Milk is rich in type of sugar called lactose. The small intestine—the organ where most food digestion and nutrient absorption take place—produces an enzyme called lactase. Lactase breaks down lactose into two simpler forms of sugar: glucose and galactose. The body then absorbs these simpler sugars into the bloodstream.

 

What is lactose intolerance?

Lactose intolerance is a condition in which people have digestive symptoms—such as bloating, diarrhea, and gas—after eating or drinking milk or milk products. Such people have deficiency of the emzyme lactase in the body.

 

Calcium and Vitamin D

Ensuring that children and adults with lactose intolerance get enough calcium is important, especially if their intake of milk and milk products is limited. The amount of calcium a person needs to maintain good health varies by age. Table 1 illustrates recommendations for calcium intake.

Table 1. Recommended Dietary Allowance of calcium by age group

Age Group	Recommended Dietary Allowance (mg/day)
1–3 years	700 mg
4–8 years	1,000 mg
9–18 years	1,300 mg
19–50 years	1,000 mg
51–70 years, males	1,000 mg
51–70 years, females	1,200 mg
70+ years	1,200 mg
14–18 years, pregnant/breastfeeding	1,300 mg
19–50 years, pregnant/breastfeeding	1,000 mg

Source: Adapted from Dietary Reference Intakes for Calcium and Vitamin D, Institute of Medicine, National Academy of Sciences, November 2010.

 

Table 2. Calcium content in common foods

Nonmilk Products	Calcium Content
sardines, with bone, 3.75 oz.	351 mg
rhubarb, frozen, cooked, 1 cup	348 mg
soy milk, original and vanilla, with added calcium and vitamins A and D	299 mg
spinach, frozen, cooked, 1 cup	291 mg
salmon, canned, with bone, 3 oz.	181 mg
pinto beans, cooked, 1 cup	79 mg
broccoli, cooked, 1 cup	62 mg
soy milk, original and vanilla, unfortified, 1 cup	61 mg
orange, 1 medium	52 mg
lettuce, green leaf, 1 cup	13 mg
tuna, white, canned, 3 oz.	12 mg
Milk and Milk Products
yogurt, plain, skim milk, 8 oz.	452 mg
milk, reduced fat, with added vitamins A and D, 1 cup	293 mg
Swiss cheese, 1 oz.	224 mg
cottage cheese, low fat, 1 cup	206 mg
ice cream, vanilla, 1/2 cup	84 mg

Source: Adapted from U.S. Department of Agriculture, Agricultural Research Service. 2013. USDA national nutrient database for standard reference, release 26.

Vitamin D helps the body absorb and use calcium. Some people with lactose intolerance may not get enough vitamin D. Foods such as salmon, tuna, eggs, and liver naturally contain vitamin D. Most milk sold in the United States is fortified with vitamin D, and vitamin D is added to some nonmilk beverages, yogurts, and breakfast cereals. People’s bodies also make vitamin D when the skin is exposed to sunlight.

In subsequent posts we’ll discuss the milk alternatives for the lactose intolerance.

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