Eating lactose-free every day: guide and tips

Do you struggle to digest milk? In most cases, you do not need to cut out all dairy products. According to EFSA, the vast majority of people who digest lactose poorly tolerate up to 12 g in a single serving, roughly a large glass of milk (about 250 ml). Matured cheeses contain only traces, yoghurts are often better digested, and lactose-free milk keeps all its calcium. The real challenge is to find your threshold and to keep meeting your calcium needs. Here is how to do it, with figures.

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Lactose, lactase, intolerance: the basics

Lactose is the natural sugar in milk. To be absorbed, it must be split into two simpler sugars, glucose and galactose, by an enzyme in the small intestine: lactase. When lactase is lacking, undigested lactose reaches the colon, where bacteria ferment it. This is what causes the symptoms.

The French national health insurance (Assurance Maladie) defines lactose intolerance as digestive discomfort caused by eating more lactose than a person’s own capacity to digest this sugar. It is therefore not “all or nothing”: it is a question of dose.

A very common situation

A fall in lactase is a normal phenomenon. According to Assurance Maladie, lactase activity declines after the age of 2 or 3 and reaches low, stable levels around age 5 to 10, and this decline affects two thirds of people. In France, 30 to 50% of adults digest lactose incompletely.

Worldwide, a meta-analysis published in 2017 (62,910 participants, 89 countries) estimates that 68% of adults digest lactose poorly. Regional differences are huge: about 28% in Western, Southern and Northern Europe, against 70% in the Middle East. Your origins therefore matter a great deal.

There are also secondary intolerances, linked to a disease that damages the gut: coeliac disease, Crohn’s disease, gastroenteritis, giardiasis, bowel surgery or abdominal radiotherapy.

The symptoms

Wind, rumbling, bloating, cramps and abdominal pain, diarrhoea. According to Assurance Maladie, they most often appear between 30 minutes and 2 hours after eating food that contains lactose. Lactose intolerance causes discomfort, but it carries no risk of complications.

Lactose intolerance and milk allergy: do not confuse them

This is the most common confusion. Assurance Maladie is clear: there is no such thing as a lactose allergy.

• Lactose intolerance is a problem digesting a sugar. The symptoms are digestive, gradual, and depend on the dose.
• Cow’s milk protein allergy is a reaction of the immune system against proteins. It most often occurs in babies and children, and can cause digestive symptoms but also respiratory (blocked nose, cough) and skin symptoms (hives, eczema). Allergic symptoms appear quickly after ingestion.

In practice: a “lactose-free” product always contains milk proteins. It suits an intolerant person, never a person allergic to milk proteins. To understand the difference better, see our glossary entries on food intolerance and food allergy.

How much lactose can you tolerate?

EFSA, the European Food Safety Authority, published an opinion on lactose thresholds in 2010. Its conclusions:

• it is impossible to set a single threshold, because tolerance varies greatly from person to person;
• some people have symptoms with less than 6 g of lactose;
• the vast majority of people who digest lactose poorly tolerate up to 12 g in a single serving, with no symptoms or only minor ones;
• higher doses may be tolerated if they are spread over the day.

An American systematic review published in 2010 in the Annals of Internal Medicine reaches the same order of magnitude: 12 to 15 g of lactose, about one cup of milk, is well tolerated by most adults.

Lactose in common dairy products

Here is what the usual portions contain, calculated from the Anses Ciqual table.

Food and portion	Lactose (g/100 g)	Lactose per portion	Calcium per portion
Semi-skimmed milk, 150 ml	4.83	7.2 g	180 mg
Whole goat’s milk, 150 ml	4.2	6.3 g	188 mg
Reduced-lactose semi-skimmed milk, 150 ml	< 0.2	< 0.3 g	180 mg
Plain yoghurt, 125 g	3.21	4 g	171 mg
Fromage blanc, 100 g	3.4	3.4 g	134 mg
Ricotta, 50 g	3.48	1.7 g	157 mg
Thick cream, 30% fat, 30 g	1.38	0.4 g	23 mg
Unsalted butter, 10 g	0.71	0.07 g	2 mg
Camembert, 30 g	< 0.1	< 0.03 g	132 mg
Comté, 30 g	< 0.3	< 0.09 g	272 mg
Emmental, 30 g	< 0.1	< 0.03 g	293 mg

This table shows three things. A large glass of milk (7.2 g) stays below the EFSA threshold of 12 g. Matured cheeses, especially hard ones, are almost lactose-free, which Assurance Maladie also confirms (traces in Camembert, none in Comté and Emmental). And goat’s milk is not a solution: it contains about as much lactose as cow’s milk.

