It's helpful to meet with a registered dietician for assistance in setting up a lifestyle diet plan to restrict your lactose intake and make sure you're getting all the nutrients and the calcium your body requires. A dietician can help you set your lactose boundaries.
Discover What Works for You No two cases of LI are the same. Some individuals may drink two glasses of milk without a problem, some may only be able to tolerate half a glass at a time, and some may not be able to drink milk at all! You are your own best lactose-level detective in determining your degree of tolerance for milk and dairy products. Try consuming different levels of lactose to determine how much and what foods you can eat and still feel comfortable.
If you love milk and it doesn't love you back, try drinking it in small amounts. In addition, drink milk with food so that the milk isn't the only thing in your digestive system. These little hints will make your body happier because they slow down digestion and make the absorption of the lactose easier! Milk seems to be the major culprit in lactose intolerance, but there are other foods in the dairy department that you may be able to handle.
Look for dairy products that are lower in lactose such as yogurt, many cheeses, and yogurt cheese, just to mention a few. In addition, there's a variety of special lactose-free milks available in the dairy case!
Other options include adding a lactase enzyme to milk or searching out a chewable lactase supplement before eating foods containing lactose. This works quite nicely for lots of folks who are lactose intolerant. This is another item to put on your list to discuss with your physician.
Obvious Lactose
A major key to your digestive comfort is being food label savvy. Read labels and look for the obvious lactose first. Naturally occurring lactose in milk is listed as sugar on the Nutrition Facts label on a milk carton but the ingredients section doesn't list any added sugar. Milk is often added to some of the commercial products in the list below:
Bread and other baked goods
Nondairy and whipped creamers
Drink mixes and breakfast drinks
Margarines
Salad dressings
Lunch meats and hot dogs
Processed breakfast cereals
Candies, cookies, and snacks
Soups (especially cream soups)
Mixes for pancakes, biscuits, cookies, and cakes
Sugar substitutes
Instant coffee and cocoa mixes
Instant mashed potatoes and French fries
Pie crusts and pie fillings
Pudding mixes
Not all of the products listed above contain lactose, and that's why reading labels is so important. It's important to look not only for milk and lactose among the contents, but also for such terms as whey, curds, buttermilk, malted milk, milk by-products, dry milk solids, nonfat dry milk powder, sour cream, and sweet cream, all of which contain lactose. It doesn't have to be in the dairy section to contain lactose. Every product and brand varies. Just because you become accustomed to a particular brand you think is free of lactose, be sure to read the label periodically because ingredients do change.
Kosher products labeled “ Parve” or “ Pareve” are lactose free. However, if the product is just labeled “Kosher” you can't be guaranteed that the product is lactose free.
Lactose Lurkers
Beware of lactose lurkers! They show up in the darnedest places and you won't know it until they hit your tummy — ouch!
Would you believe that some medications contain lactose? More than 20 percent of prescription drugs contain lactose, and over-the-counter medications are not lactose free either. Lactose is found in many types of birth control pills and tablets for stomach acid. Medications generally contain small amounts of lactose and only affect people who are very lactose intolerant.
Canned tuna and salmon are innocent-looking packages that may also contain lactose. Some of the commercial fisheries add milk products to their canned fish products in the canneries. Lactose is also commonly applied to dried vegetables to prevent discoloration. If a dried veggie is treated with a small amount of lactose when it's re-hydrated it will have a brighter color and be more appealing. Learn to read labels; it's important and your tummy will thank you big time!
Calcium Is a Team Player
It just so happens that many of the foods LI individuals shy away from are prime sources of calcium, so keeping calcium in the diet is a primary concern for people with LI. Calcium is the primary mineral for the growth, maintenance, and repair of bones and teeth. Calcium needs to be teamed with vitamin D and phosphorus for maximum benefits. Phosphorus is important to bone structure, and vitamin D allows the absorption of calcium into the body. It's possible to have a calcium deficiency due to a lack of vitamin D; even if you are taking in enough calcium, your body can't do anything with it unless it has vitamin D.
Meeting Your Calcium Quota
The Institute of Medicine released a chart listing the requirements for daily calcium intake. The calcium required to maintain good health varies by age group. The recommendations made are shown in the following table.
Table 1-1 Age Group
Amount of Calcium to Consume Daily
0–6 months
400 mg
6–12 months
600 mg
1–5 years
800 mg
6–10 years
1,200 mg
11–24 years
1,200-1,500 mg
25–50 years
1,000 mg
51–70+ years
1,500 mg
The National Digestive Diseases Information Clearinghouse (NDDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NDDK). NDDK is part of the National Institute of Health of the U.S. Department of Health and Human Services.
It was also noted that pregnant and nursing women need between 1,200 and 1,500 mg of calcium daily.
