Best Dairy Choices for Crohn’s Disease: Calcium and Lactose Guide

“Milk is such an important source of key nutrients, including B12, iodine, and vitamin D, so it is essential to remember that if you don’t have symptoms when you drink dairy milk, then there’s no need to cut it out if you have Crohn’s disease,” said Sophie Medlin, a consultant dietitian at City Dietitians and chair of the British Dietetic Association for London.

Foods like cheese, milk, and yogurt can trigger inflammatory bowel disease symptoms because they contain lactose, but patients do not necessarily need to avoid dairy entirely. Difficulties with dairy often arise when Crohn disease affects the small intestine. Patients frequently lack the natural enzyme lactase required to digest lactose properly.

“This loss is in large part due to small intestinal damage from the Crohn’s disease,” said Jeffry Katz, a gastroenterologist and a professor in the department of medicine at the Case Western Reserve University School of Medicine in Cleveland.

Key Clinical Takeaways:

• Patients with small intestinal involvement from Crohn disease may experience lactase deficiency due to small intestinal damage.
• Fermented dairy options like aged cheeses and yogurt often contain lower lactose levels and can be better tolerated.
• The Crohn’s & Colitis Foundation recommends calcium supplements, ideally paired with vitamin D, especially for patients taking corticosteroids or experiencing low bone density.

Choose Greek Yogurt or Reduced Lactose Options

Yogurt made from dairy contains less lactose than milk because bacterial fermentation breaks down the sugar, making it better tolerated, Medlin stated.

“Yogurt is a double-edged sword for people with Crohn’s,” said Patsy Catsos, a registered dietitian nutritionist in Portland, Maine, and author of The IBS Elimination Diet and Cookbook.

Catsos recommends choosing yogurts with reduced lactose content or selecting Greek yogurt when lactose-free brands are unavailable. Greek yogurt contains less lactose than other commercial yogurts and offers higher protein per serving, though it provides less calcium.

Natural cheeses can remain part of the diet because aged varieties naturally contain low amounts of lactose. These aged options fit within carbohydrate-conscious regimens like the specific carbohydrate diet and the IBD anti-inflammatory diet.

Plant-Based Milks May Lack Sufficient Nutrients

Removing animal products from the diet increases the risk of nutritional deficiencies without appropriate supplementation.

“While plant-based milk may be fortified with some of the vitamins and minerals that dairy milk has, it is unlikely that it will meet all of your needs. Plus, those protein sources aren’t as good quality as what we get from dairy,” Medlin said.

Nondairy milks such as soy, rice, coconut, and almond often feature higher calcium levels per cup than cow’s milk due to fortification. However, protein content in rice, almond, and other alternative milks typically remains low at one to two grams per serving, and many commercial varieties often include added sugars. Unsweetened versions serve as better choices.

Catsos identifies lactose-free cow’s milk as the best nutritional choice for individuals with lactose intolerance, providing eight grams of protein and 300 milligrams of calcium per cup. Goat’s milk provides slightly less lactose than cow’s milk and serves as another alternative that some patients tolerate more easily.

“I would only advise avoiding cheese where the main ingredient is coconut oil,” Lisa Simon, a registered dietitian in London, said. Research indicates these options contain higher levels of saturated fat and sodium.

“It’s really helpful to work with a dietitian or with your physician to understand which nutrients you are likely deficient in, so that you can decide what you may need to supplement,” Medlin said.

Disclaimer: The information provided in this article is for educational and scientific communication purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider regarding any medical condition, diagnosis, or treatment plan.