Milk and other dairy products are a major source of nutrients in the American diet. One of the most important of these nutrients is calcium. Calcium is essential for the growth and repair of bones throughout life. In the middle and later years, a shortage of calcium may lead to thin, fragile bones that break easily, a condition called osteoporosis.
A concern for both children and adults with lactose intolerance is getting enough calcium in a diet that includes little or no dairy products.
The Institute of Medicine released a report listing the requirements for daily calcium intake. How much calcium a person needs to maintain good health varies by age group. Recommendations from the report are shown in the following table.
Daily Calcium Recommendations, by Age Group
|Age Group||Amount of calcium to consume daily, in milligrams (mg)|
|0–6 months||400 mg|
|6–12 months||600 mg|
|1–5 years||800 mg|
|6–10 years||1,200 mg|
|11–24 years||1,200–1,500 mg|
|19–50 years||1,000 mg|
|51–70 years||1,500 mg|
In addition, pregnant and nursing women need between 1,200 and 1,500 mg of calcium daily.
In planning meals, people with lactose intolerance should make sure that each day’s diet includes enough calcium, even if dairy products are not included. Many non-dairy foods are high in calcium, including dark green vegetables such as broccoli, or fish with soft, edible bones, such as salmon and sardines. To help in planning a high-calcium, low-lactose diet, the table that follows lists some common foods that are good sources of dietary calcium and shows how much lactose they contain.
Recent research shows that yogurt with active cultures may be a good source of calcium for many people with lactose intolerance. Even though yogurt is fairly high in lactose, the bacterial cultures used to make it produce some of the lactase enzyme required for proper digestion.
Clearly, many foods can provide the calcium and other nutrients the body needs, even when intake of milk and dairy products is limited. However, factors other than calcium and lactose content should be kept in mind when planning a diet. Some vegetables that are high in calcium (Swiss chard, spinach, and rhubarb, for example) are not listed in the chart because the body cannot use the calcium they contain because these foods also contain substances called oxalates, which stop calcium absorption.
Calcium and Lactose in Common Foods
|Calcium Content||Lactose Content|
|Soymilk, fortified, 1 cup||200–300 mg||0|
|Sardines, with edible bones, 3 oz.||270 mg||0|
|Salmon, canned, with edible bones, 3 oz.||205 mg||0|
|Broccoli, raw, 1 cup||90 mg||0|
|Orange, 1 medium||50 mg||0|
|Pinto beans, 1/2 cup||40 mg||0|
|Tuna, canned, 3 oz.||10 mg||0|
|Lettuce greens, 1/2 cup||10 mg||0|
|Yogurt, plain, low-fat, 1 cup||415 mg||5g|
|Milk, reduced fat, 1 cup||295 mg||11g|
|Swiss cheese, 1 oz.||270 mg||1g|
|Ice cream, 1/2 cup||85 mg||6g|
|Cottage cheese, 1/2 cup||75 mg||2-3g|
Calcium is absorbed and used only when there is enough vitamin D in the body. A balanced diet should provide an adequate supply of vitamin D from sources such as eggs and liver. Sunlight also helps the body naturally absorb vitamin D, and with enough exposure to the sun, food sources may not be necessary.
Some people with lactose intolerance may think they are not getting enough calcium and vitamin D in their diet. Consultation with a doctor or dietitian may be helpful in deciding whether dietary supplements are needed. Taking vitamins or minerals of the wrong kind or in the wrong amounts can be harmful. A dietitian can help plan meals that will provide the most nutrients with the least chance of causing discomfort.