Lactose is a sugar found in abundance in dairy milk whether whole, lowfat or skim. It is also found in large amounts in human breastmilk.
There is about 25% less lactose in goat milk compared with fluid milk from cows.
According to the National Institutes of Health, about 65% of the human population suffers from lactose intolerance, which is a reduced ability to digest this double sugar after infancy. (1)
If you are one of these people, you might be someone who purchases containers of commercial milk labeled “lactose free”.
Others who might purchase this type of product are those seeking to reduce carbs or eliminate sugar from the diet such as diabetics or those who espouse a ketogenic diet.
The Truth About Lactose Free Milk
I first realized the surprising truth about lactose free milk a few years ago when I was on the GAPS diet.
Since lactose is a disaccharide sugar, it is not included in the legal food list. Only fruit and honey are allowed.
So, I switched off of liquid milk and only consumed 24 hour kefir and yogurt instead. Fermenting for a full 24 hours eliminates all the lactose. No commercial brands are fermented for 24 hours, by the way.
But, I really missed milk making my homemade lattes! Nondairy milks just didn’t do it for me. I didn’t find the flavor and consistency change as enjoyable.
At this point, I began checking labels for organic lactose free milk at the store to see if it might work in small amounts making the occasional latte.
I was shocked to discover that lactose free milk has the exact same amount of milk sugar as regular milk!
This includes a popular brand whose cartons are boldly labeled “100% lactose free”.
See the label in the picture above of a widely available brand of lactose free milk. Compare it to the same brand below for regular milk.
The macronutrient amount for carbs and sugar are exactly the same!
Lactose Free Milk vs Regular Milk
If the milk sugar in lactose free milk is actually still there, then what is the difference that enables people to digest it better?
The addition of the enzyme lactase!
You see, lactase is the enzyme necessary to digest lactose.
Lactase is 100% destroyed when raw milk is pasteurized. Even low temp vat pasteurized milk contains no lactase.
Those who are able to digest pasteurized milk after infancy continue to be able to make the enzyme themselves.
Those who cannot digest pasteurized milk are the same people who don’t make the enzyme at all or in insufficient amounts.
Thus, most people who suffer from lactose intolerance find they can consume raw milk with no symptoms. The only ones who can’t are those with a true milk allergy.
Hence, lactose intolerance is actually pasteurization intolerance.
It seems that Big Dairy took a lesson from the raw milk playbook when they developed their “lactose free” fluid milk brands.
Instead of removing the lactose, which would negatively affect the taste and enjoyment of the milk, they simply added lactase instead!
Once again, we find incredibly misleading labeling from dairy manufacturers that says one thing but means another.
By comparison, I have never met a raw milk farmer who falsely claimed their milk was “lactose free” just because the lactase enzyme was in it!
Buy local or risk getting scammed. It’s as simple as that.
Reducing Carbs? Lactose Free Milk isn’t an Option
Ultimately, whether or not you choose to drink commercial lactose free milk is a personal choice.
If you digest it better, then that’s great.
You may wish to consider trying raw grassfed milk, which is legally obtainable in all states except New Jersey. (2)
This option not only provides the lactase enzyme to eliminate the symptoms of lactose intolerance, but also a lot more nutrition than commercial lactose free brands, This is because pasteurization destroys most of dairy milk nutrition. That is why synthetic Vitamin A and D are typically added back after processing.
Whatever you decide, just don’t choose “lactose free milk” thinking it is somehow lower in carbs or free of sugar.
It’s not!
Lactose Free Milk Powder
When it comes to truth in labeling, is lactose free milk powder any closer to the real deal than its fluid milk cousins?
Unfortunately, the answer appears to be no.
The process for making the dry form of milk basically involves evaporating the liquid out of lactose free milk (that according to the label still contains the lactose as explained above). (3)
Hence, the milk sugar would remain in the milk powder. The lactase enzyme that was added after pasteurization would also be present providing that the level of heat used during evaporation was low enough to preserve it.
Ultimately, if you are avoiding lactose for whatever reason, you need to be using a milk substitute or consuming 24 hour fermented dairy.
References
(1) Lactose Intolerance
(2) Raw Milk Map
(3) Lactose Free Whole Milk Powder
So if I understand you correctly, “lactose free ” milk is just pasteurized milk to which lactase has been added? And the manufacturers expect this lactase to convert the lactose into simple sugars within the intestine of the person who drinks it? Which in my case won’t do me much good because my stomach doesn’t have enough acid to enable lactase enzymes to work…
I’m lactose intolerant, and if I eat or drink something that contains regular milk, and I do not take lactose tablets, then I can get acute diarrhea; and, I recently ate something that did have regular milk but I didn’t take lactase, and I had a reaction, and I continued to drink the lactose-free milk as if it were 100% free of lactose–believing that I was protected. Instead, the diarrhea kept on going after a week and tapered off only gradually. It was awful, and I lost weight, too.