Beware, however, of concentrated ingredients. Semi-skimmed milk powder contains 43.4 g of lactose per 100 g and sweetened condensed milk 10.7 g, according to Ciqual. They turn up in biscuits, sauces, ready meals or chocolates. Read the ingredients list: “milk”, “whey”, “milk powder” or “lactose” signal its presence. Our guide to food labels helps you decode them.

Lactose-free or dairy-free?

The two expressions do not mean the same thing.

• Lactose-free: these are dairy products from which the lactose has been removed or pre-digested. The reduced-lactose milk in the Ciqual table contains less than 0.2 g of lactose per 100 g, but 2.26 g of galactose: the added lactase has already split the lactose in two. This is why it often tastes slightly sweeter. Its calcium is the same (120 mg per 100 g, against 121 for ordinary semi-skimmed milk).
• Dairy-free: everything is excluded, milk, yoghurts, cheeses, butter, cream. This is necessary in the case of milk protein allergy or a vegan choice, and rarely for simple intolerance.

For most intolerant people, the right strategy is therefore to keep dairy products, choosing those that are low in lactose or lactose-free. This is also what the Manger Bouger site of Santé publique France suggests: if you have trouble digesting, yoghurts or “lactose-free” milk are alternatives.

The aids that have proved their worth

Yoghurt

Yoghurt contains about a third less lactose than milk per 100 g (3.21 g against 4.83 g according to Ciqual). Above all, its live cultures help digest what remains. This is a health claim authorised by the European Union after an EFSA opinion: the live cultures in yoghurt or fermented milk improve the digestion of the product’s lactose in people who have difficulty digesting it. Condition: at least 100 million colony-forming units of cultures (Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus thermophilus) per gram. The claim only applies to products that meet this threshold.

Lactase tablets

These are food supplements that provide the missing enzyme. The authorised European claim is as follows: lactase improves lactose digestion in individuals who have difficulty digesting lactose. It is only permitted from 4,500 FCC units, to be taken with each food containing lactose. The regulation also requires a reminder that lactose tolerance varies from person to person. Handy for a restaurant meal, not essential day to day.

Spreading it over the day

EFSA indicates that higher doses are better tolerated when spread over the day. Rather than a large bowl of milk at once, spread your dairy products over several meals.

Conversely, the 2010 review found insufficient evidence for probiotics or for gradual “adaptation” of the colon.

And calcium?

This is the point not to neglect if you sharply reduce dairy products. Anses sets the reference intake for the population at 1,000 mg a day from 18 to 24 years and 950 mg a day from 25 years, including during pregnancy and breastfeeding. Manger Bouger recommends 2 dairy products a day for adults, for example a plain yoghurt, a 150 ml glass of milk or a 30 g portion of cheese.

Sources of calcium with little or no lactose exist, but they are not all equal. Here are the Ciqual values.

Food and portion	Calcium per portion	Note
Emmental, 30 g	293 mg	Traces of lactose
Canned sardines in olive oil, drained, 50 g	216 mg	With bones; boneless fillets give only 54 mg
Calcium-fortified soya drink, 150 ml	147 mg	Close to milk
Unfortified soya drink, 150 ml	25 mg	Six times less
Unfortified almond drink, 150 ml	18 mg	Very little
Unfortified oat drink, 150 ml	1.5 mg	Almost nothing
Plain tofu, 100 g	100 mg	Silken tofu provides only 21 mg
Raw kale, 100 g	254 mg	Green vegetable rich in calcium
Almonds with skin, 30 g	78 mg	Also high in energy
Hépar mineral water, 1 litre	549 mg	Water very rich in calcium
Contrex mineral water, 1 litre	468 mg	Water rich in calcium

The main lesson: an unfortified plant-based drink does not replace milk for calcium. If you drink one, choose it fortified with calcium and check the label. Calcium-rich mineral waters are a useful addition, and Anses does cite some very calcium-rich waters among the sources of calcium, along with pulses, nuts and some leafy vegetables. Our comparison of bottled waters and our guide to foods high in calcium go further. For the role of calcium in bones, also see our guide to bone health and osteoporosis.

Example: reaching 950 mg with (almost) no lactose

• Breakfast: 150 ml of reduced-lactose milk (180 mg).
• Lunch: 30 g of Emmental (293 mg) and a portion of green vegetables.
• Snack: 30 g of almonds (78 mg).
• Dinner: 50 g of sardines in olive oil (216 mg).
• During the day: half a litre of Hépar water (about 275 mg).

Total: a little over 1,000 mg, with less than 0.5 g of lactose. This is only an example, to adapt to your tastes.

