Which cheeses are low in lactose? Aged hard cheeses vs fresh and soft

Hard, aged cheeses are the lowest in lactose. The NIDDK suggests that people with lactose intolerance try hard cheeses, like cheddar or Swiss, which are lower in lactose than other milk products. Monash University lists hard cheeses among its low-FODMAP dairy options, while soft cheeses are on its list of dairy foods high in lactose.

One important exception: if you have a milk allergy, this guide’s lactose advice doesn’t apply. A milk allergy is a reaction to milk protein, not milk sugar, so no cheese is suitable, including lactose-free cheese. More on that below.

Here is how cheese usually comes out for the conditions where it matters. "Typical answer" is what SafeBelly usually shows for a plain cheese at a typical portion; your own answer depends on the conditions you pick, the cheese and the amount.

Lactose is the natural sugar in milk. Cheese starts as milk, but the finished product can hold very different amounts of lactose depending on how it is made and how long it is aged. That is why a mature cheddar or Parmesan behaves very differently from a fresh ricotta, even though both come from milk.

Monash makes the same point from the other direction: there are many dairy foods that are naturally low in lactose, for example butter and cheese, so a lactose-reduced approach doesn’t have to be dairy-free.

As a rule of thumb, the sources above point the same way: hard, aged cheeses sit at the low end, and fresh, soft cheeses sit higher. Here is how common cheeses tend to group:

Monash holds the current tested serving sizes in its app, and we don’t reproduce them here. Our guide to FODMAP portion sizes explains why the amount on your plate changes the answer.

Lactose tolerance is a range, not a switch. The NIDDK notes that most people with lactose intolerance can have some lactose without symptoms, and that many people could have 12 grams, about the amount in a cup of milk, with no or mild symptoms.

• Spread it out. Monash notes that splitting dairy into smaller portions across the day, and having it with a meal, can help tolerance.
• Watch the stack. A cheese plate, a creamy sauce and a latte in one meal add up. A hard cheese grated over pasta is a very different dose from a bowl of ricotta.
• Mixed dishes. Lasagna, cheesecake and cheese sauces often combine soft cheese with milk or cream, which raises the total lactose.
• Lactase. The NIDDK lists lactase products as one way to help digest lactose. Ask your pharmacist or clinician which product and dose suits you.

Often not. Monash calls it a common misconception that dairy has to go on a low-FODMAP plan: lactose only needs limiting if you have lactose intolerance. That makes cheese one of the easier dairy foods to keep, because many hard cheeses are naturally low in lactose.

• Lactose intolerance is a spectrum. Monash cites research suggesting many people with lactose intolerance can tolerate up to two cups (500 ml) of regular milk a day, split into smaller amounts.
• Building up may help. Monash notes some evidence that starting small and building up over time may improve lactose digestion.
• Lactose-free products are nutritionally similar. Monash says lactose-free dairy contains the same important nutrients as regular milk, though it usually costs more.

For the wider FODMAP picture, start with our low-FODMAP guide for IBS.

The NIDDK is clear that lactose intolerance is different from a milk allergy: a milk allergy is an immune system disorder. The reaction is to milk protein, and cheese keeps that protein even when the lactose is almost gone.

• Lactose-free cheese is not milk-free. Cedars-Sinai notes that lactose-free milk still contains milk protein and should be avoided with a milk allergy.
• Goat’s and sheep’s cheese are not alternatives. FARE explains that goat’s milk protein is very similar to cow’s milk protein and may cause a reaction.
• Read labels. Milk is one of the major allergens that must be named in plain language on US packaged foods, in the ingredient list or a "Contains" statement. Watch for casein and whey too.
• Carry your medication. FARE advises keeping epinephrine with you at all times if you have a milk allergy.

Our guides to lactose-free vs dairy-free and the major food allergens go into labels in more detail.

Plain cheese has a short ingredient list. The more processed the product, the more there is to check:

• Added milk ingredients. Spreads, sauces, "cheese food" and cheese powders can include milk, cream, milk powder or whey, which add lactose.
• Lactose-free labels. Useful for fresh cheeses, but Monash notes some products labeled lactose-free are already naturally low in lactose, so the regular version may suit you just as well.
• Gluten. Beyond Celiac says shredded cheese is usually gluten-free, but anti-caking starch, some cottage cheeses with wheat starch, cheese spreads and dairy-free cheeses made with flour are worth checking. Deli-sliced cheese can pick up gluten from shared slicers.
• Flavored cheeses. Herb and garlic varieties can bring other triggers; see hidden garlic and onion.

Ingredients change, so read the label every time you buy, even on a cheese you know.

• For lactose: swap a fresh cheese for an aged hard cheese, or choose lactose-free versions of fresh cheeses.
• For milk allergy: plant-based cheeses avoid milk, but check them for other allergens such as nuts, soy or wheat, and look for "Contains" statements every time.
• For histamine: a 2021 review in Nutrients found that every low-histamine plan it compared excluded cured cheese, and that 5% of the cheese samples it reported measured well above the average. It also found little agreement between plans on other foods, so work with a dietitian on your own list. See our histamine intolerance guide.

If cheese was a main source of calcium for you, ask a dietitian how to keep your intake up with fortified alternatives or other foods.

When to talk to a clinician. See a doctor if dairy seems to cause symptoms but you haven’t been assessed, since lactose intolerance shares symptoms with other conditions. Hives, swelling, vomiting or breathing trouble with dairy point to an allergy rather than intolerance and need an allergist. Call emergency services for trouble breathing or throat swelling. A registered dietitian can help with a plan that keeps enough calcium and variety in your eating, and our lactose intolerance guide covers the wider picture.