6 Dairy Foods Naturally Low in Lactose
By Helen West
People with lactose intolerance often avoid eating dairy products.
This is usually because they are concerned that dairy may cause unwanted and potentially embarrassing side effects.
However, dairy foods are very nutritious and not all of them are high in lactose.
This article explores six dairy foods that are low in lactose.
What Is Lactose Intolerance?
Interestingly, it's most prevalent in Asia and South America, but much less common in parts of the Western world like North America, Europe and Australia (2).
Those who have it don't have enough of an enzyme called lactase. Produced in your gut, lactase is needed to break down lactose, the main sugar found in milk.
Without lactase, lactose can pass through your gut undigested and cause unpleasant symptoms like nausea, pain, gas, bloating and diarrhea (1).
Fear of developing these symptoms can lead people with this condition to avoid foods that contain lactose, such as dairy products.
However, this isn't always necessary, as not all dairy foods contain enough lactose to cause problems for people with an intolerance.
In fact, it's thought that many people with an intolerance can eat up to 12 grams of lactose at a time without experiencing any symptoms (3).
To put that in perspective, 12 grams is the amount found in 1 cup (230 ml) of milk.
Additionally, some dairy foods are naturally low in lactose. Below are six of them.
Butter is a very high-fat dairy product that's made by churning milk to separate its solid fat and liquid components.
The final product is around 80 percent fat, as the liquid part of milk, which contains all the lactose, is removed during processing (4).
This means that the lactose content of butter is really low. In fact, 3.5 ounces (100 grams) of butter contain only 0.1 grams (4).
Levels this low are unlikely to cause problems, even if you have an intolerance (1).
If you are concerned, it's worth knowing that butter made from fermented milk products and clarified butter contain even less lactose than regular butter.
So unless you have another reason to avoid butter, ditch the dairy-free spread.
Summary: Butter is a very high-fat dairy product that contains only trace amounts of lactose. This means it's usually fine to include in your diet if you have a lactose intolerance.
2. Hard Cheese
Cheese is made by adding bacteria to milk and then separating the cheese curds that form from the whey.
Given that the lactose in milk is found in the whey, a lot of it is removed when cheese is being made.
However, the amount found in cheese can vary and cheeses with the lowest amounts are the ones that have been aged the longest.
This is because the bacteria in cheese are able to break down some of the remaining lactose, lowering its content. The longer a cheese is aged, the more lactose is broken down by the bacteria in it (5).
This means that aged, hard cheeses are often very low in lactose. For example, 3.5 ounces (100 grams) of cheddar cheese contain only trace amounts of it (6).
Cheeses that tend to be higher in lactose include cheese spreads, soft cheeses like Brie or Camembert, cottage cheese and mozzarella.
What's more, even some higher-lactose cheeses may not cause symptoms in small portions, as they tend to still contain less than 12 grams of lactose.
Summary: The amount of lactose can vary between different types of cheese. In general, cheeses that have been aged longer, such as cheddar, Parmesan and Swiss, have low levels.
3. Probiotic Yogurt
It found that when people with lactose intolerance ate the yogurt, they were able to digest 66 percent more lactose than when they drank the milk.
The yogurt also caused fewer symptoms, with only 20 percent of people reporting digestive distress after eating the yogurt, compared to 80 percent after drinking the milk (10).
Additionally, full-fat and strained yogurts like Greek and Greek-style yogurt could be an even better choice for people with lactose intolerance.
This is because full-fat yogurts contain more fat and less whey than low-fat yogurts.
Greek and Greek-style yogurts are also lower in lactose because they are strained during processing. This removes even more of the whey, making them naturally much lower in lactose.
Summary: Lactose intolerant people often find yogurt much easier to digest than milk. The best yogurt for people with lactose intolerance is a full-fat, probiotic yogurt that contains live bacterial cultures.
4. Some Dairy Protein Powders
Choosing a protein powder can be tricky for those who are lactose intolerant.
This is because protein powders are usually made from the proteins in milk whey, which is the lactose-containing, liquid part of milk.
Whey protein is a popular choice for athletes, especially those who are trying to build muscle.
However, the amount found in whey protein powders can vary, depending on how the whey is processed. There are three main types of whey protein powder:
- Whey concentrate: Contains around 79–80 percent protein and a small amount of lactose (16).
