Fact sheetDiet specifications

Published on 1 Jul 2015


Allergy diet - lactose low

This document is part of the ACI Diet Specifications for Adult Inpatients. It is not to be used for patient education.

Aim

To provide a diet with a significantly reduced level of lactose (the sugar in mammalian milks).

Characteristics

Eliminates foods with > 2g lactose per 100g.

Indications

Lactase deficiency. Well-controlled double-blind studies show that people who have difficulty digesting lactose can usually tolerate small quantities of milk when consumed with other foods, therefore a completely lactose-free diet or very low-lactose diet (< 3g per day) is unnecessary. A milk-free diet is outlined separately.

Nutritional adequacy

Nutritionally adequate, if calcium-fortified dairy alternative beverages (e.g. soy beverage) or lactose-reduced milk is included.

Precautions

It is not possible to provide a full list of all permitted commercial products; the following are general guidelines only. Care should be taken to read all product ingredient lists to look for ingredients with lactose, eg buttermilk, milk or dairy solids, non-fat dairy solids, whey and curds.

Paediatrics

Suitable for use in paediatrics when combined with an age-appropriate diet.

Specific menu planning guidelines

Allowed Not allowed
Hot main dishes

All plain cooked meat, poultry, fish, eggs and legumes

Other dishes made with allowed ingredients

Any dishes containing > 2g lactose/100g e.g. mornays, macaroni cheese, lasagne

Sauces, graviesSauces or gravies made without milk, e.g. tomato sauce White sauces made with milk
Starchy vegetables / pasta / rice

All vegetables made without milk, soft or processed cheese

Mashed or pureed potato with < 2g lactose/100g

Rice and pasta dishes made without milk

Any dishes made with milk, or soft or processed cheese e.g. potato bake
VegetablesAll othersAny vegetables made with milk, soft or processed cheese, butter or regular margarine (e.g. cauliflower au gratin)
Soups All other soupsAny soups made with milk or large amounts of cream
SandwichesSandwiches made with allowed fillings

Soft or processed cheese

Salads, dressingsAll others

Soft or processed cheese

Mayonnaise with > 2g lactose/100g

Breads, cereals

Regular bread, including rolls

Rice cakes

Rolled oats prepared with water

Most regular breakfast cereals – check label

Hot breakfast cereals prepared with milk

Cereals or muesli containing > 2g lactose per100g

SpreadsButter and regular margarine Jam, marmalade, honey, Vegemite™, peanut butterCheese spreads
Hot breakfast choices All others

Omelettes made with milk

Fruit All fruit -
Yoghurt

Soy yoghurt or low lactose yoghurt may be used

Milk-based yoghurt is usually tolerated in small serves (up to 150g/day)

-
Desserts

Jelly

Some sorbets – check label

Tapioca and sago made without milk, eg lemon or orange sago

Meringues, cakes, pastries and crumble desserts which are not milk based

Milk-based desserts, (e.g. custards, ice-cream, mousses, cheesecake)

Creamy rice

Milk and cheese

Dairy alternative beverages (e.g. soy beverage)

Lactose-reduced milks (e.g. Zymil®, Liddells®)

Matured and semi-matured cheese (e.g. cheddar

All cow’s milk (full and low fat)

Processed and soft cheeses (e.g. cottage cheese, ricotta)

BeveragesTea, coffee, cordial, soft drinks, fruit juices

Milk, flavoured milk

Milo®, Aktavite®, Ovaltine®

BiscuitsMost plain biscuitsBiscuits with > 2g lactose per 100g (e.g. those made with a large amount of milk or added milk solids such as chocolate-coated cream-filled biscuits)
Miscellaneous

Plain nuts

Dark chocolate

Plain cream with <2g lactose/100g

Salt, pepper, sugar, sweetener

Some nutritional supplements - check label

References

  1. Dietitians Association of Australia. Nutrition manual. 9th ed. Canberra: DAA; 2014.
  2. National Digestive Diseases Information Clearinghouse. Lactose intolerance.
  3. McBean LD, Miller GD. Allaying fears and fallacies about lactose intolerance. J Am Diet Assoc 1998;98:671-6.
  4. Maher AK, editor; Iowa Dietetic Association. Simplified diet manual. 10th ed. Ames: Blackwell; 2007.
  5. Food Standards Australia New Zealand. NUTTAB Online searchable database: foods that contain lactose.
  6. Food Standards Australia New Zealand Standard 1.2.7 Nutrition, Health and related claims.
Back to top