Now it’s possible that there was something else besides lactose intolerance that could explain why the diarrhea ran on for well over a week, because there are many things cause diarrhea besides lactose intolerance. In looked up the topic in the Merk Manual, PubMed, Wikipedia, etc., which had nothing I could find that addressed this precise situation. I asked my doctor, too. I have an appointment with a specialist coming up, as well, to cover all the bases…but then I did a search and came right to this very discussion.
Now, why did I assume drinking “lactose free” milk was not a factor in dragging out my misery? Because I didn’t think at all–I trusted the label that claimed “100%” of it. However, not to slam the manufacturer–the carton states that “we simply add a natural enzyme to break down the lactose, and do the work some digestive systems can’t.” I find nothing to argue with in that. (It’s a perfectly reasonable statement, I think.)
Next, comes the experiment to confirm the hypothesis: do I get a big ice cream cone, topped with whipped cream, and then let it rip full blast, but drink no milk at all after that, until the episode is over? And then repeat the experiment, drinking the “100% lactose-free milk” with abandon, so see how the experiment runs.
What would you do?
Sarah, l read Anthony Wilson’s comments and your response to him. I thought his comment added balance and was needed. You tackled the milk topic from multiple angles, made some very worthwhile points, yet you didn’t acknowledge one of Anthony’s. I am not a dietitian yet I could see the same glaring inaccuracies as he did in relation to lactose even before l got to his comment. He is absolutely right in that lactose-free milk is just that. Free of lactose. That is not to say it doesn’t contain the simple sugars (glucose and galactose) you mention, or that it is a suitable food item for diabetics or keto advocates. And although pasteurised milk is not as nice or nutritious as good fresh raw milk, it is nevertheless a LOT safer than standard commercial milk that would harm highly lactose sensitive individuals. For example, I can only drink 24 hour cultured milk, pasteurised or raw milk with added lactose enzymes, 4 or 5 drops per litre shaken in and let rest for a while, and l am perfectly fine. No painful bloating or gas. BUT if l drink straight untreated pasteurised OR even raw milk that’s another story! I invariably experience hours of intestinal pain. So your statement “hence lactose intolerance is really pasteurisation intolerance” does not apply to me, Anthony Wilson and perhaps others like us.. He was very courteous and respectful of you but l felt you didn’t give credit where credit was due (in regard to his suggestion for a modified heading) but made a false assumption and cut him down. He wasn’t focusing on the political, nutritional, or glycemic aspects of milk in your post, but the conversion aspect of lactose to galactose which l completely agree with. I think readers will respect you more if you acknowledge their points when true. Regards, Jeff.
Thank you for the great info Sara. I want to ask about legal Grassfed Raw Milk being available in all states except NJ… I thought otherwise. If you are right what am I missing? Did the laws change in regard to Raw milk ?
If you click through to the source provided, it will give you info on the legality of raw milk in each state. Only in NJ is raw milk still completely illegal with no access even direct at the farm.
Sarah, what about White Mountain Foods yogurt, this is what they say on their website:
24 hour Fermentation
Our Bulgarian Yogurt is fermented for a full 24 hours, which greatly reduces the lactose content of the milk making it much easier to digest. Many of our consumers who are lactose intolerant can eat our yogurt as well as those following the SCD and Keto diets.
24 hour yogurt contains little to no lactose, so you are good to go there! That is completely truthful and legit labeling.
Hi Sarah! Thank you for posting my comment, but unfortunately, I feel that you misunderstood something. I can see why and I’m happy to clear up the misunderstanding, truly. First off, I did not say that pasteurization “enzymatically” removes lactose – obviously that is not correct. In my initial comment above you’ll see that I specifically stated that lactose was “enzymatically removed “AFTER” pasteurization” by the addition of the “lactase” enzyme.
You stated above, “ONLY THE LACTASE ENZYME IS REMOVED … THE LACTOSE REMAINS JUST LIKE IN REGULAR PASTEURIZED MILK! IF IT WAS GONE, THERE WOULDN’T BE ANY SUGAR ON THE LABEL.” No – the last part of your statement is most definitely incorrect if talking about pasteurized milk that has had the lactase enzyme added (lactose-free non-raw milk). If the lactose was “physically removed” instead of enzymatically removed by the lactase enzyme, then yes, there would be no sugar on the label. But we are not talking about the physical removal of lactose; no dairy company that I have ever heard of physically removes lactose from milk anyway. What we’re talking about is ‘lactose-free pasteurized milk that has had the lactase enzyme added’, the kind of lactose-free milk that people buy in the supermarket (2 very different things). Pasteurization of raw milk removes the lactase enzyme that “naturally occurs” in raw milk, yes, the heat destroys it. But the lactase enzyme that is added by the dairy companies is added “after” pasteurization to raw milk and this is why there is very little or 0 “lactose” molecules present in lactose-free milk.
