How to get the Nutrition you Need if you’re Lactose Intolerant
If you have lactose intolerance, obviously you’d rather avoid living with symptoms like belly cramps, gas, bloating, diarrhea and constipation. But if you simply stop eating all dairy foods, there’s a good chance you won’t be getting enough some nutrients that are important for maintaining strong bones and good overall health. Here’s what you may be missing out on, and how to get the nutrition you need if you’re lactose intolerant.
Milk and other dairy products are concentrated sources of calcium, and contain other key nutrients such as protein, and B vitamins as well. Plus, dairy foods deliver not just a healthy helping of calcium, but also minerals that work with it to maintain strong bones, such as magnesium and phosphorous—all in one convenient package.
While that doesn’t mean you can’t get sufficient amounts from other sources, if you remove regular dairy from your diet, “it’s important to make sure that the replacements are full of nutrients,” stresses Rosie Schwartz, a registered dietitian and nutrition writer in Toronto.
One of the easiest ways to adapt your diet to a body that has difficulty digesting lactose, “is to look for lactose-free products,” Schwartz says. Because the processes used to render regular milk free of lactose don’t change its nutritional profile, switching to lactose free milk, yoghurt, and cheeses—such as Black Diamond Lactose Free cheese products including the recently launched Lactose Free Marble cheddar sticks – is a tasty way to get the bone-building nutrients your body needs without having to spend extra time and effort learning new eating habits.
Alternatively, you can try consuming regular dairy products with a lactase supplement (some are taken before you eat or drink the food; others are added to it). However, some people find they don’t work well, or that one brand works better than another, so you may want to try a few different types.
Fortified Plant-Based Beverages
If you’d prefer to swap cow’s milk for one of many plant-based alternatives (such as oat, almond, and hemp) that are now available, “look to see if the product is fortified,” Schwartz urges. According to Dietitians Canada, fortified plant-based beverages contain around 20 to 25 percent of the amount of calcium you need daily, versus the roughly 30 percent in regular cow’s milk.
Many plant milks are also fortified with vitamin D as well, which enhances the absorption of calcium. (In Canada, all fluid milk is fortified with vitamin D, as is margarine.) While some of the plant-based alternatives may contain less vitamin D than regular milk, “people shouldn’t be counting on getting adequate vitamin D from milk,” of any kind, Schwartz says. Many experts recommend that Canadians of all ages take a daily supplement containing 400 IU of vitamin D.
Another factor to keep in mind when selecting a plant-based beverage is protein content, which can range from zero to about eight grams per cup, versus the nine in cow’s milk. From a protein standpoint, soya milk comes out on top among the plant-based beverages.
Finally, you may also want to choose non-sweetened versions of non-dairy milks, since some contain some contain added sugars.
As far other faux dairy alternatives go, Schwartz notes that, “a lot of plant-based cheeses don’t have any calcium.” They also vary in nutritional value, too, so you may want to compare different brands.
Other Food Sources
If you’re ditching dairy entirely, there are certainly many other foods that can supply the nutrients found in regular milk and fortified foods. However, it’s important to keep in mind that, “you need to be eating more of them because the calcium in them won’t be as well absorbed,” Schwartz explains.
Dark leafy greens, such as bok choy, rapini, kale, spinach and collards contain respectable amounts of calcium. In a half cup of spinach, for instance, you can get about 130 to 150 mg. (By comparison, regular milk, and fortified plant-based beverages deliver in the range of 300 mg or so.) And needless to say, they’re also rich in several other vitamins and minerals, including potassium, magnesium, and vitamin K (which also plays a role in bone health).
Canned Fish With Bones
“Salmon and sardines, for example, are great,” Schwartz says. And these aren’t just good sources of calcium and phosphorous—they also supply protein, heart-healthy omega-3 fats, vitamins D and B12 among other nutrients.
Soybean Based Foods
Minimally processed soy foods, such as edamame, tofu and tempeh are versatile, low in fat, packed with protein, and cup for cup, contain about the same amount of calcium as cow’s milk. However, you may want to limit your intake of soy-based products such as hot dogs and ‘burgers’, since these are highly processed, and consequently, tend not to be any healthier than their meat-based counterparts.
Beans and Pulses
Not only are beans (such as chickpeas, pintos, and kidney beans) and lentils decent sources of calcium, when you eat them, “you’re getting magnesium as well,” notes Schwartz, which is one of the minerals you may miss out on if you cut out dairy.
Nuts and Seeds
Some nuts and seeds, such as almonds and sesame seeds, can contribute to your calcium intake. For instance, 30 ml (2 tbsp) of tahini or sesame butter packs about 130 mg. What’s more, nuts and seeds are also good sources of protein, healthy fats, several minerals (including magnesium and potassium), and multiple B vitamins.
One tablespoon of blackstrap or cooking molasses contains around 170 mg of calcium. It’s also considered a ‘significant’ source of iron, magnesium, potassium, and vitamin B6. And not only is it a nutritious alternative to refined sugar and other sweeteners, it has a lower glycemic index—meaning it doesn’t cause the same sharp spikes and subsequent drops in blood sugar levels.
You can find a more detailed list of foods that contain calcium, and how much, here.
Naturally Lower-Lactose Foods
Many people with lactose intolerance can actually consume some without suffering any ill-effects, particularly if it’s in smaller amounts spread throughout the day; eaten with other foods, or in a higher-fat form, like full-fat yoghurt.
Foods higher in fat (and certain other nutrients, such as fibre) tend to slow emptying of the stomach, which can give any lactase you do have in your body more time to properly digest it before it moves into the small intestine. Since this is where undigested lactase wreaks havoc, “someone might have some ice cream, and be fine,” but experience symptoms after eating foods like cottage cheese, Schwartz explains.
You may also want to try eating dairy foods that are naturally lower in lactose—such as hard cheeses—to see if you’re able to tolerate them. If you decide to go that route, Dietitians of Canada suggests you start by eating a small amount, seeing how you feel, and keeping a food diary to record your symptoms.
Should You Consider a Supplement?
“One of the problems with taking calcium supplements is that there’s research that shows that they may increase risk for heart disease,” says Schwartz, “so you can’t just pop a calcium supplement because you haven’t had your dairy products.”
If you are modifying your diet by avoiding or cutting down on dairy, rather than immediately reaching for a supplement, Schwartz suggests the following. “It would be worthwhile talking to a registered dietitian to help increase your intake nutrients such as calcium and vitamin D naturally,” she says.