Dairy is not the same thing as lactose

Name the thing you react to

Lactose is the naturally occurring sugar in milk. The enzyme lactase breaks it into smaller sugars for absorption. When a person makes less lactase, a larger lactose load can reach the colon, where fermentation may cause gas, bloating, pain or diarrhoea.

That does not mean the person is allergic to dairy. Cow's-milk protein allergy involves the immune system and is far more common in young children than adults. The distinction matters because lactose-free cow's milk still contains cow's-milk proteins.

Aged cheese did not get the memo

Cheesemaking removes much of the lactose with the whey, and bacteria use more as cheese matures. Many hard, aged cheeses therefore contain very little lactose. Butter is also low, while ordinary milk, soft cheeses and some yoghurts carry more.

Lactose-free milk and yoghurt are not synthetic impostors. Manufacturers add lactase before the product reaches you, splitting the lactose into simpler sugars. The result may taste slightly sweeter, but it retains the protein, calcium and other nutrients of dairy.

Removing one poorly tolerated sugar is not the same as banning an entire food group.

Use tolerance, not fear

Many people with lactose intolerance tolerate small amounts, particularly with a meal. Yoghurt cultures can also make some products easier to handle. Test portions with professional guidance if symptoms are confusing or significant.

If you choose plant-based alternatives, check the label for calcium fortification, protein and vitamin B12 rather than assuming every pale liquid is nutritionally equal. The right choice is the one that fits your symptoms and still does the nutritional job.