How to get calcium and vitamin D if lactose intolerant

If you are someone with lactose intolerance, the inability to digest lactose, a sugar found in cow’s milk and other dairy foods, you may not be obtaining sufficient calcium and vitamin D.  People with lactose intolerance lack or have insufficient amounts of an in enzyme called lactase which is necessary to break down the milk sugar lactose.  When lactose is not broken down, it travels on into the large intestine, unabsorbed, where it is fermented resulting in unpleasant symptoms of cramping, bloating, and gassiness.

Calcium is a mineral necessary for building and maintaining strong bones and teeth while vitamin D is required to help us absorb the calcium we do take in.  Since dairy foods are the best sources of calcium and can be good sources of vitamin D, if a person is lactose intolerant, how does one go about making sure they are getting adequate amounts of these two vital nutrients?

·      Start with lactose-free milk

The dairy industry has made it easy for anyone with lactose intolerance to still enjoy dairy foods by offering lactose-free milk.   Lactose-reduced or lactose-free milk and milk products are sold in most grocery stores and tastes just like regular milk (actually a bit sweeter due to the lactose already being broken down).  Like regular milk, lactose-free milk still contains the same amount of calcium and vitamin D.  One can also choose plant-based milks such as soy or almond that contain no lactose to begin with but that still offer calcium and vitamin D.

·      Rely on hard cheeses

Why hard cheeses?  Hard cheeses such as Swiss, cheddar, or parmesan, have less lactose than soft cheese such as feta, mozzarella, limburger, or brie.  Cheeses are a rich dairy source of calcium making them a good option for this mineral without having to suffer the consequences of lactose intolerance.  Also consider cottage cheese which is also a lower-lactose option that’s a good source of calcium.

·      Go green to get calcium

Believe it or not, dark green veggies such as kale, collard greens, Swiss chard, and spinach are excellent sources of calcium.  One cup of cooked frozen collard greens has more than 350 mg of calcium and one cup of cooked spinach has 115 mg of calcium– however, our body still absorbs calcium best from dairy foods.  Even though these veggies can provide some calcium, plant food sources of this mineral also contain substances called oxalates and phytates that bind to calcium inhibiting its absorption.   In that same one cup of cooked spinach, only 5% of the calcium available is absorbed compared to 32% of available calcium in one cup of regular or lactose-free milk.

·      Grab a handful of nuts for calcium

Almonds are a good source of calcium with one-fourth of a cup providing about 100 mg.  Other decent sources of calcium include a handful of Brazil nuts (about 60 mg of calcium) and one cup of peanuts (about 88 mg of calcium). 

·      Go fish for sources of calcium and vitamin D

Some of the very best sources of both calcium and vitamin D are fish with soft bones such as canned salmon and sardines.  Three ounces of sardines offers 325 mg of calcium and 200 IU of vitamin D.  Other important fish sources include rainbow trout, tuna, and Atlantic perch. 

·      Increase sources of soy

Consider sources of soy as another good option for calcium.  One such source is edamame.  A half-cup serving of this immature soybean has around 40 mg of calcium.  Soy foods are also packed with protein which includes tofu, soy milk, tempeh, and soy yogurt.  Check the labels on soy foods making sure they say “calcium-fortified” to know they do contain this bone building nutrient.

·      Yogurt is a great option

When choosing yogurt, look for calcium and vitamin-D fortified brands that state “active live cultures” meaning active bacterial cultures or probiotics have been added to these yogurts.   These cultures help break down the milk sugar of lactose in the intestine, making them a tolerable option for those with lactose intolerance.  Sorry, but frozen yogurts do not have active cultures added so they still contain lactose which can cause tummy distress.

·      Beef up breakfast with calcium and vitamin D

Breakfast is the logical beginning to starting your day with good sources of calcium and vitamin D that don’t involve dairy foods.  Read the labels and look for cereals and bread fortified with calcium and vitamin D.  Also whole eggs are a good natural source of vitamin D and even some orange juice has added calcium. 

·      Step out in the sunshine

The very best source of vitamin D is the sun.  Nicknamed the ‘sunshine vitamin,” your body makes vitamin D from the rays of the sun.  The best time of day to soak up the sun’s rays boosting your body’s ability to absorb them is midday or 12 noon when your shadow is the shortest.  Have your at least your hands, arms and face exposed and stay outdoors at least 10-15 minutes. 

·      Consider calcium and vitamin D supplements

Even though it is preferable to get calcium and vitamin D from natural sources, another good option is always supplements.  Daily calcium needs for adults 50 and under are1,000 mg and 1,200 mg 51 and older.  For vitamin D, daily needs are 600 IU/day for people 70 and under; for those 71 and up, it’s 800 IU/day.

When choosing a calcium supplement, use the following guidelines:

·      Choose brands that state “purified” or have the UPS (United States Pharmacopeia) symbol

·      Calcium absorbed best when taken in 500-600 mg or less

·      Take calcium supplements with food.  Eating food produces stomach acid helping your body absorb the calcium 

·      Calcium supplements can be in the form of either calcium carbonate or calcium citrate.  Calcium carbonate is the most common and concentrated form and is commonly found in food

 

When choosing a vitamin D supplement, use the following guidelines:

 

·      Many calcium supplements contain vitamin D so check the label to be sure

·      Choose a vitamin D supplement that uses vitamin D3 (cholecalciferol)

·      Vitamin D supplements can be taken with or without food

·      Discuss with your doctor the amount of supplemental vitamin D you require