Which yogurts are low FODMAP (lactose)? Dietitian Q&A

Regular yogurt, greek yogurt, lactose-free yogurt, coconut yogurt… There are so many yogurts available in grocery stores now. For individuals with digestive troubles who are lactose intolerant or following the low FODMAP diet, it can be tricky to figure out which yogurts are best to eat. Here is a comprehensive guide to finding a low lactose and low FODMAP yogurt. Please note that this blog post is for educational purposes and does not replace individualized advice given to you by a health care provider.

LACTOSE

I’ve written about lactose before in my “Why is Butter Low FODMAP?” blog post. Just like that butter post, I’m going to start with a brief explanation of lactose.

Lactose is the sugar naturally found in most dairy products, including milk, yogurt and cheese.¹ The enzyme lactase is needed to break down lactose in our small intestines so it can be absorbed. ² Lactose intolerance occurs when we do not have enough lactase in our small intestine to break down the lactose we eat.¹ When lactose is not digested and absorbed it stays in the digestive tract.² Once it reaches the large intestine it is fermented by bacteria and may cause digestive symptoms.²

Lactose is one of the five types of FODMAPs.³ FODMAPs are all carbohydrates that are poorly absorbed, highly fermentable in the large intestine and may trigger IBS symptoms.³ The low FODMAP diet is used by dietitians to help their clients identify if any FODMAPs trigger digestive symptoms. ³

On the low FODMAP diet, only small amounts of FODMAPs are allowed. Monash University’s limit for lactose is maximum 1 gram in a serving to stay low FODMAP.⁴ Only certain yogurts are below this lactose limit.

REGULAR YOGURT

It’s important to note that the lactose content of dairy products varies a lot. Regular milk and yogurt are quite high in lactose, while hard cheeses and butter contain very little. (Note: click here to learn more about butter and cheese). One cup (250mL) of regular milk contains on average around 12-13 grams of lactose.⁵ Yogurt contains slightly less lactose, at on average around 8-11 grams of lactose per cup (250mL). ⁵

There is a fairly simple way to determine how much lactose is in your yogurt: use the Nutrition Facts Table (NFT). As mentioned above, lactose is a sugar naturally found in dairy products. If we look at a NFT for a plain yogurt, we can see how much lactose is in the yogurt by examining the sugar section. Let’s take this yogurt as an example. We can see that per serving it contains 15g of sugar (lactose per serving). Easy, right? This method works great for plain yogurts, but does not work for yogurts that have sugar and/or fruit added.

If a yogurt has sugar or fruit added we cannot know what percentage of the sugar listed on the NFT is lactose. For example, this strawberry yogurt has 16g of sugar in one small container. The ingredients list includes cane sugar and strawberries. It’s impossible to know exactly how much of the 16g of sugar is lactose and how much is from the added ingredients

Regular yogurt clearly has more lactose than the recommended limit of 1 gram per serving. Despite the high lactose content, it is commonly reported that yogurt is often better tolerated than milk.⁶ This is likely due to the fact that the bacterial cultures in yogurt ferment (aka break down) some of the lactose, making it easier to digest.⁷ However, we cannot know exactly how much of the lactose is broken down and how much is left. That is why regular yogurt is not recommended on the low FODMAP diet during elimination.

GREEK YOGURT

Next up is greek yogurt, which is very popular right now due to its high protein content. But what about its lactose content?

Greek yogurts are thicker than regular yogurts, and many are lower in lactose. There are many different brands of greek yogurt on the market. Monash University has not yet tested greek yogurt (last updated Aug. 2018). Based on the yogurts I examined in my local Ontarian grocery stores, greek yogurt seems to have on average about one-third less lactose than regular yogurt. Here are a couple examples of plain greek yogurts I found (pictures taken on my phone, apologies for the lower quality).

Those examples have approximately 5.5-8g of lactose per cup. Even though greek yogurt is often lower in lactose, it is typically not low enough for Monash University’s cut-off of 1 gram.

Please note that a dietitian’s job during nutrition counselling is to customize the low FODMAP diet for their client to best suit their needs. Your dietitian may or may not recommend eating greek yogurt during elimination. Always listen to your health care provider over what you read on the internet.

LACTOSE-FREE YOGURTS

Since the food industry knows that many people are lactose intolerant, they are creating more and more yogurt options that are lactose-free. Making lactose-free yogurt is pretty simple. The manufacturers just need to add lactase, the enzyme that breaks down lactose, and the result is a completely lactose-free yogurt. If you see a yogurt that is labelled lactose-free, lactase will be listed in the ingredients list. Lactose-free yogurts taste almost the same as regular yogurts (the taste might be slightly sweeter).