- Whey isolate: Contains around 90 percent protein and less lactose than whey protein concentrate (17).
- Whey hydrolysate: Contains a similar amount of lactose as whey concentrate, but some of the proteins in this powder have already been partially digested (18).
The best choice for lactose-sensitive individuals is probably whey isolate, which contains the lowest levels.
Nevertheless, the lactose content can vary considerably between brands and most people have to experiment to see which protein powder brand works best for them.
Summary: Diary protein powders have been processed to remove a lot of their lactose. However, whey protein concentrate contains more of it than whey isolates, which may be a better choice for sensitive individuals.
Like yogurt, kefir grains contain live cultures of bacteria that help break down and digest the lactose in milk.
This means kefir may be better tolerated by people with lactose intolerance, when consumed in moderate quantities.
In fact, one study found that compared to milk, fermented dairy products like yogurt or kefir could reduce symptoms of intolerance by 54–71 percent (20).
Summary: Kefir is a fermented milk beverage. Like yogurt, the bacteria in kefir break down lactose, making it more digestible.
6. Heavy Cream
Cream is made by skimming off the fatty liquid that rises to the top of milk.
Different creams can have different amounts of fat, depending on the ratio of fat to milk in the product.
Heavy cream is a high-fat product that contains around 37 percent fat. This is a higher percentage than that of other creams like half and half and light cream (21).
It also contains almost no sugar, which means its lactose content is very low. In fact, a half ounce (15 ml) of heavy cream only contains around 0.5 grams.
Therefore, small amounts of heavy cream in your coffee or with your dessert shouldn't cause you any problems.
Summary: Heavy cream is a high-fat product that contains almost no lactose. Using small amounts of heavy cream should be tolerable for most people who are lactose intolerant.
The Bottom Line
Contrary to popular belief, it is not necessary for lactose-intolerant individuals to avoid all dairy products.
In fact, some dairy products—such as the six discussed in this article—are naturally low in lactose.
In moderate amounts, they're usually well tolerated by lactose-intolerant people.
Reposted with permission from our media associate Authority Nutrition.
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By Ana Maldonado-Contreras
- Your gut is home to trillions of bacteria that are vital for keeping you healthy.
- Some of these microbes help to regulate the immune system.
- New research, which has not yet been peer-reviewed, shows the presence of certain bacteria in the gut may reveal which people are more vulnerable to a more severe case of COVID-19.
You may not know it, but you have an army of microbes living inside of you that are essential for fighting off threats, including the virus that causes COVID-19.
How Do Resident Bacteria Keep You Healthy?<p>Our immune defense is part of a complex biological response against harmful pathogens, such as viruses or bacteria. However, because our bodies are inhabited by trillions of mostly beneficial bacteria, virus and fungi, activation of our immune response is tightly regulated to distinguish between harmful and helpful microbes.</p><p>Our bacteria are spectacular companions diligently helping prime our immune system defenses to combat infections. A seminal study found that mice treated with antibiotics that eliminate bacteria in the gut exhibited an impaired immune response. These animals had low counts of virus-fighting white blood cells, weak antibody responses and poor production of a protein that is vital for <a href="https://doi.org/10.1073/pnas.1019378108" target="_blank">combating viral infection and modulating the immune response</a>.</p><p><a href="https://doi.org/10.1371/journal.pone.0184976" target="_blank" rel="noopener noreferrer">In another study</a>, mice were fed <em>Lactobacillus</em> bacteria, commonly used as probiotic in fermented food. These microbes reduced the severity of influenza infection. The <em>Lactobacillus</em>-treated mice did not lose weight and had only mild lung damage compared with untreated mice. Similarly, others have found that treatment of mice with <em>Lactobacillus</em> protects against different <a href="https://doi.org/10.1038/srep04638" target="_blank" rel="noopener noreferrer">subtypes of</a> <a href="https://doi.org/10.1038/s41598-017-17487-8" target="_blank" rel="noopener noreferrer">influenza</a> <a href="https://doi.org/10.1371/journal.ppat.1008072" target="_blank" rel="noopener noreferrer">virus</a> and human respiratory syncytial virus – the <a href="https://doi.org/10.1038/s41598-019-39602-7" target="_blank" rel="noopener noreferrer">major cause of viral bronchiolitis and pneumonia in children</a>.</p>
