Diet & IBD - Edward Loftus Jr., M.D.
The Best Dairy Alternatives for Crohn's Disease
If you're a dairy lover with Crohn's disease, you may be caught in a real bind. Find out how lactose-free alternatives provide the taste you love without the Crohn's symptoms.
By Wyatt Myers
Medically Reviewed by Lynn Grieger, RDN
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Are dairy products making your Crohn’s symptoms worse? Foods like milk, cheese, and butter can exacerbate inflammatory bowel disease (IBD) symptoms because they contain lactose, the naturally occurring sugar in dairy foods.
You’re more likely to have difficulty with dairy when you have Crohn’s disease that involves the small intestine. You may lack the natural enzyme lactase, which is needed to digest lactose. “This loss is in large part due to small intestinal damage from the Crohn’s disease,” explains Jeffry A. Katz, MD, the medical director of the Inflammatory Bowel Disease Center at the University Hospitals Cleveland Medical Center in Ohio.
To avoid unpleasant Crohn’s symptoms when you want to indulge a craving for a glass of milk, slice of cheese, or scoop of ice cream, satisfy your urge — and get necessary calcium — with lactose-free or lower-lactose alternatives.
Got Lactose-Free Milk?
If you’re looking for a milk replacement, you don’t have to look farther than the shelves of your local grocery store. You’ll find brands of almond, soy, and rice milk that have at least as much calcium as cow's milk.
But not all milk alternatives are good choices for those with Crohn's, says Patsy Catsos, RDN, a dietitian with a private practice in Portland, Maine, who focuses on gastrointestinal health and is the author of. “Soy milk is a frequent cause of gas and bloating,” says Catsos, “and rice, almond, and other alternative milks provide only 1 or 2 grams of protein and often have added sugars.”
She recommends lactose-free cow’s milk as the best nutritional choice for most people with lactose intolerance: "It provides 8 grams of protein and 300 milligrams of calcium per cup.” Goat’s milk is nutritious too, she adds, but has just as much lactose as cow’s milk does.
Saying Yes to Yogurt
A dairy choice with less lactose than milk is yogurt. Catsos cautions that it’s still important to choose carefully when selecting a yogurt to prevent a flare-up of Crohn’s symptoms.
“Yogurt is a double-edged sword for people with Crohn’s,” she says. Although it can be a valuable source of nutrients as well as a natural source of probiotics (friendly gut bacteria), yogurt is poorly tolerated by some people with Crohn’s disease. “Theoretically, it contains less lactose than milk, but firm figures aren’t available.”
A number of readily available yogurt varieties can fill the bill though, adds Catsos. “Several brands of lactose-free yogurt have recently come on the market,” she says. “If you can’t get one of them, is the next best thing. Greek yogurt probably has less lactose than other commercial yogurts and, as a bonus, has more protein per serving.”
Making Other Dairy Choices
There’s also good news for cheese lovers. Aged cheeses like Gouda, Camembert, feta, and cheddar are lower in lactose than processed cheeses and are an excellent source of protein and fat if you need to gain back any weight.
Your best bet is to shop around and read nutrition labels carefully. A number of lactose-free products including cheese, ice cream, and cottage cheese are now available at most stores. While you’re scanning the information on the containers, be sure to tally up the calcium contents.
If you’re relying heavily on dairy alternatives, Dr. Katz says calcium supplements may be necessary. Talk to your doctor, he suggests — and also ask if you should be taking a calcium supplement with added vitamin D.
Video: Lactose Intolerance vs. Milk Protein Allergy - Dr. Elaine Barfield & Shara Wagowski, RD
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