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Lactose intolerance
How is nutrition balanced?
Milk and other dairy products are a major source of nutrients in the American diet. 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, then, for both children and adults with lactose intolerance, is getting enough calcium in a diet that includes little or no milk.
In 1997, the Institute of Medicine released a report recommending new 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.
Age group Amount of calcium to consume daily, in milligrams (mg)
0-6 months 210 mg
7-12 months 270 mg
1-3 years 500 mg
4-8 years 800 mg
9-18 years 1,300 mg
19-50 years 1,000 mg
51-70+ years 1,200 mg
Also, pregnant and nursing women under 19 need 1,300 mg daily, while pregnant and nursing women over 19 need 1,000 mg.
In planning meals, making sure that each day's diet includes enough calcium is important, even if the diet does not contain dairy products. Many nondairy foods are high in calcium. Green vegetables, such as broccoli and kale, and fish with soft, edible bones, such as salmon and sardines, are excellent sources of calcium. To help in planning a high-calcium and 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 it is fairly high in lactose. Evidence shows that the bacterial cultures used to make yogurt produce some of the lactase enzyme required for proper digestion.
Calcium and Lactose in Common Foods
Vegetables Calcium Content Lactose Content
Calcium-fortified orange juice, 1 cup 308-344 mg 0
Sardines, with edible bones,
3 oz. 270 mg 0
Salmon, canned, with edible bones, 3 oz. 205 mg 0
Soymilk, fortified, 1 cup 200 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
Dairy Products
Yogurt, plain, low-fat, 1 cup 415 mg 5 g
Milk, reduced fat, 1 cup 295 mg 11 g
Swiss cheese, 1 oz. 270 mg 1 g
Ice cream, 1/2 cup 85 mg 6 g
Cottage cheese, 1/2 cup 75 mg 2-3 g
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 instance) are not listed in the chart because the body cannot use the calcium they contain. They also contain substances called oxalates, which stop calcium absorption. 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. Sources of vitamin D include eggs and liver. However, sunlight helps the body naturally absorb or synthesize 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 any dietary supplements are needed. Taking vitamins or minerals of the wrong kind or in the wrong amounts can be harmful. A dietitian can help in planning meals that will provide the most nutrients with the least chance of causing discomfort.
How is lactose intolerance diagnosed?
