One of the many reasons people love the Ketogenic lifestyle is all the dairy. As long as you have no allergy or sensitivity, real cream, rich cheeses, and full fat, thick yogurts can all be a part of a well-formulated Ketogenic diet.

Be mindful though as not all forms of dairy are keto friendly and not everyone can tolerate dairy products in their diet, ketogenic or not.

Dairy products are primarily made up of water, protein, fat, and lactose (a milk sugar), in various quantities. The acceptability of any dairy product on a Ketogenic plan depends entirely on that composition. Milk products that are low in lactose content but high in fats and proteins are generally more acceptable, whereas dairy that is higher in both water and lactose are best avoided. You will want to steer clear of anything that is low fat, including yogurts and cheeses, and products, that are made with 2%, 1%, or skim milk.

Why Some People Avoid Dairy

There are a variety of reasons people remove dairy from their diet, including allergies, intolerance, inflammation, issues with digesting dairy, autoimmune conditions, and skin conditions. Interestingly, many of these concerns are rooted in a handful of issues:

Casein Reactions

Most dairy issues are a result of the immune system having an adverse reaction to one single protein element found in dairy - casein. Casein protein is one of the more reactive foods for people who are struggling with their immune health. When you are unable to digest casein, your body identifies the protein as a foreign invader, and the immune system gets fired up to defend itself. This is also why intolerance to casein can contribute to intestinal permeability or “leaky gut”.

Lactose Intolerance

The other common perpetrator of dairy intolerance is lactose, the main sugar in milk. People with lactose intolerance don’t produce the enzyme lactase, which breaks down lactose so it can be digested. When lactose-intolerant people consume dairy, the lactose in that dairy ferments in the gut, creating digestive distress in the form of gas, bloating, and diarrhea.

Why Some Dairy-Tolerant People Avoid Dairy on Keto

One common mistake people make when they start keto is upping their dairy intake — low-carb pizza crusts made with mozzarella, creamy sauces on everything, blocks of cheddar packed away as a snack, heavy cream in coffee, crackers made of parmesan.

The thing is, the wrong dairy foods can be some of the most inflammatory foods you’ll eat, which takes away from all of the benefits of keto.

Some people remove dairy from their keto diet simply because they are struggling to lose weight while continuing to eat dairy.

Surprise Intolerances

Some people on a keto diet experience a significant glucose spike or ketone decline when they consume dairy–even if they’ve never been known to have issues with dairy. For anyone using keto for weight loss, this may be enough reason to delete dairy from the diet.

How to Tell if You Should Avoid Dairy on a Keto Diet

If you feel you already have reactions to dairy before starting a keto diet, it’s a good idea to continue on the dairy-free track. If you’re not sure how you tolerate dairy, the only way to find out is by testing your blood glucose and ketones for abnormal responses. If your glucose spikes or your ketones fall significantly after eating dairy, it’s a good indication that dairy doesn’t agree with you.

Types Of Dairy

There are several different types of dairy, and it is important to know what they are so you can discern whether or not they suitable for your ketogenic lifestyle.

Milk & Cream

This encompasses both milk (all categories of fat as well as raw) and cream.

Milk, even raw and whole milk, is mostly water. Milks with lower fat content have more sugar per serving than whole milk. When the fat is removed from the milk, you need more of the remaining liquid to obtain the same size serving and so the less fat in the milk, the more of the leftover sugary water you get. The fat content of whole cow milk is generally around 3.2%, and it contains slightly under 8 grams of both fat and protein and about 12 grams sugar per one cup serving, making it a poor choice. Goat’s milk is also a poor choice, coming in at 10 grams fat, 9 grams protein, and 11 grams carbohydrate per cup.

Raw milk is unfortunately no better. The general consensus amongst producers and connoisseurs is that it contains approximately 9-10 grams fat, 9-10 grams protein, and 12 grams sugar per one cup serving, making its macronutrients almost identical to processed whole milk.

Whole milk may, however, be used to make home-made fermented products and cheeses, as desired.

Cream is obtained by allowing whole milk to rest, during which time the butterfat (cream) in the milk rises to the top in a layer and is skimmed off. Heavy whipping cream (or heavy cream), can vary a bit in fat content but it is generally between 30-35% fat. A one cup serving contains almost 86 grams fat, just under 7 grams protein, and only 6.9 total sugars. Typically, you don’t need or use as much to achieve similar results as milk, and an average serving size is much smaller (tablespoons versus cups). The high fat, low sugar content make cream an excellent ketogenic choice.

Double cream is readily available in many areas of the world. Double cream is actually slightly higher in fat content than heavy cream (around 40% compared to mid-30%) and is an excellent alternative when the latter isn’t widely available. It contains approximately 120 grams fat per one cup serving, and has a similar protein and sugar content to heavy cream.

