Johns Hopkins Health Alert
No Whey -- Getting Enough Calcium If You Don't Eat Dairy
This Health Alert is intended for readers interested in learning about the prevention, diagnosis and management of osteoporosis.People who are lactose intolerant or who eat a vegan diet often don’t consume enough calcium. So how do you get enough calcium in your diet if dairy is not on your plate?
Dietary calcium is essential for maintaining normal bone metabolism, and dairy products are by far the largest source of calcium in the Western diet. But two groups of people -- those with lactose intolerance and vegans -- often don’t get enough calcium because of a lack of dairy in their diet.
What Is Lactose Intolerance?
Lactose intolerance is an inability to digest lactose, the major sugar in milk and products derived from milk. Its symptoms include gas, bloating, crampy abdominal pain and diarrhea, which occur because the small intestine lacks adequate lactase, the enzyme that breaks down lactose into simple sugars.
Studies show that lactose-intolerant people have low levels of calcium in their diet. A report in the Journal of the American College of Nutrition found that people with lactose intolerance consume only 693 mg of calcium daily, on average, primarily because they eat less dairy than the average person. This level is much less than the 1,000 mg recommended for adults age 50 and under and the 1,200 mg recommended for those over 50. The lactose-intolerant subjects also had elevated markers of bone turnover and lower-than-normal bone mass, two factors that are also common in people with osteoporosis.
What Do Vegans Eat?
A vegan is a strict type of vegetarian who chooses to eliminate all animal products from the diet, usually for ethical reasons. Other types of vegetarians typically do not eat meat, but they still may eat animal-derived products like eggs and milk.
Because vegans do not consume any milk or any foods that contain milk, they often have lower-than recommended levels of calcium in their diets. A German study of about 150 vegans published in the European Journal of Clinical Nutrition found that they consumed only 810 mg of calcium daily, on average.
Nondairy Sources of Calcium
For these groups who consume little or no dairy, nondairy foods that are high in calcium are a good option. Foods with naturally occurring, high calcium levels include collard greens, turnip greens, kale, bok choy, soybeans, okra and broccoli. Other nondairy sources include fish with soft, edible bones – canned sardines or salmon -- cultured soy yogurt, tofu and almonds, as well as calcium-fortified orange juices, soy milks and cereals.
Supplements are another excellent nondairy source of calcium. In fact, many people with lactose intolerance or vegans may need a combination of foods high in calcium along with calcium supplements to reach their recommended intake of calcium. Also, be aware that the body cannot absorb more than 600 mg of calcium at one time, so calcium intake will need to be spread throughout the day.
Posted in Back Pain on August 24, 2006
Reviewed June 2011
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I read of a similar study, I believe in Western Europe, with a similar result. Other scientists then commented that the amount of vitamin D should have been more like 1000 IU per day to have an effect. I'm taking Fosamax, 5000 IU of vit D, and 500 to 1000 mg of Ca per day.
Posted by: jgriffith | December 29, 2006 6:59 PM
Addendum to earlier comment; I've heard that vitamin D is insoluble in water. Is this true? Just in case, I eat a can of sardines first and slurp up the olive oil left in the can to dissolve the Vitamin D. Does this make any sense?
Posted by: jgriffith | December 29, 2006 7:09 PM
You mentioned "whey". Is whey isolate with its high protein content good for osteoporosis? Please let me know as I take it every day.
Posted by: marymax | June 7, 2008 4:33 PM
This is interesting. However I was hoping to read about a drug-free treatment for osteoporosis. The drugs like Fosamax, Boniva, and Actonel have some very scary side effects. If there is a proven regimen that uses supplements, diet, and exercise to build bone, I would prefer that. Anyone know about this?
Posted by: pamcarle | March 4, 2009 10:05 AM
You assume that milk and milk products and calcium supplements are all good things to take, esp. for osteoporosis. What about the article and editorial in I believe the Jan.15, 2009 British Medical Journal warning that older women who took calcium supplements had a 40% greater likelihood of heart attack and stroke? And similar disturbing results from the Women's Health Initiative? I do not understand why this data is not only not responded to, but not even mentioned.
Posted by: dahlia | April 19, 2009 6:57 PM
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You headline "No Whey -- Getting Enough Calcium If You Don't Eat Dairy". What do you mean by "No Whey"? Whey is not mentioned in the entire piece?
Posted by: Byron Mayo | September 16, 2006 1:13 PM