content in their products.

Cooking without milk

Milk and dairy products are often included to a greater og lesser extent in many dishes; for example, meat dishes, mashed potatoes, bread, and desserts. In many cases you can use lactose-free milk/cream, water, vegetable water, broth, soy drink, or oat drink instead. In bread, milk can be replaced with water and a little sour milk product such as natural yoghurt or cottage cheese, which has a low lactose content compared to milk.

Soy drink or oat drink can be bought in supermarkets and health food stores and is available in a natural version as well as with different flavors such as cocoa and vanilla. Soy-based yoghurt is also available.

Arla has lactose-free milk, cream, sour cream, and fruit yoghurts, which available in most major supermarkets. 
Levevis yoghurt is lactose free.
Coop has Valio products in their range.

Good advice

After a period without milk and dairy products, it is a good idea to start with small amounts of milk and gradually increase. This way, you will find out how much you can tolerate. Start with soured milk products and distribute the intake of dairy products thoughout the day.

Foods with low/no lactose content

Bread and grains:

• All kinds of bread, biscuits, and pastries baked without milk.
• All types of flour and grains, pasta, rice, and noodles
• Breakfast cereals: Read labels.

Vegetable and potatoes:

• Potatoes. All fresh, frozen, and canned vegetables. Dried legumes, lentils, and peas.

Fruit:

• All fresh and frozen fruits. Preserved fruit, jam, etc. Dried fruit. Almonds and nuts.

Dairy products:

• Lactose-free milk, lactose-free whipping cream, Mathilde mild cocoa milk, lactose-free sour cream.

Milk substitutes:

• Soy drink, soy yoghurt, soy desserts, or oat drink

Cheese:

• Sliced cheese, brie, camambert, danablue, parmesan, melted cheese, feta, and cottage cheese.

Yoghurt:

• Thiese, Levevis (natural, strawberry, pear/banana), Arla lactose-free, Valio

Fats:

• Oils and lard. Margarine and minarine without milk, e.g., AMA, Coop milk-free or nutana.

Butter:

• Contains very little lactose.

Meat, fish, and eggs:

• All kinds. Canned products, sausages, and ready made products: read labels.

Sugar and sweets:

• Sugar, syrup, brown sugar, honey, ice cream. Pure cocoa. Candies without fillings and usually dark chocolate with 70-80% cocoa.

Miscellaneous:

• Peanut butter. Fruit and vegetable juice, water, mineral water, soda, coffee, tea, beer, wine, and spirits. Spices, mustard, ketchup, color, etc. Yeast, baking powder, gelatin, etc. Chocoreal chocolate spread, Irmas dark chocolate for sandwiches, cookies with cocoa cream (Urtekram).

Foods to limit

Bread and grains:

• All pastries baked with milk. Danish pastries and cakes. Ready-made flour mixtures.

Vegetables:

• Potato powder. Powder and canned soups.

Dairy products:

• All dairy products and cultured milk products, cream, sour cream, fromage frais, ice cream, dry milk, and protein concentrates. Ready-made creams, milkshakes, and milk desserts. Read labels on sorbet ice cream.

Cheese:

• Cream cheese, quark, and other cheeses not mentioned under low lactose content.

Fats:

• Margarine and minarine made from milk.

Meat, fish, and eggs:

• Canned products, sausages, minced meat, and ready meals. Read labels.

Sugar and sweets:

• Chocolate, nougat, licorice, filled candies, caramels, and ready-made desserts.

Miscellaneous:

• Chocolate milk and cocoa powder with milk.

Vitamins, minerals, and calcium supplements

Milk and dairy products are our main source of calcium along with cheese. If you drink ½ liter of lactose-free milk daily and eat cheese, your needs are covered. Otherwise, a calcium supplement is recommended.

It is possible to buy juice containing calcium. Soy drinks can be bought both with and without added calcium. A vitamin and mineral tablet daily can also be recommended if the diet is not very varied or if the appetite is small, but it does not contain enough calcium to meet the needs.

Enzyme capsules

There are capsules with enzymes that can be sprinkled over food containing lactose. This causes the lactose in the food to break down. An example of this is Lactrase. The capsules are available at pharmacies.

Lactose content

Most individuals with lactose intolerance can tolerate up to 5-10 grams of lactose per meal, and some can even tolerate up to 12 grams without experiencing symptoms. This corresponds to approximately 2 and 2½ deciliters of milk, respectively. This allows for greater variety in the daily diet and ensures an adequate intake of calcium.

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