Lactose Intolerant? Two Nutrients to Watch


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Those who are lactose intolerant may have difficulty consuming enough dairy products to meet their calcium and vitamin D needs. Lactose intolerance occurs when there is a deficiency in the digestive enzyme lactase resulting in an inability to digest lactose, a sugar found in dairy products like milk. Symptoms include abdominal pain, bloating, diarrhea, and nausea, and may occur between 30 minutes and 2 hours after consuming dairy products. The degree of lactose intolerance can vary from individual to individual.

Lactose intolerance often develops in adulthood and may be genetic in origin or the result of injury to the small intestine. Some ethnic groups, including African Americans, Asian Americans, and American Indians, are more affected than others.

Watching Calcium Intake: Milk is the most accessible source of easily digestible calcium with each cup containing 300 mg. Daily needs range from 1000 mg to 1300 mg for those above age 3. Some with mild lactose intolerance can handle 2-3 cups of low fat or nonfat milk spaced throughout the day. Other dairy products, such as yogurt and hard cheese, may contain less lactose than milk. Non-dairy sources of calcium include spinach and other leafy green vegetables, canned fish with bones such as sardines, beans, peas, nuts, and calcium-fortified orange juice and cereal.

Try spacing milk throughout the day to avoid symptoms.
Try spacing milk throughout the day to avoid symptoms.

Watching Vitamin D Intake: Fortified milk is the best dietary source of vitamin D with approximately 100 IU per cup. Daily needs range from 600 to 800 IU depending on age and gender. Non-dairy sources of vitamin D include fatty fish (salmon, tuna, and swordfish), fortified orange juice, sardines, eggs, and certain mushrooms that have been exposed to UV light.

Supplements: Calcium and vitamin D supplements may help meet nutritional requirements; however, it’s important to check with a doctor before making diet changes or beginning a new supplement. With knowledge and proper planning, those with lactose intolerance can fulfill their calcium and vitamin D needs.

Check out this post I wrote way back when for more on getting the nutrients you need when you are lactose intolerant.

National Digestive Diseases Information Clearinghouse (NDDIC): Lactose Intolerance
Institute of Medicine: Dietary Reference Intakes for Calcium and Vitamin D


  1. Yep, I’m definitely one of those lactose intolerant people. I think something that’s important is for people to realize that you CAN eat some dairy if you are lactose intolerant! Some people can eat hard cheeses and yogurt and kefir, in small quantities. I meet so many people who think all dairy will effect you the same way. It’s just not true (although for some that is the case).

  2. Cátia Borges says:

    Salmon has over 400UI of vitamin D per 100g, Sardines 193 UI per 100g, Tuna 82 UI. 1 cup of milk is around 250g. So all these sources are better than milk as vitamin D provider. Don’t forget the vitamin D added to milk is usually D2 and not D3.
    Organ impairment in the elderly people can impair both synthesis of vitamin D and its conversion to D3.

    1. Hi Cátia: Thanks for your comment! You are absolutely right that some types of fish are more concentrated sources of vit D than milk; however, those who include milk or other fortified foods in their diet (e.g. OJ) are much more likely to get their vit D from these food than fish, particularly in many parts of the US where fish is not regularly included in the diet. In fact, milk fortification began in the US in the 1930s to combat rickets, a widespread problem that developed as a result of low vitamin D consumption. And luckily, our body can convert vitamin D into a form that is used by the body. It’s important to check for low vitamin D levels in people of all ages. However, I should have been clearer in the above post concerning vitamin D sources – thank you for pointing out where my wording was confusing.

      Thanks for stopping by!

  3. After having two stress fractures I am crazy conscious about my calcium intake. I try to eat/drink a ton of it and I take calcium supplements!

  4. Great info Jessie…as always, your dedication to healthy eating is spot on.
    As for my dietary needs, I eat a generous handful of raw Almonds which have helped increase my calcium intake. I’ve also had to double up on vitamin-D3…and hopefully this will keep me in check ;o)

    Have yourself safe travels.
    Ciao for now, Claudia

  5. Thanks for the info! Just talking about osteoporosis this week in class (I teach nutrition across the lifecycle now) which of course leads to a nice discussion on calcium and vitamin D.

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