Dairy products are natural “combination” foods, providing approximately 12 grams of carbohydrate and 8 grams of protein per serving. No other food group provides almost equivalent amounts of carbohydrates and protein. Additiionally dairy products are a good source of calcium, potassium, magnesium, and vitamin D.
Because of this, low-fat (they have less amounts of saturated fat) dairy products are a traditional component of a diabetes meal plan. But what if you are lactose intolerant?
What is Lactose Intolernace?
Lactose intolerance is a condition in which people experience digestive symptoms, such as, bloating, diarrhea, and gas after eating or drinking milk or milk products. This typically occurs when there is a deficiency of lactase, the enzyme that is responsible for breaking down lactose, which is a a naturally occurring sugar found in yogurt and other milk products. This can also occur when there is a lactose malabsoption. In people who have a lactase deficiency, the small intestine produces low levels of lactase and cannot digest much lactose. When the undigested lactose passes to the colon it can produce uncomfortable symptoms such as gas, abdominal pain, or bloating.
The severity of the symptoms and the degree of sensitivity depend on the person. Some people are able to tolerate small amounts of lactose, while others may experience disturbances each time they eat, or only when they eat large amounts of lactose on an empty stomach.
According to an article in the American Academey of Diabetes Educators, it’s important to be formally tested if you suspect you are in fact intolerant to dairy. Whethere or not you are diagnosed you may still be able to ingest about 12 grams of lactose (the equivalent to one cup of milk), or lower amounts found in cheese without experiencing symptoms.
What About Lactose Intolerance Amoung African Americans and Latinos?
Research suggests that both African American and Hispanic Americans consume less then the recommended inake of dairy foods due to perceived or actual lactose intolernace. This could be problematic for a varitey of reasons. First off, dairy intake has been associated with a reduced risk of chronic diseases or conditions including hypertension, cardiovascular disease, metabolic syndrome, type 2 diabetes and osteoporosis, as well as a reduction in body fat when combined with an energy restricted diet plan. Because the incidence of type 2 diabetes and heart disease is higher in those people of Hispanic and African American decent, limiting dairy may put them at increased risk of developing these diseases.
If you have not been formerly diagnosed with lactose intolerance and you suspect you have it, you would benefit from getting a clear diagnosis. You may be able to tolerant small amounts of dairy products if you introduce them slowly and do not eat them on an empty stomach. Some educators recommend adding no more than 12 grams of lactose at a time and never eating dairy on an empty stomach. Adding some low-fat dairy to the diet, assuming it’s tolerable, may improve diet quality, by providing nutrients, and increase satiey.
Here’s What a Person with Lactose Intolerance Can Do To Meet Their Nutrition Needs.
If you have lactose intolerance you may be able to add small amounts of dairy without symptoms and you simple may not. Here are some tips to get you what you need.
- Try to add some lactose free and low-lactose containing dairy products to your diet such as, lactose free milk/yogurt, Greek yogurt, low-fat mozzarella, and swiss cheese.
- Do not eat dairy on an empty stomach, especially large amounts.
- Incorporate green leafy vegetables into your diet that are also rich in calicum (if you have kidney disease, consult with your doctor before adding, as these foods may not be suitable for you).
- If you are very sensitive, substitute lactose-free dairy products in meal plans that contain dairy.
- Make sure you are getting adequate amounts of calcium and vitamin D. Ask your health care provider if you need a supplement.
Continue to focus on food quality, choosing a variety of non-starchy vegetables, fruit, lean protein and healthy fats. Aim to eat a consistent amount of carbohydrates per meal. The amount you need with depend on a variety of factors: How Many Carbohydrates Should I Eat Per Day?
Here is a rough breakdown of nutrient needs:
- 45 to 60 grams of carbohydrate per meal
- 15 to 30 grams of carbohydrate per snack
As Always, Read Labels
If you are very sensitive to lactose, remember to always scan ingredient lists on packaged foods for ingredients that indicate lactose:
- Milk by-products
- Nonfat dry milk
- Dry milk solids
- Dry milk powder
Lactose-Free Diabetes Meal Plan
Here is an example of a one-day lactose-free diabetes meal plan (breakfast, lunch, dinner and snack) that contains approximately 1600 calories—49 percent of calories from carbohydrate, and 26 percent of calories from fat.
- 2 slices 100 percent whole grain toast
- 2 tablespoons peanut butter
- 1/2 medium banana or 1 1/4 cup sliced strawberries
- Coffee with non-dairy creamer (i.e. almond milk)
- 4 oz grilled or roasted chicken breast
- 1/2 (6-inch) whole grain pita pocket
- 2 tablespoons avocado
- 1 small apple
- 1 cup raw baby carrots
- 1/3 cup hummus
- 4 ounces grilled flank steak or grilled fish
- 1 cup raw green beans
- 1 cup mixed lettuce greens
- 1 teaspooin olivie oil with 2 tablespoons vinegar ng
- 6 chopped almonds to put on beans and salad
- 2/3 cup brown rice
- 1 small apple (~4oz) with 1 tablespoon all natural peanut butter, almond butter, cashew butter or sun butter. (If you don’t have nut butter spread you can choose a nut variety to pair it with 15 almonds, 25 pistachios, 14 walnut halves, 12 cashews, 25 peanuts)
Tips for Diabetic Meal Planning
- Guidelines for Making Diabetes Diet-Approved Meals
- Two Meal Planning Methods and a Sample Meal Plan
Brown-Riggs, Constance. Lactose intolerance dispelling myths and helping minorities enjoy dairy. AADE Practice. Jan 15.
Bailey RK, Fileti CP, Keith J, Tropez-Sims S, Price W, Allison-Ottey SD. Lactose intolerance and health disparities among African Americans and Hispanic Americans: an updated consensus statement. J Nat Med Assoc. 2013;105(2):112-127.
Keith, Jeanette N. et al. The prevalence of self-reported lactose intolerance and the consumption of dairy foods among african american adults are less than expected. Journal of the National Medical Association. 2011; 103(1): 36 – 45