Jeanette M. Newton-Keith, MD

What's the best way to build up tolerance to milk and dairy products?
The best tips for tolerance include consuming milk with other foods in a meal, such as protein and fat. I recommend starting with a quarter to half cup and gradually increasing it. Cooking with milk is the best place to start. For example, adding a few tablespoons of skim milk to scrambled eggs. Later, as you build your tolerance, start having milk on cereal. I recently worked with a woman who had not consumed milk for over 20 years because of lactose intolerance. She started with 2 tablespoons of milk in foods and increase the amount over several weeks.

How long does it take for lactose sensitive people to build up their tolerance of milk and dairy products?
It depends on the person. In a study at Purdue University of girls who did not tolerate lactose, 7 out of 10 were tolerating dairy foods at the end of 21 days without symptoms.

What about taking a calcium supplement?
It's a substitute, but not an equal substitute. Not all of supplements contain vitamin D, magnesium and the other nutrients that you get from consuming dairy foods. Some studies show that they may be less effective in preventing chronic diseases, and for some, they're too expensive. Also, kids will do as you do, not as you say. If parents aren't consuming dairy foods, kids are much less likely to consume them. It's also important to balance the whole diet. A diet that combines nutritious foods is a diet you can live with the rest of your life.

Is it true that flavored milk is better tolerated than white milk?
I actually suggest that people try flavored milk as long as it is reduced fat. Before age 2, children need the fat, but as they grow, their fat requirements are less. Low fat, reduced fat and fat free flavored milk are reasonable. One study showed that when kids drank flavored milk, it replaced more sugary beverages, such as soda. Their total calories did not increase appreciably, but the nutrient quality of their diet was greatly improved.

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