“Bone Up” Foods
There's a wide array of calcium-rich foods for you to choose from, and this book contains lots of recipes that are full of calci-yum! Here's a short list of foods that will help you make sure you're meeting your daily calcium quota:
Dark leafy greens
Dandelion and mustard greens
Turnip and collard greens
Kale
Broccoli
Orange juice fortified with calcium
Whole almonds
Sesame seeds
Dried figs
Blackstrap molasses
Canned sardines and salmon with bones
Ocean perch
Shrimp
Soybeans
Beans
Calcium-fortified soy milk
Extra firm tofu
Yogurt
Yogurt cheese
Low-lactose cheeses
Boney Good Calcium
Calcium's importance in preventing osteoporosis is nothing new, but recent studies show calcium can be helpful in preventing heart disease, stroke, high blood pressure, hypertension, and possibly colon cancer.
If your regular diet isn't quite enough to meet your body's calcium requirements, ask your doctor or dietician about calcium supplements. As always, getting your calcium naturally through your food is best; it's never a good idea to try to make up for a poor diet with supplements. Developing a healthy lifestyle is a win/win situation!
Don't Inhale Your Calcium
Another little tip on calcium: try not to inhale it all at one sitting. Calcium likes to be absorbed slowly throughout the day, so spread it out to get the most from your calcium intake!
If you're an orange juice lover, you're ahead of the game. Take just a minute and read the front of the carton and the Nutrition Label. Many great orange juices today are fortified with both calcium and vitamin D. You'll get your calcium and the vitamin D necessary for your body to absorb it — score!
Vitamin D
Vitamin D is present in some foods, but you can also soak some up simply by taking a walk outsi
de! If you spend just a few minutes each day out in the sun for brief periods you will absorb much needed vitamin D. There are other sources of vitamin D besides the sun and — you guessed it — the key lies in reading labels! As with calcium, taking supplements to fill these gaps for vitamin D is not always the best answer. Consult with your doctor or dietician to make sure you're on the right path.
Who's Got My Cheese?
Did someone say cheese? But that's in the dairy department! There is some great news: most lactose intolerant folks can tolerate cheese in their diet.
Most of the lactose is removed along with the whey when cheeses are made. There are high-lactose and low-lactose cheeses. Only you will know which cheeses you can tolerate; however, the great news is that “lactose free” doesn't necessarily mean “cheese free.”
The Kingdom of Cheeses
Including cheese in your LI lifestyle depends on two things: the kinds of cheese you eat and the amount. Start out small and see what your level of tolerance is. Read labels. You'll find the lactose content in cheeses under sugar; the milk sugar in cheese is lactose.
The standards on the Nutrition Facts label allow the cheese maker to list zero grams of sugar in cheese if the cheese contains no more than half a gram of lactose per ounce. There are cheeses available to you with just trace amounts of lactose and even more with low levels of lactose (1–2 grams or less per serving).
Cheese-y
Many lactose intolerant people are able to digest aged, natural cheeses.
Here's a list of some of them, but remember the cheese world is huge so read your labels! Processed cheese spreads and cheese foods do contain lactose and most likely should be avoided.
Some cheeses with low lactose levels include but are not limited to:
Brie
Cheddar
Colby
Edam
Parmesan
Swiss
Camembert
Gouda
Danish Blue
Gorgonzola
Roquefort
Emmental
Eating cheese is another valuable way to make sure your body gets enough calcium. Eat it in moderation until you figure out how much your body can tolerate. Test lactose-reduced cheese products with your lifestyle, and look for nondairy alternatives if you need to limit the amount of real cheese but don't want it to interfere with your favorite snacks.
Yummy Yogurt Live Is In
Yes, yogurt is made from milk, but you may be delighted to know that it fits in with your LI lifestyle.
Enter stage left the culturing process that milk goes through to become yogurt. It's this process that allows most lactose intolerant folks to enjoy yogurt's nutritional benefits and satisfying taste. Yogurt is also a great boost to your calcium intake!
While you're label sleuthing, look for descriptions such as “contains active cultures,” “living cultures,” and “active yogurt cultures.” This will tell you the cultures are live and not pasteurized. Live cultures are important because they help your digestive system process the lactose. Avoid yogurt if the label reads “heat treated after culturing.”
In the Yogurt Culture
All yogurts are not created equal in the culturing process, and it's important to look for yogurts that contain live and active cultures. These pure bacterial cultures convert the lactose content to lactic acid, which lowers the intestine's pH, reduces harmful bacteria, and aids in digestibility and the absorption of key nutrients.
The bacteria in yogurt are a friendly sort and contribute to the health of your colon; they are thought to lower the risk of colon cancer. That's just one example of a long list of the good things the friendly bacteria in yogurt does for your health and nutrition.
