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Patients who are lactose intolerant primarily avoid milk products because lactose intolerance occurs when the body lacks adequate levels of lactase, the enzyme necessary to digest lactose, the sugar found in milk and dairy products. When these individuals consume milk products, they may experience gastrointestinal symptoms such as bloating, diarrhea, gas, and abdominal pain due to the undigested lactose fermenting in the gut.

In contrast, gluten is a protein found in wheat and related grains and is specifically relevant to individuals with celiac disease or gluten sensitivity, not lactose intolerance. Nightshade vegetables include tomatoes, potatoes, and eggplants, and they do not contain lactose, making them safe for those who are lactose intolerant. Soy products, while they may be avoided by some people for various reasons (such as allergies or personal dietary choices), do not inherently contain lactose and can often be consumed by those with lactose intolerance. Therefore, the primary food group that individuals with lactose intolerance should focus on avoiding is milk products.