CHEESE FAQs, Ep. 1: How to Eat Cheese When You’re Lactose Intolerant

My plan to use this blog to answer common cheese questions and address the concerns of average cheese consumers has, uh, faced some competition from posts in the category of “omg lookie this cheese I cheesed today!!!” To that I say, it’s my party and I’ll cut the cheese if I want to.

But seriously, I still want to do the thing I wanted to do before. And I don’t have to be at the shop tomorrow, so I can stay up late drinking Dickel 12 in bed and typing. This post covers a concern I hear nearly daily: “I love cheese, but I’m lactose intolerant!” And the related question, “Why do bad things happen to good people?” I’ll offer a few words of advice*.

  1. Go for cheeses that contain little or no lactose. They’re not as hard to find as you might think. For one thing, most cheeses are made by separating the whey from the curds; when the whey is rinsed off, much of the milk’s lactose is removed along with it. Secondly, as cheeses age, lactose is broken down into lactic acid. Thus, fresh cheeses (cheeses that aren’t aged—e.g., mozzarella, ricotta, feta, and chevre) still contain quite a bit of lactose, but aged cheeses have very little lactose. And the more aged the cheese is, the less lactose remains, generally speaking. So, most naturally aged cheeses—even if they’re not aged for very long—contain little or no lactose. Cheeses that are aged for long periods are very safe bets. For example, Beemster XO gouda is aged for 26 months and contains no lactose at all. Parmigiano Reggiano, Pecorino Romano, Manchego, Jarlsberg, and aged cheddars are typically lactose-free or contain only trace levels of lactose.
  2. Look for a “lactose free” label. If you don’t find one, look at the nutrition information label. Lactose is milk sugar, so a cheese that’s high in sugar is high in lactose, while a cheese with little or no sugar is very low in lactose. The nutrition info label doesn’t list lactose, but it does list sugar, which in the case of cheese is basically the same thing.
  3. Consider your portion size. Most adults are at least mildly lactose intolerant. I certainly am! Some of us are more intolerant of lactose than others, but in any case, lactose intolerance is not an allergy—a little lactose isn’t going to send you to the ER or even to the bathroom in a hurry**. If you have Chron’s disease, it’s wise to avoid even trace amounts of gluten, but lactose intolerance doesn’t work like that. It’s more a matter of degree. You may find that you tolerate a little bit of lactose with no problem at all, a moderate amount with a bit of mild indigestion, and a lot with, well, let’s call it distress. Good cheese packs a wallop of flavor, so you may find that you can thoroughly enjoy a little bit of even a fresh cheese (relatively high lactose) without any trouble whatsoever. And frankly, a little bit is plenty anyway. And with low-lactose or lactose-free cheeses, you can pig out if you want.
  4. Know your condition. Are you sure that lactose is the problem? Or are you perhaps allergic to milk protein (casein)? If there’s an allergy to milk protein involved, then it doesn’t matter whether the cheese is low in lactose or not—it’s gonna mess you up***.
  5. If you’re eating a dish that contains cheese, you should know not only what kind of cheese is in it, but what other dairy products are included. If that big bowl of mac and cheese you want is made with aged cheddar, the cheese is probably fine for you as far as lactose goes—but your digestive system is still headed for chaos if it’s also full of cream or milk, or if you’re gobbling amounts of it appropriate only for a hot dog eating competition. If your lactose intolerance isn’t severe, you shouldn’t be worried about a bite of even a young cheese like brie****. But eating a large portion is obviously more risky.
  6. Stay away from the processed stuff. They’re not only unaged (high lactose), but they typically include added milk and/or whey (also high lactose).
  7. Consider non-dairy “cheeses,” I guess? If you must? A vegan friend tells me some of them are delicious. I’ve tried quite a few and ended up with McKayla Maroney-level chagrin on my face, but I might just have a bad attitude. The cashew- and almond-based cheeses aren’t the worst thing ever. Whatever you do, stay away from “imitation cheese” made with, I dunno, chalk and recycled chapstick or whatever they use. I’m not sure what loopholes they abuse to sell this as a food product, since it’s clearly more useful as a cheap construction material.
  8. Don’t get confused by all the bogus nutritional advice. I hear the results of misinformation every day. “I can only eat goat cheese because it doesn’t have lactose.” (Nope. Goat’s milk has slightly lower lactose than cow’s milk, but it’s more likely the difference in casein between cow and goat milk that’s making a difference in your digestion.) “I can only eat raw milk cheese because it doesn’t have lactose.” (Not exactly. If you’re eating raw milk cheese in the US, it’s going to be an aged cheese as required by law, so yeah, that helps. But raw milk has exactly the same amount of lactose as pasteurized milk, though there’s a decent argument that it’s easier to digest because it contains more lactase enzymes and probiotics.) “I only eat cheese from grass-fed cows because it has no lactose.” (No, I’m pretty sure calves would die of malnutrition if that were the case. But hey, grass-fed, pasture-raised animals make tastier, more nutritious cheese, so sure, let’s go with that.) I’m not a medical doctor or a dietitian, so it’s not my place to give medical advice. I try to help people find whatever it is they’re looking for, but I’m sometimes frustrated to hear these myths over and over again.
  9. Just, yeah, eat what you want and suffer the consequences*****. That’s what most of us do, isn’t it?

* I’m not a medical doctor. I mean, I’m a doctor, yeah, but not of the medical sort. I’m qualified to diagnose problems with prose, not problems with your guts, which I call “guts” because I’m not a medical doctor.

** I’m still not a medical doctor. I sell cheese. I’m biased. Go talk to your doctor, for chrissake.

*** You can tell I’m not a medical doctor because I just wrote “gonna mess you up.” Don’t take medical advice from me.

**** Not a medical doctor. Not a dietitian. Just a guy who thinks brie is delicious. I likely know more about cheese than your doc does, and your doc definitely knows more about health than I do, so perhaps you can learn something from both of us?

**** I don’t have malpractice insurance. Don’t listen to me!

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