What is Lactose intolerance? 
Lactose is a type of sugar found in milk and dairy products. Our bodies need an enzyme known as lactase to digest lactose and break it down in our gut. When this enzyme lactase is less or lacking in your gut it becomes difficult to digest lactose containing milk and dairy products and can cause distressing symptoms like nausea, cramps, gas, bloating diarrhoea, vomiting. The severity of symptoms depends on the amount of lactose an individual can tolerate. Some individuals can tolerate more than others before they start noticing symptoms.
Food that contain lactose [1,2]
- Major sources of lactose in our diet is milk including cow’s milk, goat’s milk and sheep’s milk.
- Products made with milk such as cream, cheese, yoghurt, ice cream and butter contain lactose.
- Other food and drink such as salad cream, salad dressing, mayonnaise, biscuits, chocolate, boiled sweets, cakes, baked goods, breakfast cereals, pancake mixes, mashed potatoes, instant soup.
- You can check the ingredients list on packaged food to see if the product contains lactose. Look out for milk, lactose, whey, curds, milk by products, dry milk solids, non-fat dry milk powder.
- Some medication could also have a small amount of lactose.
Nevertheless, the level of lactose in these products varies and is sometimes low. You may be able to have some lactose without experiencing symptoms depending on if your intolerance is mild, moderate or severe. Additionally, you may notice that some foods containing lactose could trigger more than others. Therefore, it’s always good to recognise your triggers and boundaries with quantities you can handle. 
Calcium, Vitamin D and alternatives you can have 
Milk and dairy products are an important food group to obtain Calcium and vitamin D. Therefore, it is important to obtain alternative sources of food to help you meet calcium and vitamin D levels.
Other sources of calcium
- Fish with soft bones, canned sardines
- Leafy green vegetables
- Almonds, nuts
- Soy milk, almond milk, oat milk (ensure the milk product is fortified with calcium)
Other sources of Vitamin D
- Plant based milk with fortified Vitamin D
What you can do [1,2]
If you love dairy products or interested in identifying your level of tolerance;
- Drink small amounts of milk at a time or have it with main meals
- Add milk or dairy products in small quantities gradually in your diet and monitor symptoms
- Eat yoghurt, hard cheese like cheddar cheese which are lower in lactose and monitor if you have any symptoms
- Use a lactase enzyme to help digest lactose in milk and dairy products.
- Eating &, Health N. Eating, Diet, & Nutrition for Lactose Intolerance | NIDDK [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases. 2018 [cited 22 April 2022]. Available from: https://www.niddk.nih.gov/health-information/digestive-diseases/lactose-intolerance/eating-diet-nutrition
- Facioni M, Raspini B, Pivari F, Dogliotti E, Cena H. Nutritional management of lactose intolerance: the importance of diet and food labelling. Journal of Translational Medicine. 2020;18(1).
- Dalal SR, Chang EB. Chapter 65: Disorders of epithelial transport, metabolism, and digestion in the small intestine. In: Podolsky DK, Camilleri M, Fitz JG, Kalloo AN, Shanahan F, Wang TC, eds. Yamada’s Textbook of Gastroenterology. 6th ed. West Sussex: John Wiley & Sons; 2016;1276–1293.