So why IS there “sugar” on the label, as you mentioned, if the lactose sugar is not present? And the answer comes from nutritional biochemistry. The lactase enzyme added after pasteurization converts the lactose sugar to 2 other “NON-LACTOSE” sugars, specifically, these sugars being glucose and galactose. So there is virtually 0 molecules of lactose present, but these other types of sugar ARE present, and this is why the label DOES show ‘JUST AS MUCH SUGAR’ as regular lactose-containing milk.
If you take “lactose-free” pasteurized milk that has already had the enzyme lactase added to it after pasteurization, (as your milk carton pictures above show), to a food scientist and ask them to find the lactose molecules in it, they won’t be able to find “LOTS” of them as you have stated. They are just not physically present in that great of a quantity. But there is certainly plenty of sugar present!
BTW, I have no affiliation of any kind with “big dairy”. Rather, I am a Registered Dietitian for the past 13 years who studied a lot of biochemistry at Cornell University who believes in consuming “raw” milk first and foremost. Honestly, I believe your article should be entitled “WHY LACTOSE-FREE MILK STILL CONTAINS A LOT OF SUGAR”. Consumers should not believe that lactose-free pasteurized milk has “lots of lactose” in it and that they shouldn’t consume it if they are lactose intolerant – that would be a tremendous disservice to them. In the past I’ve had lactose-free pasteurized milk in large quantities (like almost half a gallon) at one sitting and would have found out very quickly, and in the worst way, if there were lots of lactose molecules in there! I didn’t.
Thank you Sarah!
Anthony Wilson, RD
AnthonyWilsonRD.com – currently under construction
FYI … your comment does not meet comment guidelines as it is too long. But, I’m allowing it because of the important discussion.
Bottom line. The sugar is still there … hence, it is incredibly misleading and potentially dangerous especially for ketogenic or diabetic folks to see “lactose free” boldly proclaimed on the label. It doesn’t matter how you chemically describe it. Raw milk has lactase too and yet no one erroneously claims that the lactose somehow magically disappears because it effectively “zeroes it out” or splits the sugar molecules.
I would call your attention to the fact that every single lactose intolerant person I know who tries raw milk can drink it with no problem just like “lactose free” milk.
Labeling shenanigans and shading of the truth to maximize profits at consumer expense is the issue here. We consumers are used to lying labels as it is happening all over with many different foods. This is just one more example.
All Big Dairy is trying to do with their so-called “lactose free milk” is take one of the best benefits of raw milk and industrialize it, label it misleadingly, and sell it for a premium.
No wonder people are fleeing supermarket dairy in droves. Considering how incredibly leveraged the industry is, I anticipate some major bankruptcies in the coming years.
Hi Sarah! The title of your article is “WHY LACTOSE-FREE MILK STILL CONTAINS LOTS OF LACTOSE”, but that is not accurate, it doesn’t contain lots of lactose. I’m not sure why you are hung up on the fact that the lactose is not physically removed from the milk, rather, that it is enzymatically removed after pasteurization with the lactase enzyme. Either way, the lactose sugar is not there, or in very small amounts. You mention how there is still “sugar” in the milk, so it is not sugar-free, and that IS accurate. If your point is that obtaining pasteurized milk with a label that states there is “no lactose” in it, still has “sugar” in it, then the title of your article should read “WHY LACTOSE FREE MILK STILL CONTAINS LOTS OF SUGAR”. That would be accurate. The lactase enzyme breaks the lactose sugar into glucose and galactose, 2 simple sugars that don’t need digestion, and consequently, there are no “lactose” molecules left. Your article is unintentionally misleading for people who may want to consume “lactose-free milk” that is not raw milk, and that would be unfortunate. Thanks Sarah!
Unfortunately, lactose is not “enzymatically removed” by pasteurization. Only the lactase enzyme is removed … the lactose remains just like in regular pasteurized milk! If it was gone, there wouldn’t be any sugar on the label. And believe me, if Big Dairy could remove the sugar grams from the label, THEY WOULD.
Playing semantics with consumers isn’t going to work.
For milk to be “lactose free” the lactose MUST BE PHYSICALLY REMOVED FROM THE MILK. I think you must be a paid Big Dairy spin doctor?