Lactose intolerant? Here’s how you can get your daily dose of calcium

surprised cow
If you have to restrict your intake of calcium-rich dairy foods, you should be aware of other options that will help you get enough of this important mineral.

Lactose intolerance means that you have trouble digesting lactose, a sugar found in milk and to a lesser extent in other dairy products. As milk and dairy products provide by far the highest amounts of calcium compared to other food groups, their exclusion from the diet can compromise your ability to get your recommended daily levels.

It’s a common problem, especially in certain parts of the world. The frequency of lactose intolerance ranges from 5% in Northern European countries to more than 90% in most African and Asian countries.1 Symptoms can vary from mild to severe and the most common are flatulence, bloating, abdominal cramps, diarrhea and nausea. Symptoms often occur 30 minutes to two hours after a lactose-containing meal.

All lactose intolerance is not equal

Very few people are actually 100% lactose intolerant. Most people find that they only need to limit the amount of lactose they consume. Through trial and error, they discover which dairy foods they can tolerate (and in what quantities). There are also many non-dairy alternatives that can ‘boost’ the calcium levels in your diet. When it is not possible to avoid lactose, or on those special occasions when you want to enjoy a dairy-rich meal, lactase tablets can be taken.

Tips to help you reach your calcium-intake requirements

Lactose-free and lactose-reduced milk and milk products
In many countries lactose-free or lactose-reduced milk products are increasingly available in local supermarkets. They provide the same nutritional value as regular milk and milk products.

Dairy alternatives with calcium
Good examples of dairy alternatives are fortified soy or rice drink, almond milk and fortified soy yogurt. It is important to note however that they do not contain the same amounts of calcium as in dairy milk – for example, a portion of milk contains more than double the amount in the same portion of almond milk.

Many people with lactose intolerance are able to enjoy certain types of cheeses – and cheeses are very rich in calcium, with only 30 mg of hard cheese providing the same amount of calcium as a glass of milk. Traditionally made hard cheeses and soft ripened cheeses create less reaction than the equivalent amount of milk. This is because the process of fermentation and higher fat content contribute to lower lactose content. Traditionally made Cheddar or Emmental, for example, usually contain only 10% of the lactose found in whole milk. In addition, the ageing methods of traditional cheeses (sometimes over two years) almost completely reduce their lactose content. However, it should be noted that commercial cheeses are often manufactured by processes that do not have the same lactose-reducing properties.

Many types of beans (for e.g. white beans and soy beans) are fairly high in calcium content. A raw weight of 80 mg of white beans contains 132 mg of calcium, which is roughly the equivalent of the amount of calcium contained in a half-glass of milk.

Fruits and vegetables
Dark green vegetables such as kale, collard greens, bok choy, cress, and broccoli provide a calcium boost as do cerain fruits, ntably figs, currants and oranges. 

Nuts and seeds
Consumption of almonds, hazelnuts, Brazil nuts, and sesame seeds can also help boost your calcium intake.

Mineral Water
Check the labels of the various brands of mineral water available in your supermarket – some brands have more calcium content than others and they would be a good beverage option.

Calcium supplements
Calcium supplements are an obvious choice for people with lactose intolerance who are unable to meet their calcium needs from food sources. Look for supplements that also include vitamin D as this helps the body absorb calcium. 

Good to know
Note that dairy products that are ‘reduced-fat’ or ‘fat-free’ generally have slightly higher lactose content. If using butter, use clarified butter which contains very little lactose and is safe for most lactose-intolerant people. Traditionally made yogurt, kefir and frozen yoghurt generally have reduced lactose levels.

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How much calcium do you need? See recommended daily calcium intakes.

1. Bulhões AC, Goldani HA, Oliveira FS, Matte US, Mazzuca RB, Silveira TR (2007). "Correlation between lactose absorption and the C/T-13910 and G/A-22018 mutations of the lactase-phlorizin hydrolase (LCT) gene in adult-type hypolactasia". Brazilian Journal of Medical and Biological Research 40 (11): 1441–6. doi:10.1590/S0100-879X2007001100004. PMID 17934640.