Lactose Free Diet

 

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LACTOSE FREE DIET


Lactose is a carbohydrate that is found primarily in milk and milk products as well as in foods with added milk or whey. In order to be used by the body, lactose must be hydrolyzed  into  galactose and glucose by the enzyme lactase. Lactose intolerance occurs whiten there is a deficiency of this enzyme.


If the small intestine contains insufficient lactase activity to hydrolyze an ingested load of lactose, the unabsorbed lactose remains in the intestine and acts osmotically to draw water into the area. This may cause symptoms of nausea, bloating, and cramping. Later, when the lactose and water enter the colon, the lactose is metabolized by bacteria producing carbon dioxide, hydrogen, and  organic acids.  The patient can experience bloating and cramping, plus gas and diarrhea.


SPECIAL INSTRUCTIONS


Read labels each time a product is purchased. Ingredients often change. Be alert to whey, curd, lactose, skim milk powder or dry milk solids, casein, and galactose.


Lactate, lactic acid and lactalbumin do not contain lactose and do not have to be eliminated.


All foods must be prepared without milk, cream or other foods, which contain lactose.


A vitamin/mineral supplement may be necessary. Consult your physician or dietitian. Be aware that certain vitamin/mineral preparations may contain lactose.


FOOD


BEVERAGES





INFANT FORMULA



BREADS & CEREALS








DESSERTS


ALLOWED


Carbonated drinks, coffee, tea, fruit drinks, some instant coffees, Lactaid 100 (1) and other lactose free milks or those treated with lactase enzyme,

Lactose free products such as Pediasure (2), Ensure (2), Forta Drink (2), and Mocha Mix (3) Lactose Free Hot Cocoa (by Carnation)


Isomil (2), Prosobee (2)  Nutramigen (4),

Portagen (4), Pregestimil (4)





Breads and rolls made without milk, French bread, some cooked and prepared cereals, macaroni, spaghetti, soda crackers







Fruit ice, gelatin, angel food cake, homemade cakes, pies, cookies made without milk, pudding made with substitute, tofu based desserts, mocha mix frozen dessert, Popsicle’s.


OMITTED


Milk (including cow’s, goat’s, etc.) in all forms such as evaporated, powdered, condensed, buttermilk, yogurt, cheese, ice cream, sherbet, Ovaltine, hot chocolate, some cocoas ,and instant coffee beverages, powdered drink mixes, lactobacillus/acidophilus treated milk



Similac (2), Enfamil (2), Good Start






Prepared mixes such as muffins, biscuits, waffles, pancakes, some dry cereals such as Total (5), Special K (6), and Cocoa Crispies (6), (read labels), instant Cream of Wheat (7), breads and rolls to which milk solids have been added, Zwieback, French toast made with milk.





Commercial cakes and cookies and mixes, custard, pudding, sherbet, ice cream, chocolate, pie crust made with butter or margarine, gelatin made with carrageenan






FOOD


EGGS



FATS/OILS






FRUITS




MEAT/FISH/POULTRY




SOUPS




VEGETABLES



MISCELLANEOUS






ALLOWED


All eggs and egg products which do not contain lactose




Margarine’s (Nucoa or Fleischmann’s) or dressings that do not contain milk products, oils, shortening, bacon fat, Rich’s Nondairy Whipped Topping, some non-dairy creamers,  nuts, nut butters



All fresh, canned, or frozen fruit that are not processed with lactose



Plain beef, chicken, fish, turkey, lamb, veal, pork and ham, strained junior meats and vegetables and meat combinations that do not contain milk products, kosher frankfurters, tofu



Clear soups, vegetable soups, consommé, cream soups made with Mocha Mix (3) or non-dairy creamer



Fresh, canned or frozen vegetables made without milk products






Soy sauce, carob, popcorn, olives, sugar candy, jelly or marmalade, sugar, corn syrup, gravy made with water, bakers cocoa, pickles, pure seasonings, spices, wine, molasses, monosodium glutamate, instant coffees without  lactose

OMITTED


Scrambled eggs made with milk, soufflés or omelets containing milk




Margarine or dressings containing milk products, butter, cream, cream cheese, peanut butter with milk, solids fillers, salad dressings containing lactose, sour cream




Any canned or frozen fruit processed with lactose




Creamed or breaded meat, fish or fowl, sausage products, frankfurters, liver sausage, cold cuts containing milk solids, cheese




Cream soups made with milk or cheese, chowders, commercially prepared milk based soup



