Published Feb 12, 2021

Just what is lactose and why is avoiding this natural milk sugar sometimes the best thing you can do for your health?

When most people think of milk they picture a white liquid in bottles and cartons, ready to pour onto their breakfast cereal or add to their tea. But of course this is only one kind of milk, and one that is some way removed from its source in the cow shed. 

Different forms of milk are produced by all mammals to nurture their offspring when too young to eat regular food – and of course, that goes for humans too. And in that simple truth lies a problem. We evolved to be able to digest our mother’s milk when very young but for much of our history, we would not encounter it again once weaned and so our bodies would lose the ability to absorb its central ingredient, lactose (milk sugar). Digesting lactose requires the continuing production of an enzyme called ‘lactase’.

It was only when some of our ancestors began using milk from cows and other animals as a food source that the inability to digest lactose – lactose intolerance – began to linger into adulthood among some populations. On a global scale, lactose intolerance is widespread: in fact about 65 per cent of the world’s population is lactose-intolerant. The frequency of the condition varies among ethnic groups, according to how common it was for their ancestors to drink milk into adulthood or make cheese and other dairy foods. People with African, South American and East Asian ancestry are most likely to be intolerant, while those with an European or Indian heritage least likely.

Without lactase, drinking milk or eating dairy can trigger such unpleasant reactions as gas, bloating, stomach pain and diarrhea. In this it resembles gluten intolerance: another common condition in which people have trouble digesting the protein gluten.

Of course, experiencing such symptoms doesn’t necessarily mean you are lactose or gluten intolerant, and it’s always a good idea to talk to a doctor or nutritionist about your symptoms. Alternatively why not try a do-at-home tests, which may uncover other food sensitivities and some valuable insights into your state of health.

The severity of lactose intolerance symptoms can ebb and flow, but ultimately there is no cure and the only way to avoid the symptoms is to avoid the foods which trigger it by following a lactose-free diet.

Lactose intolerance is not, however, the only reason for following a lactose-free diet. Some people choose to do so for ethical reasons, because they wish to follow a vegan lifestyle, or because they have an allergy to milk proteins – for example, whey – rather than lactose. But lactose intolerance is the majority motivation.

Unfortunately, avoiding lactose isn’t as easy as it may seem as it is hidden in a number of processed foods, including, including sweets, baked goods, and even cold meat.

Eating lactose-free

So just what can you eat? The key is to focus on simple, healthy wholefoods. Here are some of the best options, all guaranteed lactose-free. Let’s start with the basics:

  • Meat and poultry – e.g. chicken, lamb, pork, beef, turkey
  • Fish and seafood – for example, tuna, salmon, sardines, mackerel
  • Vegetables – including carrots, spinach, garlic, broccoli, onions
  • Legumes – for example, beans, lentils, chickpeas
  • Fruit – e.g. apples, grapes, mangoes, oranges, berries
  • Whole grains – barley, wheat, oats and others
  • Nuts: almonds, walnuts, pistachios, cashews, Brazil nuts, hazelnuts
  • Eggs

More adventurous dietary options include:

  • Tofu, miso and and soya-based foods
  • Seeds – for example, pumpkin and sunflower
  • Healthy oils – e.g. olive oil, coconut oil

And if you still feel the lure of diary, why not explore the various substitutes made from almond, coconut, cashew, hemp and soya, often available in both milk and yoghurt form?

Like any diet, it’s important to get the balance right. When compiling your lactose-free diet shopping lists and gathering your recipes make sure you’ll still be getting plenty of the nutrients essential to good health – everything from vitamins to iron.



Written by Bev Walton

Food Writer and Nutritionist, dietician

A chef of over 35 years with experience in all types of cuisine, dietary plans, recipe development, health and nutrition. I have been writing for over 10 years for both magazines, websites and ghostwriting for ebooks, Kindle and fully published books. I have a degree in nutrition and dietetics and work with restaurants and organisations within the healthcare profession. I am also able to take high quality photographs of recipes created. No writing task is too great, and whilst I specialise in the above, I am able to write about any topic you throw at me. Member of the Guild of food writers.