Page 34 - Today's Dietitian (February 2020)

proprietary probiotic strains for specific benefits—for exam- could change the microflora in a way that enhances lactose
ple, digestive health or immune response. tolerance for some people,” Scarlata says. “However, it’s impor-
Nevertheless, lactose-free yogurts may or may not be suit- tant to go slowly. People who have a high concentration of
able for a low-FODMAP diet, depending on their source of mast cells in their intestine could become more reactive to
sweetening. “Eliminating lactose gets rid of a major FODMAP lactose, as well as GOS and other prebiotics. Also, it’s hard to
source, but products sweetened with agave, honey, fructose, or know which bacteria the lactose and prebiotics are feeding
certain fruits add a different source of FODMAPs and should be and whether the bacteria are beneficial.”
avoided by people trying to eliminate FODMAPs,” Scarlata says. Nurica hasn’t been launched yet in products in North Amer-
ica but is approved for use in Europe, the Middle East, Africa,
Cheeses and Latin America. It won’t appear in the ingredient list, but
Most hard cheeses are naturally low in lactose. Lactose is found pri- the presence of GOS likely will be highlighted.
marily in the whey component of milk and cream, the liquid that’s In the fall of 2019, the start-up Perfect Day launched a limited-
drained off from curds during the cheese-making process. The edition lactose-free ice cream made from an animal-free dairy
curd—sometimes rinsed to remove any remaining whey—eventu- protein created through a microflora fermentation process. For
ally is turned into cheese. Any small amount of lactose on the curds protein production, the company adds genes to Trichoderma,
is consumed by lactic acid bacteria during the ripening process for a fungus, to enable it to ferment plant sugar into the proteins
making hard cheeses such as parmesan, Swiss, and cheddar. whey and casein. The fungus doesn’t produce lactose.
“Many people don’t realize that all cheddar cheese, for
example, is lactose-free as a result of the aging process,” Implications for Practice
explains Sara Wing, RD, health program director at Cabot Public health recommendations continue to cite the impor-
Creamery in Waitsfield, Vermont. “Cheeses that undergo a nat- tance of consuming three dairy servings per day, including
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ural aging process contain little to no lactose.” among those who can’t tolerate lactose. For people who enjoy
Softer cheeses such as Brie and cream cheese contain small dairy but can’t tolerate lactose, products labeled lactose-free
amounts of lactose. Their lactose content is low enough (1 to 2 can replicate the taste and nutrition benefits of dairy with
g/oz) to be tolerated by many people who are lactose intolerant little or no discomfort.
as long as the cheeses are consumed in small portions. Cottage “When looking for a lactose-free cheese, first look at the
cheese, in contrast, must be treated to remove lactose because label,” Wing advises. “On every Nutrition Facts panel, you’ll
its curds are packaged in milk or a combination of milk and find the amount of total sugar in that food. If it says 0 g, that
cream; burrata, a cheese that consists of unfermented cream means there’s no sugar, and no sugar means no lactose.”
encased in mozzarella, likewise isn’t lactose-free. Because dairy products aren’t culturally significant for all
populations, dietetics professionals should tailor their guid-
Other Dairy Products ance to include lactose-free products and strategies when rel-
Other dairy products have varying amounts of lactose. Ice cream evant and provide other sources of calcium and dairy nutrients
and frozen desserts are made from cream and milk, both of which for non-Western-style diets.
contain lactose. Their lactose-free counterparts are created by “Each client’s food beliefs, culture, and lifestyle affect their
either starting with lactose-free milk and cream or adding lac- food choices,” says Vandana Sheth, RDN, CDE, FAND, a Los
tase to the ice cream mix before freezing. Higher–dairy fat prod- Angeles–based private practitioner, author of My Indian Table:
ucts such as butter and ghee contain less lactose because of their Quick & Tasty Vegetarian Recipes, and spokesperson for the
low content of fluid whey. During butter production, whey and Academy of Nutrition and Dietetics. “When it comes to dairy
most of the water-soluble components in milk, including lactose, and dairy products, if a client doesn’t incorporate these and
are removed, thereby reducing the lactose content in butter to I notice a nutrition gap, I discuss lactose-free products as an
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<0.1%. Removing milk solids, which have trace amounts of lac- option if they would like to try them. Clients who avoid dairy
tose, from butter yields ghee, a lactose-free dairy fat. due to a specific belief or lifestyle may find dairy-free alterna-
tives to be more acceptable, or they may prefer to avoid dairy
New Technology products and dairy alternatives altogether. I always encourage
DuPont recently introduced a new product, Nurica, that splits my clients to share their cultural food stories with me so I can
lactose into glucose and galactose and then connects the two better help them meet their nutrition goals with or without
simple sugars to form a nondigestible prebiotic fiber called lactose-free dairy products.”
galacto-oligosaccharide (GOS). GOS has been shown to allevi-
ate symptoms of lactose intolerance while stimulating growth Mindy Hermann, MBA, RDN, is a food and nutrition writer and
of particular strains of beneficial microorganisms. 4 communications consultant in metropolitan New York.
According to a representative from DuPont, Nurica offers a
combination of benefits that include lactose reduction, sugar For references, view this article on our
reduction, and GOS fibers that are key prebiotic ingredients website at www.TodaysDietitian.com.
in infant formula. “It is possible that GOS and other prebiotics

34 TODAY’S DIETITIAN • FEBRUARY 2020