*This is a re-post of an old blog post. If you found yourself here again THANK YOU! 

When I invite people over for dinner, I usually ask them if they have allergies, sensitivities and or dislike certain foods.  Most people say, “I eat anything”, which usually isn’t true. I ask so that all dinner guests can enjoy the meal and if I know ahead of time, I can plan around their diet limitations, dislikes or allergies.  Last month a friend whom I had invited to a mutual friend’s birthday dinner sent me a note to let me know that he was lactose intolerant, but he would be fine with whatever I served - he would eat around the dairy. The birthday boy and I briefly discussed this and the interesting peculiarity he shared was that the invited guest was okay with some dairy foods like blue cheese and parmesan but not string cheese. We joked that he was intolerant of cheap cheese but okay with expensive cheese…..funny thought, but seriously this got me thinking so I dug around online and this is what I found.

First of all, lactose intolerance is technically not a disease and it is different from a milk allergy. It turns out that most mammals are somewhat lactose intolerant or precisely, as we grow older, we naturally become lactose intolerant. When mammals are born we only consume milk and then we move on to solid foods. In order to digest mother’s milk (human milk having the highest concentration of lactose), we need the enzyme lactase to break down the milk sugar aka lactose. When we are babies, we have high levels of lactase (an enzyme) production and as we are weaned and move on to solid foods and the lactase production is slowed down and eventually for some, turned off. Have you noticed that once weaned, other mammals do not consume milk unless it is fed to them by humans?  An interesting piece of trivia: some marine mammals- seals, sea lions and walruses - do not have lactose in their milk. Which means that they don’t produce lactase either. This was discovered the hard way when a certain baby walrus was being transported from Alaska to California. During its travels the baby walrus was fed cow’s milk and that turned out to be a very messy, bad idea!

Native Americans, people of Asian and some African ancestries have the least amount of lactase production closely followed by Southern Europeans (Italians and Greeks). Some people also ‘develop’ lactose intolerance, from diseases such as Crohn’s disease and celiac disease. While others may develop it because of chemotherapy or intestinal parasites. Be aware that about 20% of prescription medication including some brands of birth control pills contain lactose. And ironically, some over the counter meds such as ones for stomach acid and gas also contain lactose. Besides medication, foods that should be dairy free may also contain lactose; cereals, baked goods including bread, salad dressings, and candies to name a few. If you have an unsettled tummy, you may want to check your drugs and/or packaged foods, you never know where those milk sugars could be hiding.

Now, not all milk products are created equal. Those of you with dormant lactase can still enjoy dairy.  I found online chatter about some milk product/foods that are okay for people with lactose intolerance. So I had to check in to that. Milk, fresh cream, ice cream, butter, cottage cheese, and cream cheese are foods high in lactose. Apparently, dairy that has been fermented, such as yogurt, kefir, sour cream, buttermilk, and crème fraîche have low or no lactose because the lactose in the milk has been converted to lactic acid. Voila! So this loops back to the original question: cheap vs. expensive cheese for folks lacking the enzyme. Why was the string cheese no good for our friend? Because it wasn’t made like traditional cheese, it was highly processed and included one (or more) of the following: whey, curds, milk by-products, milk solids or non-fat dry milk - they all contain lactose.  Let’s look at sour cream. If made properly (traditionally using starter cultures for mild fermentation), it does not have lactose but many companies add ‘extras’ to sour cream. Check out the photos of the labels listing the ingredients of two different sour creams.

Note the one that has whey in it also has other ingredients including some form of corn derivative and three types of ‘gelling’ agent.   It helps to read your labels.

If you find that you are sensitive to all milk products including ones without lactose,  you should get a proper diagnosis because you’re probably not lactose intolerant. You may be allergic to milk or there could be something else going on. While doing this research I found blogs about misdiagnosis of lactose intolerance. I won’t be getting into that right now but I understand how that could happen easily.

In the end, I believe the birthday dinner was a success, I managed it with a few adaptations including a non dairy chocolate pot de creme for dessert.  And remember, if you can’t eat something TELL ME!!!!