Lactose intolerance is widely misunderstood and too often prompts individuals to avoid all dairy products. But there are ways to limit the intake of dairy foods and still get enough calcium.
Meeting calcium requirements is a challenge for many people, and for women, in particular. For those with lactose intolerance, the bar is set even higher. These individuals do not produce enough lactase, the enzyme necessary for the proper digestion of lactose, the sugar in milk and other dairy products. These foods are the main natural sources of calcium in the Western diet, and eliminating them can leave a significant gap in calcium intake. Fortunately, there are ways to meet the US recommended intake of 1200 mg a day for those over age 50 without relying exclusively on dairy foods.
As background, it is important to know that lactose intolerance is a highly variable condition. Individual tolerance levels differ greatly, and studies find that the presence or absence of symptoms is not directly related to the physical ability to digest milk sugar. And it is not uncommon for individuals to believe that they are lactose intolerant, when, in fact, they are not. The only sure way to confirm the diagnosis is with a “breath hydrogen test,” a simple diagnostic procedure.
Eating around the problem
At the practical level, however, no one wants to experience regular discomfort as a result of eating a particular kind of food. People should establish their own limits of what they can tolerate without ill effects. Research indicates that many adults diagnosed with lactose intolerance can comfortably consume a cup or more of milk a day, especially if included in small amounts along with a meal. For anyone who has eliminated milk as a beverage entirely and wants to start drinking it again, the American Dietetic Association recommends starting with about ¼ cup at a time and gradually increasing intake. Fluid milk is just one alternative. Many people who find they can’t tolerate milk can eat yogurt with active cultures or drink buttermilk, partly because there is less lactose in yogurt, but also because the bacteria used in making these products produce enzymes that aid digestion. Cheese is usually considerably lower in lactose than milk. That is because most lactose is in the whey portion of milk that is removed during the cheese-making process. Aging further reduces lactose levels, so Swiss, cheddar, and other aged cheeses are excellent sources of calcium for the lactose intolerant.
Other foods, such as leafy dark greens, canned fish, and tofu processed with calcium sulfate all provide calcium and contain no lactose. Granted, these foods aren’t dietary staples for many people, but a serving a day will help meet calcium recommendations. A serving or two of calcium-fortified foods can make up for residual shortfalls. For example, a cup of calcium-fortified orange juice will add 300 milligrams of calcium to the diet. Some, but not all soy beverages are also fortified; check the package for calcium content.
How to you know if you’ve gotten enough?
The following values are guidelines, since the actual calcium content of foods will depend on several factors. Check the labels for the amount of calcium in the growing array of calcium-fortified foods.
|1 cup milk||300|
|1 cup yogurt||350|
|1 oz. Cheddar cheese||200|
|½ cup cottage cheese||70|
|½ cup ice cream||85|
|3 oz. salmon (with bones)||200|
|½ cup cooked spinach||120|
|1 cup Chinese cabbage||160|
|1 cup broccoli||70|
|½ cup firm tofu (processed with calcium)||205|
|1 tbsp. blackstrap molasses||170|
|½ cup baked beans||80|