The approach in practice

Assurance Maladie suggests a simple method:

1. Avoid dairy products that are sources of lactose for two weeks, making up for the calcium intake.
2. If the symptoms disappear, gradually reintroduce lactose until you reach your tolerance threshold.
3. If the symptoms persist after two weeks, consult your GP: the cause may lie elsewhere.

For reintroduction, start with the foods lowest in lactose (matured cheeses, butter), then yoghurt, then small amounts of milk with a meal. Note your symptoms at each stage. If your digestive problems go beyond lactose (bloating with onion, wheat or certain fruits), lactose is only one of the FODMAP families: our guide to the FODMAP diet and irritable bowel can help.

The doctor may prescribe a hydrogen breath test. According to Assurance Maladie, it involves measuring hydrogen in the exhaled air after swallowing 20 to 25 g of lactose, and lasts about 4 hours.

Alternatives for cooking

• To replace milk: lactose-free milk, or calcium-fortified plant-based drinks (especially soya).
• For cream: coconut milk in curries and soups, or a lactose-free cream.
• For butter: often no need to replace it, as 10 g provides only 0.07 g of lactose. Otherwise, olive or rapeseed oil.
• For a cheesy taste: grated Parmesan or Comté (traces of lactose), or nutritional yeast if you avoid all dairy products.
• For desserts: almond butter, peanut butter, avocado.

On the recipe side, treat yourself to the avocado chocolate mousse, the baked falafels, the date and almond energy balls or the vegetable curry with coconut milk. All our lactose-free recipes are gathered here.

Common myths about lactose

“Intolerant, so no more dairy ever”

False for the majority. EFSA indicates that most people affected tolerate up to 12 g of lactose in a single serving, and matured cheeses contain only traces.

“Lactose-free milk is less nutritious”

False for calcium: 120 mg per 100 g in lactose-free milk against 121 mg in ordinary semi-skimmed milk, according to Ciqual.

“Goat’s milk goes down better”

Not as far as lactose is concerned: 4.2 g per 100 g, against 4.83 g for semi-skimmed cow’s milk. The difference is small.

“Plant-based drinks are milks”

Nutritionally, no. Unfortified, they provide very little calcium (1.5 to 25 mg per 150 ml depending on the drink, against 180 mg for milk).

“You can be allergic to lactose”

No, allergy concerns milk proteins. Lactose is a sugar.

Frequently asked questions

Which cheeses can you eat if you are lactose intolerant?

Matured cheeses, especially hard ones: Emmental, Comté and Parmesan contain less than 0.3 g of lactose per 100 g according to Ciqual, and Camembert less than 0.1 g. Fresh cheeses (fromage blanc, ricotta) contain more, around 3.4 g per 100 g.

How much lactose can you consume a day?

There is no single threshold. EFSA indicates that the vast majority of people who digest lactose poorly tolerate up to 12 g in a single serving, and more if it is spread over the day. Some react with less than 6 g.

Is yoghurt allowed?

Often, yes. It contains less lactose than milk and its live cultures help digest it: this is a health claim authorised in the European Union. Test your tolerance with one pot during a meal.

Can lactose intolerance appear in adulthood?

Yes. The fall in lactase is gradual and affects two thirds of people. An intolerance can also appear after a gut disease (gastroenteritis, coeliac disease, Crohn’s disease).

Do you need a calcium supplement?

Not necessarily. By keeping matured cheeses, a lactose-free milk or a fortified drink, sardines and a calcium-rich water, you can reach the Anses figure of 950 mg. If you exclude all dairy products, talk to your doctor or a dietitian.

What about children?

Assurance Maladie advises not to wait and to consult the doctor if you suspect lactose intolerance in your child.

This article is for information only and does not replace the advice of your doctor or a dietitian.

Our sources

• EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA). Scientific Opinion on lactose thresholds in lactose intolerance and galactosaemia. EFSA Journal, 2010, 8(9):1777.
• European Commission. Regulation (EU) No 432/2012 establishing a list of permitted health claims (live cultures in yoghurt; lactase). 2012.
• Shaukat A, Levitt MD, Taylor BC et al. Systematic review: effective management strategies for lactose intolerance. Annals of Internal Medicine, 2010. PMID 20404262.
• Storhaug CL, Fosse SK, Fadnes LT. Country, regional, and global estimates for lactose malabsorption in adults: a systematic review and meta-analysis. Lancet Gastroenterology & Hepatology, 2017. PMID 28690131.
• Assurance Maladie (ameli.fr). Lactose intolerance: definition and symptoms; what to do and when to see a doctor (in French).
• Anses. Nutritional reference values for vitamins and minerals (in French) (calcium). 2021.
• Santé publique France, Manger Bouger. Aim for a sufficient but limited consumption of dairy products (in French). Recommendations 2019.
• Anses. Ciqual food composition table (in French), 2025.

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