It’s important to note that if you look at the Nutrition Facts Table of a lactose-free yogurt, it will still list sugar. However, this sugar is okay as we know the lactose is already broken down into simple sugars that are easy to digest. For example, this plain lactose-free yogurt has 4g of sugar per serving, but since lactase is in the ingredients list, it is low FODMAP.

Even when a yogurt is labelled lactose-free, you still need to read the ingredients list to ensure it is low FODMAP. In particular, the flavoured versions commonly have high FODMAP ingredients added. Some common ingredients you need to look out for are high FODMAP fruits, honey, fructose, inulin/chicory root extract, glucose-fructose, and sorbitol. It can be simplest to just buy a plain lactose-free yogurt and add your own fruit, a sprinkle of cinnamon and maybe a drizzle of maple syrup.

COCONUT YOGURT

We now have one more option for low FODMAP yogurts. Monash University has recently tested coconut yogurt and found it to be low FODMAP at 125g (1/2 cup). This is a great option for those who are vegan or allergic to milk. Just like lactose-free yogurt, make sure to read the ingredients list and choose a yogurt without any high FODMAP ingredients such as inulin. Here is one example.

GOAT’S MILK YOGURT

Monash has tested goat’s milk yogurt and found it to be low at 1 tub (170g). Just like the other yogurts, read the ingredients list to check for any added high FODMAP ingredients.

LACTASE SUPPLEMENTS

You may have seen lactase supplements for sale in pharmacies. These supplements can be very helpful for managing lactose intolerance. They are taken moments before consuming dairy to help break down the lactose. I typically recommend clients to purchase lactose-free dairy products to use at home and save the lactase pills for when they are eating out. Talk to your dietitian to learn if they are the right option for you. Just like yogurt, some lactase pills have added FODMAPs. Read the ingredients to check to see if it has any mannitol, sorbitol, inulin, etc.

Lactase supplements aren’t always effective. This blog post by dietitian Patsy Catsos breaks down all of the possible reasons why.

Click here to read my blog post all about digestive enzymes and IBS.

FINAL THOUGHTS

You might be wondering, aside from FODMAPs, which yogurt is healthier. If you are trying to decide between coconut and dairy, I recommend lactose-free dairy. Coconut yogurt has less than a gram of protein, while dairy yogurt is packed with protein, making it more filling. I also recommend buying the plain version to avoid lots of added sugar.

To wrap up, yogurt is nutritious and delicious, and there is no need to completely avoid it if you are lactose intolerant. Lactose-free yogurt and coconut yogurt are low FODMAP options. Remember, when buying your yogurt always read the ingredients to check for sneaky added high FODMAP ingredients.

During the elimination phase, it is important to be cautious about serving sizes. and stay below the recommended limits. However, the reintroduction phase is the chance to learn your personal FODMAP tolerance levels. Most individuals tolerate much more than 1 gram of lactose per serving. Reintroduction is the only way to know exactly how much lactose you can eat before you experience symptoms.

What is your favourite way to eat yogurt? I love my yogurt with strawberries and a drizzle of maple syrup. You can also try out these recipes which use yogurt!

Strawberries and Cream Oatmeal

Carrot Ginger Soup

Strawberry Raspberry Yogurt Popsicles

Tzatziki Dip (Available in my Low FODMAP Snacks Ebook)

 

 

REFERENCES

1. Eat Right Ontario, 2016. https://www.eatrightontario.ca/en/Articles/Food-allergies-intolerances/Managing-Milk-Allergies.aspx
2. National Institute of Diabetes and Digestive and Kidney Diseases, 2014. https://www.niddk.nih.gov/health-information/digestive-diseases/lactose-intolerance
3. Sue Shepherd, 2017. http://shepherdworks.com.au/disease-information/low-fodmap-diet/
4. Alana Scott & Joanna Baker, 2016. https://www.alittlebityummy.com/blog/lets-talk-about-dairy-and-the-low-fodmap-diet/ 
5. Dietitians of Canada, 2013. https://www.dietitians.ca/Your-Health/Nutrition-A-Z/Lactose/Food-Sources-of-Lactose.aspx
6. Nutrition Australia, 2011. http://www.nutritionaustralia.org/national/resource/lactose-intolerance
7. Dairy Farmers of Canada, n.d. https://www.dairygoodness.ca/yogurt/how-yogurt-is-made