Building Strong Bones on a Low-Lactose Diet
If you've been diagnosed with lactose intolerance, your first thought is likely managing your symptoms and finding dairy-free alternatives for your favourite foods. Once you've found your new routine however, your next question might well be "am I getting enough calcium in my diet?"
We grow up learning that milk and dairy products are the cornerstones of calcium intake, essential for strong bones and teeth. On top of this, calcium also plays a vital role in regulating muscle contractions (including your heartbeat) and ensuring your nervous system functions correctly.
A healthy, calcium-rich diet is entirely achievable, even with little or no dairy consumption. The NHS recommends that adults aim for 700mg of calcium per day. In this Nutrition Gaps article, we're going to look at non-dairy sources of dietary calcium and give you the knowledge to hit that target through a variety of delicious and accessible foods.
A Quick Reminder: Intolerance vs. Allergy
Before we get started, let's clarify the difference between lactose intolerance and a milk allergy. Lactose intolerance is a digestive issue caused by a deficiency of enzyme that breaks down lactose (milk sugar), which is called lactase. A milk or dairy allergy is an immune system reaction to the proteins in milk, which can be much more severe. This article is written for those managing an enzyme intolerance. If you suspect you have a milk allergy, it is crucial to speak with a healthcare professional.
Low Lactose Dairy Options
Many people with lactose intolerance don't need to eliminate dairy completely. You may have an 'individual threshold', meaning you can tolerate small amounts of lactose without symptoms, especially when consumed with other foods. Some dairy products are also naturally lower in lactose:
- Hard, aged cheeses: Cheeses like cheddar, parmesan, and swiss have very little lactose because it's drained off with the whey during the cheesemaking process
- Live yoghurt and kefir: The live bacterial cultures in these fermented products help to break down some of the lactose, which may make them easier for some people to digest
We have an article that looks at these lower-lactose dairy options here. However, if you prefer to avoid dairy or find your tolerance is very low, there are plenty of other fantastic options.
Calcium Without Dairy
Any healthy diet plan should be based around variety, and a calcium-rich plate is no different. Here are some of the best non-dairy sources to incorporate into your meals.
1. Fortified Foods and Drinks
Many food manufacturers now add calcium to their products, making them an easy and reliable source. Always check the nutrition label for the words 'fortified with calcium'.
- Plant-based milks: Soya, oat, almond, and rice milks are often fortified to match or even exceed the calcium levels of cow's milk. They are incredibly versatile for use in cereals, tea, coffee, and cooking
- Fortified yoghurts: Soya or coconut-based yoghurt alternatives are frequently fortified with calcium (per the section above, ensure that you can tolerate the yoghurt that you are eating)
- Tofu: Look for tofu that has been 'calcium-set' (it will list calcium sulphate in the ingredients). This type is an excellent source of both protein and calcium
- Bread: Flour used for most types of bread (excluding wholemeal) in the UK is required to be fortified with calcium
2. Leafy Green Vegetables
Dark green leafy vegetables are nutritional powerhouses, and many provide a good source of calcium:
- Top choices: Kale, rocket, watercress, bok choy, and collard greens are all excellent
- A note on spinach: While rich in many nutrients, spinach also contains substances called oxalates, which can bind to calcium and reduce how much your body can absorb. It’s still a healthy food but you should not rely on it as your primary source of calcium
3. Tinned Fish with Bones
This might be a surprising one but certain types of tinned fish are some of the most effective non-dairy sources. The tiny, soft, edible bones are where all the calcium is stored.
- Sardines and pilchards: A serving of tinned sardines can provide over a third or even half of your daily calcium needs. They're delicious on toast or mixed into a pasta sauce
- Tinned salmon: Make sure you buy the type with the soft bones included and mash them in
Tuna, a favourite tinned fish for many, is unfortunately not high in calcium as it's sold boneless. While a healthy meal choice, a standard tin of tuna contains around 10-35mg of calcium.
4. Pulses, Nuts, and Seeds
These plant-based staples can contribute significantly to your daily calcium intake, as well as providing valuable protein and fibre.
- Pulses: Chickpeas, kidney beans, baked beans, and lentils all contain calcium
- Nuts: Almonds are a standout source of calcium. A small handful makes a great snack
- Seeds: Sesame seeds are particularly rich in calcium. Tahini, a paste made from sesame seeds, is a key ingredient in hummus and is a brilliant way to add calcium to your diet
Vitamin D: Calcium's Essential Partner
Vitamin D plays a crucial role in calcium absorption. It acts like a key, unlocking your body's ability to take calcium from your gut and put it to use. You can hit your recommended daily calcium intake every day, but if you are Vitamin D deficient you may still encounter issues.
Our main source of Vitamin D is from the action of sunlight on our skin. While this summer has seemed endless, in the UK it can often be difficult to get enough sun, especially during the autumn and winter months. Government advice found on the NHS website is that all adults should consider taking a 10mg Vitamin D supplement from October to March.
Never Self-Proscribe Calcium Supplements
For most people, a well-planned diet can provide all the calcium they need. There are of course some individual circumstances where a supplement may be suggested. It is essential not to self-prescribe, as taking too much calcium can be harmful.
If you are concerned about your intake or believe you may need a supplement, we strongly encourage you to speak with your GP or a healthcare practitioner. They can assess your individual needs and provide safe, personalised advice.
Living with lactose intolerance doesn't mean you have to compromise on your long-term health. By exploring the incredible variety of calcium-rich foods available, you can build a diet that not only keeps your digestion happy but also supports strong, healthy bones for life.
This article is for informational purposes only and does not constitute medical advice. Please consult a qualified healthcare professional for advice specific to your situation.