Half-n-half or coffee cream is a type of cream often used in coffee and tea. It is composed of half cream and half milk, which both raises the sugar and lowers the fat content considerably. One cup contains 25 grams fat, 7.6 grams protein, and a total of 11.4 carbs, 10 of which are sugar. Light cream has a similar nutrient profile. Half-n-half and light creams are probably more of a ‘grey zone’ for ketogenic diets. I recommend using heavier creams (which you can thin out with water if needed for texture), however if you are in a location where this is your only option, half-n-half or a light cream is acceptable to use upon occasion.

Fermented Dairy

This includes milk products like yogurt or kefir. Fermented milk products may or may not be acceptable on a Ketogenic diet for those with severe insulin resistance, depending on personal tolerance levels.

While these products are made from milk, the sugar content of the end product is greatly reduced. During fermentation, microorganisms feed off the lactose in the milk and leave behind lactic acid as waste (the increased acidity is what gives these products their sour taste), thickening it in the process. In fermented milk products that are made from whole milk, the vast majority of the milk sugar is “consumed” during this process, leaving a relatively low carbohydrate count. A one cup serving of full fat, plain Greek yogurt contains approximately 8 grams fat, 22 grams protein, and 8 grams sugar.

As long the fermented milk product is made from full fat milk and does not contain added sugars or flavorings, these products may be enjoyed these foods in small quantities.

Sour Cream

Sour cream is made in a similar fashion to other fermented milk products, however it begins with fattier cream instead of thinner milk. Full fat sour cream has very little lactose left over after fermentation, and therefore may be enjoyed regularly. One cup of full fat sour cream contains a little over 44 grams fat, 5 grams protein, and a hair under 8 grams sugar. Since portion sizes tend to be smaller, sour cream can be considered acceptable on a ketogenic plan.

Buttermilk

Buttermilk was originally the liquid leftover and drained off after churning cream into butter. Now-days buttermilk is actually a cultured milk product as it is partially fermented by bacteria cultures and has a sour or acidic taste. This cultured buttermilk is made with low fat milk, and beginning and ending the fermenting process with a much higher sugar content. The finished product still has a substantial amount of lactose left behind. Both original and cultured buttermilk have a similar macronutrient profile to whole milk and are not keto friendly foods.

Evaporated and Condensed Milks

These are products that begin with milk and are cooked for extended periods at lower heat in order to allow much of the water content to evaporate. The longer the milk cooks, the more condensed it becomes. These products are both very high in sugar and should be avoided. Evaporated milk contains 19 grams fat, 17 grams protein, and 25 grams sugar per cup. Condensed milk is almost universally sweetened and contains 26 grams fat, 24 grams protein, and a whopping 166 grams of sugar in one cup.

Don’t use condensed milk!

Cheese

Cheeses are made in a relatively similar way to fermented milk products. In cheese making, the protein content of the milk is allowed to coagulate, and various types of bacteria or mold are used (depending on type of cheese) which then feed on the lactose and, over time, raise the acidity of the product by leaving behind lactic acid as waste. The water content is then drained off and the solids are pressed into molds.

The nutrient content of cheese can vary pretty widely depending on type, making it more difficult to give a definite set of nutrition parameters. In general, the hard cheeses (Cheddar, Parmesan, Gouda) will have the most consistent carbohydrate content across types, usually coming in at around 1g carb per ounce (a typical serving). Soft cheeses vary in carb count (0.6 carbs per ounce for whole milk mozzarella, for example) and are also acceptable. As always, you only want to use full fat cheeses.

Cottage cheese is technically a cheese product made by curdling cheese, and then only lightly pressing it so some of the liquid whey remains. Full-fat cottage cheese (which is very challenging to find) tends to contain a little over 4 grams of fat, and 3 grams total carbohydrate (2.67 grams of which are sugar) per 100 gram serving. The carb count is similar, per ounce, to other cheeses, making it an acceptable choice as long as you’re not consuming low-fat or fat-free versions, both of which contain around double the carbs per serving.

Butter

Butter is made from churning cream and draining off the water content (buttermilk) that separates. The small amount of lactose that was originally in the cream is almost entirely left behind in the drained off buttermilk, making butter pretty much pure fat. It contains 184 grams fat, almost 2 grams protein, and a minuscule 0.1 grams sugar (the carb total) in one cup.

Ghee is butter that has been clarified and has the milk solids removed. It has a very nutty, toasted flavor because the butter is heated for a time during this process. The macronutrient content of ghee is almost identical to butter.

Butter and ghee are fat powerhouses, very keto friendly and can often be consumed by those intolerant to other dairy products. Be sure to experiment.

Dairy can definitely be a part of a well formulated ketogenic lifestyle. You do, however, need to self-experiment and determine how you feel with it, and how (and if) your body weight fluctuates when you eat different types of dairy.

If you don’t digest some types of dairy very well, going dairy-free will also help you. You can always slowly reintroduce them one by one (by giving yourself a few days between each new product you try) to see what are the right types and quantities of dairy for you and your digestive system.

Knowledge is power, so stay informed and stay keto!

Food Freedom Friday Edition 220 - Keto & Dairy