Coach on Call. Even with lactose intolerance, you can still get the good nutrition found in milk and other dairy foods. Follow the guidelines below.

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1 Coach on Call It was great to talk with you. Thank you for your interest in learning about lactose intolerance. I hope you find this tip sheet helpful. Please give me a call if you have more questions about this or other topics. As your health coach, I m ready to help in any way I can. Do milk and foods made from milk give you gas, bloating, or diarrhea? You may not be able to fully digest lactose, the sugar found naturally in milk. This condition is called lactose intolerance. Even with lactose intolerance, you can still get the good nutrition found in milk and other dairy foods. Follow the guidelines below. Why are dairy foods important? How much do I need? Dairy foods such as milk, cheese, and yogurt are a key part of healthy eating. These foods are: Rich in calcium, potassium, vitamin D, and protein. Essential to building bone mass during childhood and the teenage years. Linked to better bone health throughout life. Linked to a lower risk of heart disease and type 2 diabetes. Linked to a lower blood pressure in adults. Nutrition experts recommend adults eat three servings of dairy foods per day. A serving is 1 cup of milk or yogurt, 1½ ounces of natural cheese such as cheddar, 2 ounces of processed cheese such as American, ½ cup ricotta cheese, or 2 cups of cottage cheese. Note: Choose nonfat or low-fat (1-percent) dairy foods. They contain the same vitamins, minerals, and protein as whole or reduced-fat (2-percent) dairy foods but much less, or none, of the fat. The type of fat in dairy foods increases the risk of heart attack and stroke. Also, eating a lot of fat makes it hard to avoid consuming more calories than you need. CMN (f) Copyright 2018 UPMC Health Plan Inc. All rights reserved. ABT LCTS INT FL 18ISD5711 (MCG) 5/25/18 PDF

2 Page 2 of 5 Ways to better handle dairy foods If you have lactose intolerance, you may be able to eat dairy foods without problems if you: Eat only a small amount at a time. For example, take sips of a half-cup of milk at a time. Drink milk only with other foods. The other foods will slow the digestive process. Avoid milk and choose yogurt or hard cheeses instead. Because of the culturing process, yogurt contains the enzyme lactase, which digests lactose. Hard cheeses such as cheddar and Swiss are naturally low in lactose. Choose lactose-free milk, yogurt, or cheese. Use lactase enzyme pills or drops, which you can find at grocery stores and drug stores. Take the pills right before a meal or snack that contains dairy foods. You can also add the drops to a carton of milk. Ways to get the nutrients in dairy foods from other sources Another option is to choose other sources of the nutrients found in dairy foods. When fortified with calcium and vitamin D, soy products are a good substitute for dairy foods. They are naturally rich in potassium and protein. Examples are soy milk, soy cheese, and soy yogurt. Many other foods are fortified with calcium, such as cereals, orange juice, and rice or almond milk. But these foods often lack the other key nutrients in dairy products. For example, rice and almond milk are very low in protein. It is best to get calcium from foods. But for some people, calcium supplements are an option. Talk with your doctor before taking calcium supplements. They may make certain medicines less effective. Also, high doses of calcium supplements may be harmful. Beware of hidden lactose Did you know that milk and lactose are often found in these foods? Cereals Salad dressings Nondairy creamers Instant soups Baking mixes Some processed meats

3 Page 3 of 5 Read food labels carefully. Look for these words on the ingredient list: Milk solids Milk powder Milk byproducts Whey (the liquid that remains after making cheese) or whey powder Lactose is also found in some medicines. Tell your pharmacist if you have lactose intolerance. Do you think you may have lactose intolerance? Try avoiding all dairy foods for one week. If your symptoms improve, follow the guidelines above. Talk with a dietitian or your health coach if you have questions. If your symptoms do not improve, talk with your doctor.

4 Page 4 of 5 Take Action My SMART Goal for This Week Check when completed Do your best to reach the SMART* goal you set with your health coach. Write it below. Check the box when you have completed it. Staying on the path to wellness When you are ready, choose one or two ideas from this tip sheet that you would like to put into action. Set a weekly SMART goal for each one. Write your goals below. Check the boxes when you have completed them. SMART goal 1: SMART goal 2: *SMART goals are Specific, Measurable, Appropriate, Realistic, and Timely. For example, Next week, I will switch from whole milk to unsweetened soy milk. If I begin to feel better, I will try other tips that are listed in this tip sheet. SMART goals help you succeed! If you have any trouble setting your weekly SMART goals, ask your health coach for help. The information in this tip sheet is for educational purposes only. It is not intended or implied to be a substitute for professional medical advice. Before making changes, always talk to your doc-tor about what is right for you. UPMC_15_1377

5 Page 5 of 5 Sources Eat Confidently with Lactose Intolerance, National Dairy Council. Available at www. eatconfidentlywithli.org. Accessed February 2, Lactose Intolerance, National Institute of Diabetes and Digestive and Kidney Diseases. Available at Accessed February 2, 2018.