Chronic Disease and Microbes<p>Patients with chronic illnesses including Type 2 diabetes, obesity and cardiovascular disease exhibit a hyperactive immune system that fails to recognize a harmless stimulus and is linked to an altered gut microbiome.</p><p>In these chronic diseases, the gut microbiome lacks bacteria that activate <a href="https://doi.org/10.1126/science.1198469" target="_blank" rel="noopener noreferrer">immune cells</a> that block the response against harmless bacteria in our guts. Such alteration of the gut microbiome is also observed in <a href="https://doi.org/10.1073/pnas.1002601107" target="_blank" rel="noopener noreferrer">babies delivered by cesarean section</a>, individuals consuming a poor <a href="https://doi.org/10.1038/nature12820" target="_blank" rel="noopener noreferrer">diet</a> and the <a href="https://doi.org/10.1038/nature11053" target="_blank" rel="noopener noreferrer">elderly</a>.</p><p>In the U.S., 117 million individuals – about half the adult population – <a href="https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/" target="_blank" rel="noopener noreferrer">suffer from Type 2 diabetes, obesity, cardiovascular disease or a combination of them</a>. That suggests that half of American adults carry a faulty microbiome army.</p><p>Research in my laboratory focuses on identifying gut bacteria that are critical for creating a balanced immune system, which fights life-threatening bacterial and viral infections, while tolerating the beneficial bacteria in and on us.</p><p>Given that diet affects the diversity of bacteria in the gut, <a href="https://www.umassmed.edu/nutrition/melody-trial-info/" target="_blank" rel="noopener noreferrer">my lab studies show how diet can be used</a> as a therapy for chronic diseases. Using different foods, people can shift their gut microbiome to one that boosts a healthy immune response.</p><p>A fraction of patients infected with SARS-CoV-2, the virus that causes COVID-19 disease, develop severe complications that require hospitalization in intensive care units. What do many of those patients have in common? <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm" target="_blank" rel="noopener noreferrer">Old age</a> and chronic diet-related diseases like obesity, Type 2 diabetes and cardiovascular disease.</p><p><a href="http://doi.org/10.1016/j.jada.2008.12.019" target="_blank" rel="noopener noreferrer">Black and Latinx people are disproportionately affected by obesity, Type 2 diabetes and cardiovascular disease</a>, all of which are linked to poor nutrition. Thus, it is not a coincidence that <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6933e1.htm" target="_blank" rel="noopener noreferrer">these groups have suffered more deaths from COVID-19</a> compared with whites. This is the case not only in the U.S. but also <a href="https://www.washingtonpost.com/world/europe/blacks-in-britain-are-four-times-as-likely-to-die-of-coronavirus-as-whites-data-show/2020/05/07/2dc76710-9067-11ea-9322-a29e75effc93_story.html" target="_blank" rel="noopener noreferrer">in Britain</a>.</p>
Discovering Microbes That Predict COVID-19 Severity<p>The COVID-19 pandemic has inspired me to shift my research and explore the role of the gut microbiome in the overly aggressive immune response against SARS-CoV-2 infection.</p><p>My colleagues and I have hypothesized that critically ill SARS-CoV-2 patients with conditions like obesity, Type 2 diabetes and cardiovascular disease exhibit an altered gut microbiome that aggravates <a href="https://theconversation.com/exercise-may-help-reduce-risk-of-deadly-covid-19-complication-ards-136922" target="_blank" rel="noopener noreferrer">acute respiratory distress syndrome</a>.</p><p>Acute respiratory distress syndrome, a life-threatening lung injury, in SARS-CoV-2 patients is thought to develop from a <a href="http://doi.org/10.1016/j.cytogfr.2020.05.003" target="_blank" rel="noopener noreferrer">fatal overreaction of the immune response</a> called a <a href="https://theconversation.com/blocking-the-deadly-cytokine-storm-is-a-vital-weapon-for-treating-covid-19-137690" target="_blank" rel="noopener noreferrer">cytokine storm</a> <a href="http://doi.org/10.1016/S2213-2600(20)30216-2" target="_blank" rel="noopener noreferrer">that causes an uncontrolled flood</a> <a href="http://doi.org/10.1016/S2213-2600(20)30216-2" target="_blank" rel="noopener noreferrer">of immune cells into the lungs</a>. In these patients, their own uncontrolled inflammatory immune response, rather than the virus itself, causes the <a href="http://doi.org/10.1007/s00134-020-05991-x" target="_blank" rel="noopener noreferrer">severe lung injury and multiorgan failures</a> that lead to death.