In recent years, lactose in the diet has become one of the most controversial topics when discussing digestive health, inflammation, and overall well-being. While some people completely eliminate dairy products at the slightest discomfort, other experts insist that, in the absence of a true intolerance, removing them without reason may not make any nutritional sense.
In Spain and much of Europe, where consuming milk, yogurt, and cheese is part of daily life, conflicting messages abound regarding whether dairy products are necessary , dispensable, or even harmful . Nutritionists and digestive system specialists agree that the key lies in distinguishing between those who digest lactose well and those who suffer from a confirmed intolerance, as well as understanding that dairy products are a useful, but not essential, food group.
Lactose, inflammation and microbiota: what nutritionists say
One of the voices most actively trying to bring order to this debate is that of nutritionist Cristina Capella , who works daily with people suffering from chronic fatigue, indigestion, and a feeling of "brain fog." She describes this condition as a low-grade inflammation that persists silently , in which the immune system functions like an alarm that never quite shuts off.
According to Capella, this prolonged inflammatory state can lead to digestive problems, changes in the gut microbiota , and an increased risk of cardiovascular disease , in addition to affecting mood and causing anxiety. In her practice, she observes that many people directly attribute these discomforts to lactose without prior professional evaluation.
The nutritionist insists that there are many myths surrounding lactose in the diet and that it isn't always the culprit behind all symptoms. She reminds us that, in people without a diagnosed intolerance or allergy, there's no reason to eliminate dairy products preventively. In fact, she emphasizes that yogurt and many cheeses contain little lactose thanks to fermentation, so they are usually better tolerated even in cases of some sensitivity.
Capella advocates a comprehensive approach to digestive health, based on five pillars: a diet rich in fresh foods, fiber, and healthy fats ; daily exercise that helps generate anti-inflammatory substances; emotional management; restorative sleep; and adequate levels of vitamin D, which she refers to as "the inflammation switch." In this general context, lactose is just one piece of the puzzle, and not necessarily the most important one.
In their opinion, completely eliminating dairy products without a justified reason leads to losing accessible sources of quality protein, calcium, and vitamins A and D, something especially relevant in certain population groups if there is no good alternative dietary planning.
Are dairy products essential in a healthy diet?
Contrary to the traditional idea that "without dairy there is no health," some nutrition and food technology experts offer a more nuanced perspective. Food communicator and technologist Aitor Sánchez points out that, from a scientific standpoint, an essential food is one without which the body cannot function , and dairy products do not meet that condition.
Sánchez cites as an example millions of people in different parts of the world, especially in regions of Asia and other areas where milk consumption is minimal , who have enjoyed normal health for generations without including dairy products in their regular diet. For him, the problem isn't consuming them, but rather assuming they are mandatory regardless of the circumstances.
One of the classic arguments in favor of dairy products has always been their high calcium content . However, the food technologist points out that this mineral is also found in other products such as legumes, nuts, seeds, leafy green vegetables, small fish eaten with the bones, and fortified foods. In other words, calcium is not exclusive to milk , and a person can meet their daily needs without consuming any dairy products if their diet is well-planned.
Furthermore, the actual absorption of calcium doesn't depend solely on its presence in food. Factors such as vitamin D, physical activity, hormonal status, and gut health influence how the body uses it. Therefore, focusing solely on milk as the guarantee of strong bones can lead to an overly simplistic view.
From this perspective, dairy products are understood as just another food group: interesting if they are well-tolerated and fit the person's preferences , but perfectly dispensable if one prefers to do without them for digestive, ethical, cultural or economic reasons, as long as the key nutrients are covered by other sources.
Lactose intolerance: causes, symptoms and types
Lactose intolerance is likely the main reason why many adults experience bloating, gas, and diarrhea after consuming dairy products . This condition is due to reduced lactase activity , the enzyme responsible for breaking down milk sugar, which typically declines naturally with age.
Digestive system specialists explain that when lactase is lacking, lactose reaches the colon virtually intact, where it is fermented by intestinal bacteria . This process generates gas and other byproducts that cause symptoms such as bloating, intestinal noises, pain, a feeling of heaviness, and even diarrhea. These discomforts usually appear between 30 minutes and two hours after consuming milk or other dairy products containing lactose.
Experts distinguish between two main types of lactose intolerance. First, there is the genetic or primary form , which is linked to a progressive decrease in lactase production over time and is very common in the adult population. Second, there is the secondary or acquired intolerance , which appears after damage to the lining of the small intestine, for example, following severe intestinal infections, prolonged episodes of acute diarrhea, or poorly controlled conditions such as celiac disease.
In the case of acquired lactose intolerance, the good news is that it is often reversible if the underlying problem is addressed and the gut is allowed to regenerate. The ability to digest lactose can improve over time, increasing the tolerance threshold for small amounts of dairy.