Any vegetable to which lactose is added during processing, creamed, breaded or buttered vegetables, instant potatoes, frozen French fries if processed with lactose




Chocolate, some cocoas, toffee, peppermint, butterscotch, Carmel, some instant coffees, certain antibiotics and vitamin/mineral preparations, milk containing spice blends, monosodium glutamate extender, artificial sweeteners containing lactose, such as Equal (8), Sweet ‘N Low (9), some non-dairy creamers


Lactaid Milk & Tablets

Ross laboratories

Presto Food Products

Mead Johnson

General Mills

Kellogg Company

Nabisco

G.D. Searle and Company

NIFDA ( National Institutional Food Distributor Association


NOTE:  Brand names are used for clarification only and do not constitute an endorsement. Also, the manufacturer without notice may change ingredients. ALWAYS READ LABELS








TYPICAL USES OF LACTOSE

Ascorbic acid and citric acid mixtures

Buttermilk

Cakes and sweet rolls

Canned and frozen fruits and vegetables

Caramels, fudge, and coated candies

Cheese foods and spreads

Cookies and cookie sandwich fillings

Cordials and liquoers

Cottage cheese and cottage cheese dressings

Dietetic and diabetic preparation

Dried soups

French fries and corn curls

Health and geriatric foods

Ice cream

Infant formula

Instant coffee

Instant potatoes

Meat products prepared with fillings, such as luncheon meats, frankfurters

Modified skim milk

Party dips

Pie crusts and fillings

Powdered coffee cream

Powdered soft drinks

Puddings

Salad dressings

Sherbets, frozen desserts, and ices

Sour cream

Spice blends

Starter cultures

Sweetened condensed milk

Sweetness-reducers in icings, candies, preserves, and fruit pie fillings

Tablets

Vitamin and mineral mixtures (lactose commonly used as a filler)

PARTIAL LISTING OF NAME BRAND FOODS FREE OF LACTOSE

ALLOWED


Breads: Country Hearth, Honey Wheat  Berry Bread,  

Orowheat Cracked Wheat Bread, Rainbow White Bread, Wonder Wheat White Bread, Toscana’s Extra Sour Dough French Bread, San Luis Sour French Bread, Basque Sour  Dough Bread


Crackers: Von’s Graham and Cinnamon Graham, Sunshine Honey and Cinnamon Graham, Premium Saltines, Triscuits, Nabisco Honeymaid Graham and Cinnamon Graham, Ritz, Nabisco Wheat Thins, Von’s Wheat Thins, Nabisco Rykrisp


Cereals: Cheerios, Honey-nut Cheerios, Rice Krispies, Cornflakes, Chex Cereals, Total, Froot Loops, Cocoa Pebbles, Trix,  Cocoa Puffs, Crispix, Post Raisin Bran, Captain Crunch, Lucky Charms, Wheaties


Von’s Crunchy Granola Bars, (oats/honey, cinnamon) Nature Valley Crunch Granola Bars


Condiments: All brands mayonnaise, mustard


Lunchmeats:  Louis Rich, Turkey Ham, Turkey Bologna, Smoked Turkey Breast, Oven-Roasted Turkey Breast, Oscar Mayor Bologna, Louis Rich Turkey Franks



MISCELLANEOUS:  Ore-Ida Tator Tots, Golden French Fries, Golden Crinkles, Von’s French Fries, Shoestring, Tator Tots, Crinkle Fries

AVOID


Von’s white or wheat bread, Orowheat 12 grain bread





Sunshine Krispy Saltines (mild cheddar flavor), Nabisco Vegetable Thins, Nabisco Chicken-in-a-Basket, Cheese Crackers, Hi-Ho Crackers, Honeymaid Chocolate Grahams



Cinnamon Toast Crunch, Golden Grahams, Special K





All other granola bars



Milk or cream base salad dressings







Tyson Chicken Chunks, any brand batter dipped fish

CALCIUM, SUPPLEMENTATION

TUMS ULTRA  400 MGTABLETSCALCIUM CARBONATE 600 MG TABLETS


Age 1-3yr11                   

RDA 500mg

                                                                                                                                       

Age 4-8yr21&1/2                                                                                          

RDA 800mg

                                                                                                                                                                                                                           

Age 9-1832

RDA  1300MG                                                                                                                                                                                

Judy Davis, MD, FAAP

Fellow American Academy of Pediatrics

Fellow Sub-Board American Academy of Pediatric Gastroenterology

American Board of Nutrition

Clinical Professor, Department of Pediatrics, University of California, San Francisco

www.judydavismd.com