10 Lactose Intolerance Myths Busted

Misconceptions regarding lactose intolerance can result in elimination of dairy products from the diet, potentially leading to nutrient shortfalls and risk of adverse health outcomes. Dispelling lactose intolerance myths can help avoid these negative consequences.

MYTH #1 Lactose intolerance and milk allergy are the same.

FACT: Not true. Lactose intolerance refers to gastrointestinal symptoms following consumption of lactose (the sugar naturally found in cow’s milk) greater than the body’s amount of lactase, the intestinal enzyme needed to digest and absorb lactose. Milk allergy, on the other hand, is a reaction to one or more milk proteins triggered by the immune system. Cow’s milk allergy is reported in about 2% of infants and young children and tends to be outgrown by five years of age.

MYTH #2 Lactose intolerance is a common condition.

FACT: Actually, lactose intolerance is not as common as many believe. Roughly one in 10 adults report being lactose intolerant, based largely on self-diagnosis. Lactose intolerance is overestimated and much lower among individuals clinically diagnosed, as opposed to self-diagnosed, with the condition.

MYTH #3 The prevalence of lactose intolerance is similar among children, adults, and different ethnic and minority groups.

FACT: The prevalence of lactose intolerance is relatively low among young children and Americans of Northern European decent compared to that in Asian Americans, African Americans, Native American Indians, and Hispanics/Latinos. Emerging research indicates that the prevalence of lactose intolerance among these ethnic groups and the U.S. population as a whole is much lower than previously thought.

MYTH #4 One can rely on symptoms alone to diagnose lactose intolerance.

FACT: No. Without testing it’s impossible to know for sure if the digestive symptoms are caused by lactose, or a learned aversion, or an unrelated gastrointestinal problem. Medical experts recommend an objective test, such as the breath hydrogen test, to diagnose lactose maldigestion (genetically controlled decline in the activity of lactase). If you suspect that you are lactose intolerant, check with your health care provider about testing. Misdiagnosis of lactose maldigestion could lead to unnecessary dietary restrictions, expense, and nutritional shortcomings, or failure to diagnose a gastrointestinal disorder.

MYTH # 5 A diagnosis of lactose maldigestion means that one will experience lactose intolerance (symptoms).

FACT: Individuals vary in the amount of lactose they can tolerate. Whether or not symptoms (lactose intolerance) will occur depends on a number of factors such as the amount of lactose consumed at any one time, as well as other factors unrelated to lactose, such as culturally-based attitudes toward milk. An expert panel convened by the National Institutes of Health Consensus Development Conference on Lactose Intolerance and Health concluded “The majority of people with lactose maldigestion do not have clinical lactose intolerance.”

MYTH # 6 Everyone with lactose intolerance experiences the same symptoms.

FACT: No. The gastrointestinal symptoms and their severity differ among individuals. Many people with lactose maldigestion do not experience gastrointestinal symptoms.

MYTH #7 Persons with lactose intolerance should avoid milk, dairy products, and other lactose-containing foods.

FACT: Most individuals with lactose intolerance do not have to give up cow’s milk and other dairy foods from their diets. There are several effective dairy-based strategies to help lactose intolerant individuals comfortably consume cow’s milk and other dairy products. These include consuming smaller amounts of milk at a time, particularly with other foods or meals; yogurt with live, active cultures; hard cheeses such as Cheddar or Swiss; and lactose-free dairy products such as lactose-free milk or lactose-free cottage cheese. Chocolate milk may be better tolerated than unflavored milk. Also, consuming a small amount of cow’s milk each day and gradually increasing over several days or weeks may help build tolerance to lactose. If you are lactose intolerant, talk with a registered dietitian about a dietary plan to help manage symptoms and still meet nutrient needs.

MYTH #8 Lactose-free cow’s milk is not real milk.

FACT: Lactose-free cow’s milk is 100% real dairy, just without the lactose. It provides all the benefits of cow’s milk without the lactose. The lactase enzyme is added to cow’s milk to break down the lactose and make it lactose-free. Lactose-free cow’s milk and milk products provide the same essential nutrients, such as calcium and high-quality protein, expected from regular cow’s milk, cheese, and yogurt.

MYTH #9 It’s not important for people with lactose intolerance to keep cow’s milk in their diet.

FACT:  Cow’s milk not only is naturally nutritious, providing nine essential nutrients including calcium, protein, vitamin D, and potassium, but also is affordable at about 25 cents per 8-ounce serving, accessible, and available in many varieties such as low-fat, fat-free, lactose-free, unflavored, and flavored. Many health and nutrition professionals recommend that individuals with lactose intolerance try to keep dairy in their diet.

MYTH #10 It’s just as easy to get some of cow’s milk nutrients from non-dairy foods.

FACT: Not so. As an example, you would have to eat about 10 cups of raw spinach to get the same amount of calcium (300 mg) as from an 8-ounce glass of cow’s milk. Also, cow’s milk alternatives such as almond, coconut, and soy beverages may be more processed and usually contain more than eight added ingredients compared to cow’s milk, which is naturally nutrient-rich with minimal added ingredients, such as vitamins A and D.

For more information, visit National Dairy Council’s new lactose intolerance microsite.