Yogurt's Nutritional Benefits
Look at a few of the nutritional benefits in just 1 cup of plain low-fat yogurt:
450 milligrams of calcium
154 calories
13 grams of protein
574 milligrams of potassium
4 grams of fat
Reading labels is extremely important in the yogurt department because of the sheer quantity of yogurt on the market. Please note that fruit-flavored yogurts and added sugars can drive the calorie count up over the top of 300 calories for one serving of some brands of yogurt.
A Glimpse at Cooking with Yogurt
Cooking with yogurt may seem like a bit of a strange culinary approach at first, but you're in for a palate-pleasing surprise! You can use it as a replacement for milk, buttermilk, mayonnaise, cream cheese and sour cream in many of your favorite recipes. Not only does it fit in with your LI lifestyle, but in many cases it's better for your overall health.
How do I get my mashed potatoes to be really fluffy?
Use yogurt in your homemade mashed potatoes. Not only are you forgoing the lactose, but you and your family will like them better with yogurt stirred in as a substitute for milk or cream!
In baking, yogurt lends a flavorful moistness to quick breads, muffins, yeast breads, and breakfast grains like pancakes and waffles. The protein in the flour and the acid in the yogurt react well and lends a very fine texture and tenderness to baked products.
You can convert any recipe that calls for buttermilk or milk. It depends on whether you are substituting thick or thinner yogurt. If the yogurt has whey on top, stir it well and substitute cup for cup. If the yogurt is thick and your recipe calls for one cup of liquid, then use 1∕ cups of yogurt in place of the one cup of liquid.
More Adventures with Yogurt
You'll find recipes made with yogurt scattered throughout this entire book. Using yogurt as a marinade will enhance the flavor of chicken, beef, pork, and lamb and tenderize the meat at the same time. Try it in dips and dressings. There isn't much that yogurt doesn't go with, from smoothies to great veggie sauces.
Versatile Yogurt Cheese
Even lower in lactose than yogurt is yogurt cheese, which is sometimes referred to as yogo-cheese. Call it whatever you want, but make sure you include it in your lactose intolerant lifestyle!
Yogurt cheese has a mild flavor and texture somewhere between sour cream and cream cheese. Yogurt cheese is low in cholesterol, sodium, calories, and lactose, but it's high in calcium and packs more nutrients than plain yogurt because the whey has been removed.
Making yogurt cheese is a very simple process. The main component is the quality of the yogurt you choose. Select a natural, plain low-fat yogurt. Read the label, and make sure there is no gelatin in the yogurt. Avoid the custard yogurts; they don't separate from the whey very well because of the binding agents. Some flavored yogurts will work, but not the ones that contain chunks of fruit.
Line a strainer or a colander with a layer of cheesecloth or two layers of white paper towels or a coffee filter. Make sure the cheesecloth drapes over the sides of the draining device. Place the draining device over a bowl so the whey can drain efficiently. Pour the yogurt into the draining device, cover tightly with plastic wrap, and place in the refrigerator overnight. The whey will drain off the yogurt. One cup of yogurt yields ⅓ cup of yogurt cheese. The consistency of your yogurt cheese depends on the number of hours you allow it to drain. If you want the consistency of sour cream or cream cheese, then 18–24 hours is ideal. The longer it drains, the firmer the yogurt cheese becomes, so it depends on what you're going to use it for — as a replacement for cream cheese, in a recipe for an herb spread, or in a cheesecake recipe. You'll learn as you go along. Remove the yogurt cheese from the refrigerator and discard the whey. Cover it tightly and store it in the refrigerator. Yogurt cheese will keep for up to a week.
There are special funnels available that are specifically designed for making yogurt cheese. These are a good investment if you're going to be making yogurt cheese on a regular basis. Recipes made with yogurt cheese are extra creamy, and you'll wonder how you've ever cooked without it!
Got Soy?
In looking for nondairy alternatives you'll find all kinds of soy products readily ava
ilable to you in most grocery stores and definitely in health food stores. Most soy products are free of lactose as well as milk protein. If you are using soy milk as a milk replacement, be sure to choose one that is fortified with calcium. Today there are literally thousands of soy products on the market. Soy milk, tofu, soy cheeses, soy yogurt, soy sour cream, miso, tempeh, and soy sauce are all made from soybeans.
Where Soy's “Bean”
Soy cultivation dates back to the Chou dynasty in the eastern half of Northern China. It wasn't until sometime in the 1760s that soybeans were planted and harvested in the United States. Soy milk is made by grinding the beans, cooking them briefly, squeezing them, and combining the extracted liquid with water.
The handling of soy milk and soy products is no different in the kitchen than handling a perishable dairy product. Be sure to pay attention to the dates on the packaging, and dispose of the products if you haven't used them by their freshness dates.
The Everything Lactose Free Cookbook Page 2
