Johns Hopkins Health Alerts | Back Pain - Osteoporosis | Osteoporosis on Calcium Deficiency
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.
Johns Hopkins Health Alerts | Back Pain - Osteoporosis | Osteoporosis on Calcium Deficiency
