Navigating Cheese with Lactose Intolerance: Expert Advice
During a college icebreaker game, a classmate once shared that she was banned from eating cheese in her apartment because her fiancé couldn't stand its sight or smell. While that might be a dealbreaker for some, for others, avoiding cheese isn't just about preference—it's a matter of health due to lactose intolerance. But according to dietitians, you don't have to give up cheese entirely if you're lactose intolerant. With careful selection and moderation, many cheeses can still be part of your diet.
Understanding Lactose Intolerance
Lactose intolerance occurs when the small intestine produces insufficient lactase, the enzyme needed to digest lactose, the natural sugar in milk. Michelle Routhenstein, a preventive cardiology dietitian and certified diabetes educator at Entirely Nourished, explains, "Undigested lactose moves into the large intestine, where bacteria ferment it, leading to symptoms like bloating, gas, cramps, and diarrhea." However, she notes that many people with lactose intolerance can tolerate 1 to 4 grams of lactose per serving, especially when consumed with other foods. Individual thresholds vary, so sticking to about 1 ounce of cheese per meal and spacing servings throughout the day can improve tolerance.
It's important to distinguish lactose intolerance from a true milk allergy. Routhenstein emphasizes, "Anyone with a dairy allergy should avoid these cheeses entirely." But for those sensitive to lactose, Amanda Sauceda, a registered dietitian and gut health nutritionist, offers hope: "Most of the lactose is strained out with the whey during cheese-making. The remaining lactose gets broken down during fermentation as the cheese ages." This means older cheeses typically have lower lactose levels.
Cheeses Lower in Lactose: A Guide
Cheeses with more than 3 grams of lactose per 100 grams, such as mascarpone (4% lactose), ricotta (up to 5% lactose), and cream cheese (4-4.6% lactose), are higher in lactose and may cause discomfort. In contrast, several cheeses are lower in lactose, making them suitable for people with lactose intolerance. Here are expert-recommended options:
- Parmesan: Contains less than 0 grams of lactose per 1-ounce serving. Sauceda praises it for adding depth of flavor to soups and as a topping for pizza or pasta.
- Cheddar: An aged, hard cheese with less than 1 gram of lactose per 1.5-ounce serving (less than 2% lactose). Sauceda suggests pairing it with fruits like pears or using it to enhance vegetables like broccoli.
- Goat Cheese: Made from goat's milk, it has 0.5 to 1% lactose. Routhenstein notes its gentler digestion due to fat structure and mild acidity, recommending it on salads or toast.
- Havarti: Contains 1% lactose when aged enough. Kristen Carli, a registered dietitian from WOWMD, advises looking for a darker yellow color or crumbly texture to ensure aging, and enjoying it with fruit or in omelets.
- Gouda: Aged Gouda has 1% lactose, with a sweet, nutty flavor. Carli suggests pairing it with fruits and nuts on a cheese board.
- Brie: Known for its creamy texture, brie contains only 1 to 2% lactose. Routhenstein explains that lactose is removed early, and bacteria continue breaking it down during aging, making it easier to digest.
- Swiss: With 1% lactose, this cheese is great melted in soups or paired with cured meats and crackers, according to Carli.
- Feta: At 1% lactose, made from sheep's milk, it's ideal for Mediterranean salads. Carli notes it's even lower in lactose than cow's milk versions when aged.
- Farmer's Cheese: Contains 2 to 3% lactose, but small portions are usually well-tolerated. Routhenstein highlights its probiotics for gut health, recommending it with fruit or cucumbers.
- Cottage Cheese: With 3 to 4% lactose, it's higher but still manageable in moderation. Sauceda advises starting with a quarter cup and using it in recipes like pancake scrambles or pasta sauces.
Practical Tips for Enjoying Cheese
To make cheese more tolerable, dietitians recommend consuming it as part of a meal, limiting portions to about 1 ounce, and choosing aged or fermented varieties. Routhenstein adds, "Aged or fermented cheeses contain very little lactose and are often easier to tolerate than milk or fresh dairy products." Additionally, lactose-free dairy-based cheeses and plant-based alternatives are available for those seeking options without lactose.
By understanding lactose content and listening to your body, you can still savor the flavors of cheese without discomfort. As Sauceda puts it, "Cheese doesn't have to be off the table—just choose wisely and enjoy in moderation."
