If you’re lactose intolerant, you may cringe at the thought of eating dairy products.

But there’s really no need. In this day and age, there are plenty of nutrient-rich dairy products you can enjoy, without suffering the all-too-familiar consequences.

Here are answers to some of the most frequently asked questions about lactose intolerance.

What is lactose?

Lactose is the naturally-occurring sugar found in milk and most dairy products.

What does it mean to be “lactose intolerant?” 

Most people have an enzyme in their gut called lactase, which helps to break down lactose during digestion. People with lactose intolerance don’t have enough lactase to fully digest lactose, so eating dairy products can cause digestive distress like stomach aches, bloating, gas and diarrhea.

Is lactose intolerance the same as being allergic to milk?

No. These two conditions are completely different. Lactose intolerance refers specifically to the lactose (sugar) component of milk, whereas milk allergies are a reaction to the protein component of milk. Here’s more on the difference between an intolerance and allergy.

Do you have to avoid all dairy if you’re lactose intolerant?

Not necessarily. Different people have different levels of sensitivity, so if you’re lactose intolerant you may need to do some experimenting to see which foods you can best tolerate. Some people choose to give up dairy products altogether, but since dairy is a great source of naturally-occurring calcium and protein, it can be healthy to keep some dairy in your diet. Looking for lactose free dairy products is a great place to start.

What can you eat if you’re lactose intolerant?

1. Yogurt.  Most people with lactose intolerance can eat yogurt. The good bacteria (live, active cultures) found in yogurt will help digest the lactose for you.  Choose a high quality yogurt (here’s a guide to help) with very few ingredients or Greek yogurt, which has very little lactose.
2. Kefir. If you haven’t had kefir before, it’s kind of like drinkable yogurt, but with even more probiotics for even better digestion.
3. Aged cheeses. The harder a cheese, the less lactose it has.  Lactose is found in the watery part of milk, and since harder cheeses have less liquid, that means they contain less lactose.  Extra sharp cheddar, Parmesan, Pecorino, aged gouda and other very hard cheeses have essentially no lactose.
4. Lactase-fortified dairy products.  Lactaid is the most well-known example in this category, but there now quite a few other cheeses, yogurts, and ice creams that are fortified with the lactase enzyme, so people with lactose intolerance can digest them.
5. Low-fat dairy products in small amounts. Low-fat dairy like low-fat milk and cheese tend to be easier on the system when eaten in small amounts and/or combined with other foods at a meal. (These foods are also higher in protein and calcium than their high-fat counterparts). Finding the foods that work for you may just be a matter of trial and error, so start slow.
6. Dairy products eaten with a lactase pill.  Some people find lactase enzyme pills more effective than others, but they’re worth a try.  Pop a lactase pill 30-60 minutes before consuming dairy to see if this method works for you. (Note: it probably won’t work if you take lactase and then down a huge banana split, but it may be effective for eating a small serving of milk with your cereal).

What foods should be avoided?

1. Large serving sizes of dairy products. Even if you’ve found a food that doesn’t cause bad symptoms, it’s still best to eat it in small portions. Your body is more likely to tolerate dairy if you eat only a little at a time.
2. Very high fat dairy products like ice cream, soft creamy cheeses and cream (or foods made with cream). These actually have less lactose than low-fat products, but tend to be more irritating to those with lactose intolerance or who are sensitive to rich foods. The one exception here is aged cheese, which is high-fat but low-lactose.
3. Whey protein concentrate. This is a doozy, because it’s added to a lot of foods to make them seem richer and creamier.  But it can wreak havoc on a lactose intolerant person’s system (and on a normal person’s system), because it often contains concentrated lactose.
4. Soft-serve ice cream/frozen yogurt. This is mostly because of reason #2.  Many soft-serve desserts, smoothies, and protein shakes have significant amounts of whey protein concentrate, and will cause major digestive distress. If you love ice cream-style desserts, buy real frozen yogurt from the grocery store (Stonyfield, Julie’s Organic, and Straus Family Creamery all contain live active cultures that will help you digest) or make it yourself.

Thinking about using milk alternatives?  Here’s everything you need to know about which of them offer the best nutritional bang for your buck.