</p><p>Several studies <a href="https://doi.org/10.1016/j.trsl.2020.08.004" target="_blank" rel="noopener noreferrer">described in one recent review</a> have identified an altered gut microbiome in patients with COVID-19. However, identification of specific bacteria within the microbiome that could predict COVID-19 severity is lacking.</p><p>To address this question, my colleagues and I recruited COVID-19 hospitalized patients with severe and moderate symptoms. We collected stool and saliva samples to determine whether bacteria within the gut and oral microbiome could predict COVID-19 severity. The identification of microbiome markers that can predict the clinical outcomes of COVID-19 disease is key to help prioritize patients needing urgent treatment.</p><p><a href="https://doi.org/10.1101/2021.01.05.20249061" target="_blank" rel="noopener noreferrer">We demonstrated</a>, in a paper which has not yet been peer reviewed, that the composition of the gut microbiome is the strongest predictor of COVID-19 severity compared to patient's clinical characteristics commonly used to do so. Specifically, we identified that the presence of a bacterium in the stool – called <em>Enterococcus faecalis</em>– was a robust predictor of COVID-19 severity. Not surprisingly, <em>Enterococcus faecalis</em> has been associated with <a href="https://doi.org/10.1053/j.gastro.2011.05.035" target="_blank" rel="noopener noreferrer">chronic</a> <a href="https://doi.org/10.1016/S0002-9440(10)61172-8" target="_blank" rel="noopener noreferrer">inflammation</a>.</p><p><em>Enterococcus faecalis</em> collected from feces can be grown outside of the body in clinical laboratories. Thus, an <em>E. faecalis</em> test might be a cost-effective, rapid and relatively easy way to identify patients who are likely to require more supportive care and therapeutic interventions to improve their chances of survival.</p><p>But it is not yet clear from our research what is the contribution of the altered microbiome in the immune response to SARS-CoV-2 infection. A recent study has shown that <a href="https://doi.org/10.1101/2020.12.11.416180" target="_blank" rel="noopener noreferrer">SARS-CoV-2 infection triggers an imbalance in immune cells</a> called <a href="https://doi.org/10.1111/imr.12170" target="_blank" rel="noopener noreferrer">T regulatory cells that are critical to immune balance</a>.</p><p>Bacteria from the gut microbiome are responsible for the <a href="https://doi.org/10.7554/eLife.30916.001" target="_blank" rel="noopener noreferrer">proper activation</a> <a href="https://doi.org/10.1126/science.1198469" target="_blank" rel="noopener noreferrer">of those T-regulatory</a> <a href="https://doi.org/10.1038/nri.2016.36" target="_blank" rel="noopener noreferrer">cells</a>. Thus, researchers like me need to take repeated patient stool, saliva and blood samples over a longer time frame to learn how the altered microbiome observed in COVID-19 patients can modulate COVID-19 disease severity, perhaps by altering the development of the T-regulatory cells.</p><p>As a Latina scientist investigating interactions between diet, microbiome and immunity, I must stress the importance of better policies to improve access to healthy foods, which lead to a healthier microbiome. It is also important to design culturally sensitive dietary interventions for Black and Latinx communities. While a good-quality diet might not prevent SARS-CoV-2 infection, it can treat the underlying conditions related to its severity.</p><p><em><a href="https://theconversation.com/profiles/ana-maldonado-contreras-1152969" target="_blank">Ana Maldonado-Contreras</a> is an assistant professor of Microbiology and Physiological Systems at the University of Massachusetts Medical School.</em></p><p><em>Disclosure statement: Ana Maldonado-Contreras receives funding from The Helmsley Charitable Trust and her work has been supported by the American Gastroenterological Association. She received The Charles A. King Trust Postdoctoral Research Fellowship. She is also member of the Diversity Committee of the American Gastroenterological Association.</em></p><p><em style="">Reposted with permission from <a href="https://theconversation.com/a-healthy-microbiome-builds-a-strong-immune-system-that-could-help-defeat-covid-19-145668" target="_blank" rel="noopener noreferrer" style="">The Conversation</a>. </em></p>
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