What About Cheese?

What is Lactose Intolerance?
Lactose intolerance is a condition in which there is not enough of the enzyme, lactase in the small intestine to digest the milk sugar, lactose. Most infants produce enough, but many people also become intolerant as they age. Intolerance occurs more commonly in certain ethnic groups (African American, Native Americans, Asian Americans and about 15% of Caucasian Americans. On the other hand, about 90% of Asian Americans are affected.)

When people with lactose intolerance consume milk, e.g. the lactose is not digested in the small intestine but instead passes into the large intestines and attracts more water by osmosis. The lactose is quickly metabolized by intestinal bacteria (the microbiome) and produces acid and gas. This process causes symptoms of abdominal distention, flatulence, cramping, and diarrhea. In some people, this occurs only when they consume a large amount of lactose such as a glass of milk or certain types of cheeses. In others, symptoms occur even when the food consumption contains only small amounts of this sugar (lactos

How to determine what Cheese to Eat (or not)
While it’s true that some cheeses are lower in lactose, it’s important to keep serving sizes in mind. Even a low lactose cheese may affect your stomach if you eat a ton of it. And the truth is that even among folks with diagnosed lactose intolerance, sensitivity to lactose can vary greatly. Something that barely affects one person could leave another curled up in the fetal position with stomach cramps. No matter what cheese you’re eating (even if it’s supposedly low in lactose), it is recommended tasting a small amount first, then giving yourself time to see how your body reacts.
In general, it’s also best to eat cheese as part of a larger meal whenever you can, because eating it with other foods can make it easier to digest. And unfortunately, There isn’t always an easy way to know for sure how much lactose is in a product, unless it’s explicitly marked low-lactose or something similar. So if you’re really not sure how much lactose you should (or shouldn’t eat,) check in with your doctor first.

The Bottom Line
If you can’t tolerate even a small amount of Parmesan, your problem with dairy might be something else—like a milk allergy. Most experts say that while lactose intolerance isn’t life threatening, a severe allergy definitely can be, so if you’re not sure what you have or just how sensitive you are, talk with your doctor or registered dietitian before experimenting with any cheeses.