I believe the cream is better, from a carb point of view, but also a lactose point of view too. I switched from milk to cream for a few months, and have this week gone all the way to black coffee (which I couldn't have done before) and I am now enjoying it.

Cream: Here's a simple rule of thumb: the higher the fat content, the lower the lactose content. (Even whole milk has a tiny bit less lactose than skim milk.) Half-and-half has just over 4.0% lactose. Light or table cream runs just under 4.0% lactose. Whipping cream (also called light whipping cream) has somewhere between 3.0% and 3.5% lactose. Heavy cream has about 3.0% lactose. For most people, therefore, a splash of cream in their coffee contains too little lactose to be concerned about.

http://www.natmedtalk.com/showthread.php?t=4933

Saturated fat is the most important element in your diet. Whole cultures have existed healthily on it and still do - the Inuit, for example - live on a diet of whale fat, and have incredibly low rates of all twentieth century diseases: heart, cancer, and other recently emerging ailments, like depression, ADHD, autism, etc. All these problems skyrocketed in the late twentieth century when the mantra became low-fat, high carbohydrate. Eat cream aplenty - whole fat, always, if you want to stay alive and be relatively healthy. Don't buy the "saturated fat is evil" propaganda.

Surprised to see all the thumbs up for the heavy cream over the milk simply based on the lactose content. Lactose is not a big deal for the majority of people. If you are lactose intolerant, than of course the cream is a decent alternative. There is also a half way meshing of the two in half and half. Trade Joes sells a pure one. But if you can get cream top milk, I'd say it might be a better idea to consume that regularly vs the high fat cream. I practively lived off cream for a time. Delicious for sure, but I no longer see heavy cream as "diesel fuel". It's very dense with sat fat and I'm just not so sure we are supposed to be chugging that stuff. Just because we can burn sat fat for energy does not mean that it's an excellent idea to suddenly consider cream a food staple. I admit full guilt myself so I'm not comin down on anyone. But I think many of us have gone woefully off course with the gorging on butter and cream.

Go with the heavy cream (ideally from grass-fed cows, otherwise organic). But check the ingredients list to make sure it is just heavy cream and nothing else (I am not joking, I've seen some odd things on the lists of "heavy cream"). And (this one time) check the nutrition label, proper heavy cream should have 0g carbohydrates (no lactose and no fillers) and 0g protein (generally the other problematic area with dairy).

Heavy Cream.

Heavy cream contains less than 3% lactose (<1gram per serving) and virtually no casein so the likelihood of gut irritation is very minimal.

I don't drink coffee, but I'm sure if I don't say it someone else will: have you tried coconut milk in your coffee?

I like cream and I do seem to have a little sensitivity to the lactose. I don't consider myself lactose intolerant per se, but if I ingest it later in the day I will often have reflux at night, so I suppose I'm at least lactose sensitive. Cream does it to me too.

My daughter is lactose intolerant, so we've bought lactase drops that are added to the milk. Over a 24 hour period the lactase breaks the lactose down into it's component sugars (glucose and galactose). Milk tastes icky sweet (to me) once that happens because your tongue has more receptors for glucose and galactose than for lactose. I haven't tried the drops in cream.

So when I'm being good and more paleo I use something I got off a website called "Paleo Cream". It's made by mixing one egg into a can of coconut milk in the blender. The proteins in the egg give the coconut milk a little more body, so that the "paleo cream" doesn't water down your coffee, and it tastes good (you can add some vanilla if you like). Of course, the egg is raw, so make sure it comes from a trusted source, or use a pasturized egg (I've seen instructions online how to pasturize the eggs yourself).

I know there will be the crumudgeon who says to learn to like coffee black. I've tried and never succeeded. You could probably put white paint in coffee and I'd drink it, but I just don't like it black.