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How do I get enough calcium if I am lactose intolerant?

Author: Patricia Cheong (Clinical Dietitian in Singapore)

After working as a clinical dietitian over the past few months, I have come across many patients who are lactose intolerant and experience gastrointestinal issues such as bloating, abdominal cramps and diarrhoea when they consume milk. As a result of that, they avoid milk and dairy products at all cost to avoid the discomfort. Some of my patients have also asked me for some recommendations on what they can do about it as they know that milk and dairy are good sources of calcium. If you have the same issues, let me share a couple of tips with you!

It has been suggested that over 70% people of Asian decent are lactose intolerant. While cow's milk are highly encouraged in Western communities from a young age, individuals of Asian heritage may be missing out on the opportunity to optimise their nutrition due to this. It is never too late so keep reading to find out what alternatives are available for you!

What is lactose intolerance?

Lactose intolerance is an impaired ability to digest lactose, a sugar most commonly found in milk and other dairy products such as yoghurt and cream cheese. As a result of lactose intolerance, when they consume food with lactose, the lactose moves through their gut undigested and causes digestive symptoms such as bloating, diarrhea and abdominal cramps. Do you know that about 75% of the world's population is lactose intolerant? It ranges with rates as low as 5% among northern Europeans and as high as over 90% of adults in some communities in Asia!

Why is calcium so important?

Calcium is a mineral found in many foods. Our body needs calcium to form and maintain healthy teeth and bones and to prevent osteoporosis – a disease of low bone mass which leads to weak bones and increased risks of fractures. When we think about calcium, we usually think about milk and dairy products. However, for people with lactose intolerance, milk products can become unsuitable sources of calcium for them. Thankfully, there are many other calcium containing foods for those who are lactose intolerant

Sources of non-dairy calcium containing food

The recommended dietary intake of calcium is different for people of different ages and life stages. However, for adults in general, the recommended dietary intake of calcium is 1000mg/day. I have listed some of the non-dairy calcium food sources that you can consider including in your diet to optimise your calcium intake.

  1. Fortified high calcium Soy milk One glass (250ml) can easily provide you with 500mg of calcium. That is about half of the adult’s daily requirement for calcium!

  2. Low sodium canned sardines or salmon with their soft bones One serving of sardines (approximately 100g) will provide you with 200-300mg of calcium.

  3. Tofu Firm Tofu will usually provide you with higher amount of calcium. On average, 100g of Tofu will provide you with 150-250mg of calcium

  4. Dark green leafy vegetables such as broccoli, collards, kale, mustard greens, turnip greens, and bok choy One cup of cooked broccoli contains about 45 mg of calcium, One cup of kale contains about 100mg of calcium and one cup of Bok Choy contains about 70mg of calcium.

  5. Almond with skin A handful (30g) of almond will provide you with about 80mg of calcium. If possible, choose the plain baked version and leave the salted or flavoured ones for special occasions.

  6. Dried figs Three pieces of figs (40g) will provide you with 80mg of calcium.

  7. Calcium fortified food such as breakfast cereals, fruit juices and bread. Look out for the packaging on these foods to find out the amount of calcium that they contain.

It is also important to consume Vitamin D at the same time as it helps our intestine to absorb calcium from our diet. Sources of Vitamin D includes sunlight! Sunlight is one of the best sources of Vitamin D as our skin can make them when exposed to Ultraviolet B rays. If going under the sun isn’t an option for you, consider obtaining vitamin D from food sources such oily fish (e.g. salmon, mackerel and sardines), egg yolk, and liver.

Key takeaways

Calcium is important for optimal bone health throughout your life. Even if you are unable to obtain calcium through milk and dairy products, there are still many other food sources where you can obtain your calcium. Although diet is the best way to get your calcium, if you are unable to obtain enough calcium from your diet, you may consider calcium supplements. Discuss with your doctors or dietitians regarding the appropriate dosage.

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