Lactose And Keto: A Bad Combination?

Dairy products are allowed on the keto diet, but not all are created equal. Lactose is a milk sugar that affects blood glucose levels in the same way regular sugar does. It breaks down into glucose, which pushes you out of ketosis. Therefore, milk, which contains lactose, is not considered keto-friendly. However, not all hope is lost for dairy lovers. Butter, for example, is lactose-free and a good source of fat on the keto diet.

Lactose intolerance affects two-thirds of people globally

Lactose is a milk sugar that affects blood glucose levels in the same way that regular sugar does. Lactose intolerance is a condition that makes it difficult to digest lactose. Lactose intolerance affects up to two-thirds of people globally, although there is variation between different regions. For example, in western, southern, and northern Europe, the prevalence of lactose intolerance is around 28%, whereas in the Middle East, it is around 70%. In northern America, the prevalence is estimated to be around 42%.

Lactose intolerance is caused by a lack or loss of the enzyme lactase, which breaks down lactose. This can be due to both genetic and non-genetic factors. Congenital lactase deficiency, a rare disorder where infants are unable to break down lactose, affects an estimated 1 in 60,000 newborns in Finland. Lactase non-persistence, on the other hand, is the reduced production of lactase after infancy and affects most humans.

People with lactose intolerance can experience abdominal pain, bloating, flatulence, nausea, and diarrhea after consuming lactose-containing dairy products. However, most people with lactase non-persistence can include varying amounts of lactose in their diets without experiencing symptoms. Additionally, they may be able to tolerate fermented dairy products such as cheese or yogurt, as these foods have lower lactose content.

On a keto diet, not all dairy products are equal. While butter, most cheeses, and some yogurts are considered keto-friendly, milk and other high-lactose dairy products are not recommended due to their high lactose and sugar content, which can affect blood glucose levels and kick you out of ketosis.

Lactose is a milk sugar that raises blood glucose levels

Fermented dairy products, such as cheese and yogurt, tend to be lower in carbs because the lactose is broken down during fermentation. For example, in the production of cheese, bacteria are added to milk, causing the lactose to be fermented into lactic acid, thereby removing most of the carbs. Additionally, the liquid whey, which contains lactose, is drained off, leaving mainly casein. Similarly, during yogurt production, most of the lactose is fermented into lactic acid, although some remains, resulting in slightly more carbs than in cheese.

The amount of carbs in yogurt also depends on the fermentation time, with longer fermentation resulting in lower carb content. Plain Greek yogurt, which has more whey strained out during processing, is a better choice for keto than regular yogurt.

Milk, on the other hand, is high in lactose and, therefore, carbs. A cup of cow's milk contains 12 grams of net carbs, while a cup of goat's milk has 11 grams. Other milk alternatives that should be avoided on keto due to their high carb content include oat milk (17 grams of net carbs per cup), rice milk (21 grams of net carbs per cup), and sweetened condensed milk (165 grams of net carbs per cup).

When following a keto diet, it is important to monitor your carb intake, as lactose can affect blood glucose levels and potentially knock you out of ketosis. However, this does not mean that all dairy is off-limits. Full-fat dairy products like butter, ghee, hard and soft-ripened cheeses, cream, and Greek yogurt are all keto-friendly options, as they are lower in carbs and higher in fat.

Lactose intolerance can cause abdominal pain, bloating, nausea, and loose stools

Lactose intolerance is a common condition, affecting up to two-thirds of people worldwide, although it is less prevalent in people of European ancestry. People who are lactose intolerant can usually tolerate small amounts of lactose without experiencing any issues. For example, lactose is present in small amounts in fermented dairy products like cheese and yogurt, and most people with lactose intolerance can consume these foods without problems. However, some individuals may be sensitive even to the small amounts of lactose in these foods and should avoid them.

The symptoms of lactose intolerance can be quite uncomfortable and may lead to a person needing to modify their diet to exclude or limit lactose-containing foods. This can be challenging, as lactose is found not only in dairy products but also in some baked goods, breakfast cereals, and other processed foods. However, there are now many lactose-free alternatives available, such as lactose-free milk and dairy-free recipes, which can help people with lactose intolerance manage their symptoms and still enjoy a varied diet.

Lactose intolerance is rare in people of European ancestry

Lactose intolerance is a condition that makes it difficult to digest lactose, a sugar found in milk and other dairy products. It is caused by a lack of the enzyme lactase, which breaks down lactose into glucose and galactose. While lactose intolerance is common worldwide, affecting around 65% of adults, it is less prevalent in people of European ancestry. Only about 5% of people of Northern European descent are lactose intolerant, making it a rare condition in this population.

The reason for the low prevalence of lactose intolerance in people of European ancestry lies in their genetic makeup. After infancy, most people experience a reduction in lactase production, leading to lactose intolerance. However, some individuals have inherited genetic variations that sustain lactase production in the small intestine, enabling them to digest lactose throughout their lives. This condition is known as lactase persistence.

The evolution of lactase persistence in Europeans is a fascinating example of convergent evolution. Northern Europeans began inheriting a genetic mutation that enabled them to digest lactose about 5,000 years ago. This mutation became common in just a few thousand years, and today, up to 95% of the population carries it. This rapid evolution is believed to be driven by exceptional stressors such as famines and pathogens, which may have exacerbated the gastrointestinal effects of lactose intolerance, making the ability to digest milk a matter of survival.

It is important to note that lactose intolerance is not an allergy but a sensitivity to dairy caused by a deficiency of the lactase enzyme. Milk allergy, which is a separate condition, occurs when milk proteins trigger an immune reaction. Lactose intolerance typically causes symptoms such as abdominal pain, bloating, flatulence, nausea, and diarrhea, which can range from mild to severe depending on the individual and the amount of lactose consumed.

While lactose intolerance is rare in people of European ancestry, it is always advisable to monitor your body's response to any food, including dairy. If you experience digestive issues or other adverse reactions after consuming dairy, it is best to consult a healthcare professional for guidance and advice.

Dairy-free recipes are available for those on the keto diet

Dairy products like cheese and butter are staples in many keto recipes. However, some people choose to avoid dairy for various reasons, such as lactose intolerance or dairy allergies. Lactose is a milk sugar that affects blood glucose levels in the same way that regular sugar does, and many people are unable to digest it, making them lactose intolerant.

Fortunately, there are plenty of dairy-free keto recipes that are just as delicious and satisfying. Here are some ideas for dairy-free meals and recipes to suit every palate:

• Poultry dishes: Venezuelan keto chicken salad, keto chicken BLT salad, keto Asian chicken with peanut coleslaw, keto chicken curry stew, and keto crispy baked chicken with BBQ mayo are some tasty options.
• Fish and seafood: Try Mediterranean roasted cod, lemon-baked salmon sheet pan, keto Thai fish curry and bok choy, or sesame-crusted tuna steaks with wasabi mayo and bok choy.
• Beef dishes: Keto Asian cabbage stir-fry, classic keto hamburger, keto ground beef and broccoli, and chimichurri steak with zoodles are some beefy choices.
• Pork dishes: How about keto pulled pork with roasted tomato salad, crispy Chinese pork with cabbage, or keto BBQ ribs with creamy squash salad?
• Vegetarian options: Try keto vegan tofu scramble, vegan kale and spinach soup, or boiled eggs with mayonnaise.

For those with a sweet tooth, there are also dairy-free dessert options, such as keto flourless chewy double chocolate chip cookies, keto peanut butter cookies, and keto white chocolate macadamia nut cookies.

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