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Avoidance of Dairy Products: Implications for Nutrient Adequacy and Health

Theresa A. Nicklas Theresa A. Nicklas, DrPH

Professor of Pediatrics, Baylor College of Medicine, Texas

With up to 16 essential nutrients, dairy products provide a nutritional package that is difficult to replicate. Moreover, a growing body of evidence demonstrates a link between dairy intake and a decreased risk of several conditions, including hypertension and type 2 diabetes . Unfortunately, many individuals avoid dairy due to the often mistaken belief that they are lactose intolerant.


  • Avoiding dairy products means missing out on several key nutrients and potential health benefits (e.g., reduced risk of hypertension and type 2 diabetes).
  • It is not recommended to avoid dairy products even if you have lactose There are several recommended strategies to manage lactose intolerance and there is evidence that gradually increasing lactose intake over time can.
  • There are several recommended strategies to manage lactose intolerance and there is evidence that gradually increasing lactose intake over time can result in colonic adaptation.

Dairy products are an important contributor of many essential nutrients often lacking in the typical North American diet including calcium, potassium and vitamin D, and limiting dairy intake may adversely affect health.1 According to the NIH Consensus Development Conference Statement on Lactose Intolerance and Health, dairy exclusion diets may exacerbate the risk of osteoporosis and negatively impact other health outcomes such as blood pressure control and colon cancer risk.1

Self-perceived lactose intolerance and dairy avoidance

In a recent cross-sectional study of a national sample of 3,452 adults, individuals who believed they were lactose-intolerant had significantly lower average daily calcium intakes from dairy foods than did those without self-perceived lactose intolerance. A significantly higher percentage of respondents with self-perceived lactose intolerance, compared to respondents without self-perceived lactose intolerance, also reported having physician diagnosed diabetes or hypertension.2 The odds of self-reported, physician diagnosed diabetes or hypertension decreased by 30% and 40%, respectively, for every 1,000-mg increase in calcium intake from dairy foods per day.2

Managing lactose intolerance

The National Institutes of Health recently issued a consensus statement indicating that the prevalence of lactose intolerance is lower than previous estimates suggested and advised against avoiding dairy, even for those with lactose intolerance.1 Symptoms can usually be managed by ingesting small amounts of milk, eating yogurt and hard cheeses or using reduced-lactose milk.

The limited data available suggest that individuals with lactose malabsorption can ingest up to 12 grams of lactose (the equivalent of one cup of milk) without significant symptoms, particularly when accompanied by other foods.1 Also, there is evidence that gradually increasing lactose intake over time can result in colonic adaptation.1


  1. National Institutes of Health. NIH Consensus Development Conference Statement: Lactose Intolerance and Health . NIH Consens State Sci Statements 2010 Feb 24;27(2).
  2. Nicklas TA et al. Self-perceived lactose intolerance results in lower intakes of calcium and dairy foods and is associated with hypertension and diabetes in adults . Am J Clin Nutr 2011;94:191-8.

Keywords: lactose Intolerance , national institute of health , hypertension , type 2 diabetes

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