To confirm the diagnosis, intuition or simply abstaining from milk for a few days is insufficient. Tests such as a detailed medical history, a hydrogen breath test , specific genetic studies, or, in selected cases, biopsies obtained via endoscopy are used . All of these help to differentiate lactose intolerance from other digestive disorders that can produce similar symptoms.
Beyond lactose: dairy proteins, additives and other causes of discomfort
Not all discomforts related to dairy consumption are caused by lactose. Some patients have a specific sensitivity to casein , the main protein in cow's milk, especially to certain variants such as A1, which is very common in modern dairy cattle in Europe.
In these situations, the person may experience gas, bloating, or abdominal pain even with low-lactose products, because the problem lies not in the milk sugar itself but in the inflammatory response to the protein . This sensitivity to dairy proteins should not be confused with a milk protein allergy, which is a different and potentially more serious condition requiring more rigorous evaluation by an allergist.
On the other hand, some additives present in highly processed dairy products , such as certain gums or thickeners used to improve texture, can irritate the intestines of sensitive individuals. Ingredients like carrageenan, guar gum, or xanthan gum, common in light products, dairy desserts, or beverages with long ingredient lists, can also contribute to discomfort mistakenly attributed to lactose.
All of this explains why, sometimes, changing the type of dairy product, improving its quality, or choosing versions with fewer ingredients can reduce discomfort without completely eliminating this food group. A plain yogurt without added sugar or thickeners can be very different from a sugary dairy dessert with various additives, even if the label includes the word "dairy."
Therefore, specialists insist that it's best to avoid hasty self-diagnosis . For recurring discomfort, it's preferable to consult a doctor or a registered dietitian nutritionist to rule out more serious conditions and develop a personalized strategy, rather than relying solely on the complete and permanent elimination of dairy products on one's own initiative.
How to manage lactose in your diet according to your personal tolerance
When an intolerance is confirmed, the goal doesn't necessarily have to be to eliminate all traces of lactose for life. Many specialists recommend a flexible approach, adjusting the quantity, type of product, and timing of consumption to reduce symptoms and, if desired, maintain some of the nutritional benefits of dairy products.
One of the most common strategies is to use products labeled "lactose-free ," in which the lactose has already been broken down into simple sugars to make it easier to digest. These foods allow you to continue enjoying milk, yogurt, or fresh cheese much more easily, something that is simple in Spain thanks to the wide variety available in supermarkets.
It is also suggested to take advantage of the fact that yogurt and aged or very mature cheeses contain much lower amounts of lactose . Fermentation significantly reduces this sugar, so some lactose-intolerant people can consume them in small portions with little discomfort, especially when eaten with other foods and not on an empty stomach.
Another common guideline is to divide dairy intake into small portions throughout the day instead of consuming one large serving at once. This distribution can increase the tolerance threshold and minimize digestive problems, especially in cases of partial intolerance.
In any case, if you decide to almost completely eliminate dairy products, it is important to ensure a good intake of calcium, protein and vitamin D through other sources : legumes, nuts, seeds, leafy green vegetables, fortified plant-based drinks, small fish with bones or supplements prescribed by a professional when necessary.
Inflammation, lifestyle, and the real role of lactose
The conversation about lactose in the diet cannot be separated from the overall context of lifestyle . Both Capella and other specialists point out that the combination of sedentary behavior, excessive consumption of ultra-processed foods, high stress levels, and poor sleep is altering our gut microbiota and promoting low-grade inflammatory conditions.
In this scenario, it's easy to blame dairy or lactose alone for any indigestion , when often the problem stems from a combination of factors: large meals, excess sugar, insufficient fiber, alcohol, lack of exercise, or even poor anxiety management. Reviewing your entire eating pattern and habits is usually more effective than eliminating a single food.
Furthermore, the relationship between an imbalanced gut microbiota, obesity, and emotional health is being studied in increasing detail in Europe. It is known that an unhealthy gut can have a lower tolerance for many foods , including dairy, but this does not necessarily mean that lactose is the root of all problems. Sometimes, improving overall gut health can increase tolerance to small amounts of lactose.
Some professionals also incorporate tools such as overnight fasting of about 12 hours (for example, eating dinner early and not eating again until breakfast) to facilitate the cleansing and regeneration processes of the digestive system without triggering food cravings. These types of moderate approaches are always evaluated according to each person's circumstances and do not replace a specific analysis of symptoms.
Ultimately, the actual role of lactose in inflammation and digestive discomfort must be analyzed on a case-by-case basis, avoiding generalizations such as "dairy is always bad" or "everyone should consume it." Current evidence suggests that there is no single solution that works for everyone.
With the information available today, the message repeated among nutritionists and digestive specialists is that it is neither an obligation nor a universal enemy : those who do not present symptoms or a diagnosed intolerance can continue to consume dairy products without problem within a healthy eating pattern, while those who do suffer discomfort have alternatives available such as lactose-free products, yogurts and aged cheeses or well-planned dairy-free diets that ensure the intake of calcium, proteins and key vitamins, always with the support of a health professional.
