The Best Dairy Choices for Crohn’s Disease

While people with Crohn’s disease may not tolerate milk well, Sophie Medlin, RD, a consultant dietitian at City Dietitians and chair for the British Dietetic Association for London, says it doesn’t mean everyone should completely cut milk from their diet. “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.” Just be conscious of symptoms, Medlin advises, and if you think milk is making your symptoms worse, try eliminating it for two weeks and see if symptoms improve. Medlin stresses that while plant-based alternatives are good options, they aren’t as great as dairy.

“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, protein sources aren’t as good quality as what we get from dairy,” Medlin says. She recommends people with Crohn’s disease consider consulting with a dietitian or physician about cutting dairy milk for the long-term before making the transition.

If you decide to opt for a milk replacement, you don’t have to look farther than the shelves of your local grocery store. The American Society for Nutrition reports that almond, pea, and flaxseed milks contain more calcium per cup than cow’s milk. Lisa Simon, RD, a registered dietitian in London who works with PB Health Online, recommends going for fortified plant-based milk products, which have the bonus of extra vitamins and minerals.

Not all milk alternatives are good choices for those with Crohn’s, says Patsy Catsos, RDN, a dietitian in Portland, Maine, and author of The IBS Elimination Diet and Cookbook. “Soy milk is a frequent cause of gas and bloating,” says Catsos, “and rice, almond, and other alternative milks provide only 1 or 2 grams (g) of protein and often have added sugars.” Unsweetened versions of these milks usually don’t contain added sugars, though.

She recommends lactose-free cow’s milk as the best nutritional choice for most people with lactose intolerance: “It provides 8 g of protein and 300 milligrams of calcium per cup.” Goat’s milk has slightly less lactose than cow’s milk, per research, and some people find they tolerate it better.

RELATED: 10 Gut-Soothing Foods for People With Crohn’s Disease

Best Yogurt for Crohn’s Disease

A dairy choice with less lactose than milk is yogurt. Medlin explains that the bacteria in yogurt ferment the lactose, making it less of a carbohydrate-heavy product and better tolerated than other dairy products.

Yogurt is also a valuable source of nutrients as well as a natural source of probiotics (friendly gut bacteria), though Catsos cautions that it’s still important to choose carefully when selecting a yogurt in order to prevent a flare-up of Crohn’s symptoms. “Yogurt is a double-edged sword for people with Crohn’s,” she says.

Catsos recommends people with Crohn’s disease choose yogurts with less lactose. “Several brands of lactose-free yogurt have recently come on the market,” she says. “If you can’t get one of them, Greek yogurt is the next best thing.” Greek yogurt contains less lactose than other commercial yogurts and, as a bonus, has more protein per serving, according to an article from the American Dairy Association North East.

Best Cheese for Crohn’s Disease 

Cheese lovers with Crohn’s disease have options. “Natural cheeses may contain some beneficial bacteria, so we don’t want to demonize cheese or dairy. It can be really helpful for fighting diseases and a healthy part of the diet for someone with Crohn’s disease,” Medlin says.

Aged cheeses may be the best option, since a cheese’s lactose content tends to decrease as cheeses age, according to Self. Indeed, a review article reported that two weekly portions of aged cheeses that don’t contain lactose can be helpful in an IBD diet.

For alternatives to dairy, Simon recommends nut-based cheeses such as cashew cheeses and almond-based cheeses, including almond cream cheese. Just note that these nondairy cheeses typically contain less protein than dairy cheeses.

But there are certain cheeses you shouldn’t be eating. “I would only advise avoiding cheese where the main ingredient is coconut oil,” Simon says. To avoid coconut oil-based cheeses, read labels carefully. While you’re scanning the nutritional info, be sure to note the calcium content.

Stock Up on Calcium Supplements

Medlin says removing animal products from your diet increases your risk of becoming nutritionally deficient without the proper supplementation. The Crohn’s & Colitis Foundation recommends calcium supplements for all patients with IBD — especially if you’re taking corticosteroids, have low bone density, or have been diagnosed with osteoporosis (weak bones).

“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 says. Dr. Katz also suggests taking a calcium supplement with added vitamin D.