Dairy-Free Diet?

What you need to watch out for if you’re following a dairy-free diet – Anna Nicholson (Nutritionist)

The trend for going to a dairy-free diet has been increasing in popularity over the past few years, whether it be due to a genuine lactose intolerance or allergy or just health concerns. It’s no wonder, given that the consumption of dairy has been linked to:

Digestive issues (lactose or casein-sensitivities);
Bloating;
Respiratory issues (increased mucus production and asthma);
Exacerbating skin issues (acne and eczema);
Inflammation and oxidative stress (due to the D-galactose content);
Increased risk of prostate cancer (promotes the production of IGF 1, which cancer cells love); and
Increased exposure to pesticides, antibiotics and hormones used in the dairy industry.

However, there are some risks in eliminating dairy from your diet, which you should be aware of! Dairy is an important source of calcium, vitamin D, protein, riboflavin, potassium and magnesium, as well as other nutrients. This is a concern given that the 2011 – 2012 Australian Health Survey identified that that majority of Australian women are not getting adequate calcium in their diets.

Calcium

Calcium is essential for strong, healthy bones and for the healthy functioning of the heart, muscles, blood and nerves. Almost 99% of the body’s calcium is found in the bones and your bones act like a calcium bank so if you don’t get enough calcium from your diet, the body takes it from your bones for use elsewhere in the body. If this continues, bone density (strength) will gradually decrease and risk of developing osteoporosis (brittle bones) increases. Osteoporosis is a serious issue in older age as broken bones take longer to heal and can lead to significant loss of mobility and independence.

The amount of calcium you need depends on your age and sex, with teenagers (growth spurt), women over the age of 50 (menopause causes more rapid bone loss) and men over the age of 70 (calcium is absorbed less efficiently from the intestine and lost increasingly through urine in older adults) having greater calcium requirements. Unfortunately, we lay down most of our calcium reserves during the first 30 years of our lives (especially during puberty), so maximising calcium intake during those early years is important for achieving and maintaining optimum bone health throughout life. After the age of 30 it is just about managing that calcium bone bank so that your dietary intake is equal to or greater than any losses.

Vitamin D

Vitamin D has a crucial role in maintaining bone health as it improves the absorption of calcium from the intestine and helps control calcium levels in the blood. Food is generally not a great source of vitamin D but luckily, we can get plenty of vitamin D from the sun so making sure you get out for at least 20 minutes a day (especially during the winter months!) will really help support your bones. Other sources of vitamin D include oily fish (salmon and mackerel), eggs and liver. Some milk and dairy-free alternatives are also fortified with vitamin D.

Alternative Sources of Calcium

The Australian Dietary Guidelines recommend that you should include 2.5 serves of milk, yoghurt, cheese and/or alternatives (mostly reduced fat) in your diet each day. This increases to 4 serves per day for post-menopausal women. So, if you’re not eating dairy, what are the most calcium-rich alternatives?

There are sooo many dairy-free alternatives available in the supermarkets these days, but not all of them will provide you with calcium you need. It should be noted that whilst some plants provide calcium, not all of this is in a form that is available for our bodies to absorb. This means that we would need to eat large quantities of these foods in order to achieve the recommended daily intake. For example:

1 cup of cooked spinach contains 100 mg of calcium but only 5% of this might be absorbed so you would need to eat 60 cups in order to obtain the same amount of calcium as in a glass of milk!
1 cup of broccoli contains approximately 45 mg of calcium but only around 50-60% is absorbed so you would need to eat around 13 cups of broccoli to get the same amount of calcium as in a glass of milk.
15 almonds contain around 40 mg of calcium, so you’d need to consume around 375 almonds to match a glass of milk. This may not sound that bad but also means that you’re consuming approximately 225 g of fat and 2,625 calories – ouch!

Adding to this, we also need to consider the calcium losses from the body through urine. These losses are increased with increase salt, caffeine and alcohol consumption, so it is important to reduce our intake of these to ensure that we’re not undoing all the good work of increasing consumption of calcium-rich foods! Diets high in animal protein and nuts and seeds can also lead to increased excretion of calcium through urine so this is also something to consider.

Tips for getting more calcium

If you are avoiding dairy products, try including some of the following foods in your diet to increase your calcium intake:

Try to eat the bones in salmon and sardines as this is where most of the calcium is concentrated;
Green leafy veg, especially broccoli, bok choy, silverbeet, kale and spinach;
Almonds (maybe not 375 but even a few will help!);
Dried figs and dried apricots;
Chickpeas;
Eggs;
Tahini;
Fortified foods such as calcium-set (firm) tofu and some soy milk – calcium from these is easily absorbed as it is from other foods that naturally contain calcium;

If you’re unsure, this Online Calcium calculator can help you work out if you need to up your calcium intake!

Calcium Supplements

There has been a lot of controversy surrounding the negative effects of calcium supplements. Some studies suggest that taking calcium supplements may lead to an increased risk of breast and prostate cancer, heart attacks or strokes and kidney stones as well as interfere with the absorption of other minerals like iron, magnesium and zinc. Calcium supplements can also interact with various medications, including antibiotics, thiazide diuretics, digoxin and phenytoin so it’s best to speak to your doctor before taking them. As always, it is better to get your nutrients from actual food!

This article is not intended to substitute for informed medical advice. You should not use this information to diagnose or treat a health problem or condition. Always check in with a medical practitioner before making drastic changes to your diet, taking supplements or starting a new fitness routine.

References

Afeiche, M.C., et al., (2016). Dairy intake in relation to in vitro fertilization outcomes among women from a fertility clinic. Human Reproduction, Vol. 31, No. 3, pp. 563-571, 2016, d.o.i. 10.1093/humrep/dev344.

Australian Bureau of Statistics. 4364.0.55.008 – Australian Health Survey: Usual Nutrient Intakes, 2011-12. http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4364.0.55.008~2011-12~Main%20Features~Calcium~401. Updated 06 March 2015.

Australian Dietary Guidelines. https://www.eatforhealth.gov.au/sites/default/files/files/the_guidelines/n55_australian_dietary_guidelines.pdf

Chavarro, J.E., Rich-Edwards, J.W., Rosner, B., Willett, W.C., (2007). A prospective study of dairy foods intake and anovulatory infertility. Human Reproduction, Vol. 22, No.5, pp. 1340-1347, 28 February 2007. D.o.i 10.1093/humrep/dem019.

Feskanich, D., Willet, W.C., Colditz, G.A., (2003). Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. Am J Clin Nutr 2003;77:504-11

Dr. Josh Axe, 2018. Dairy-Free Diet Benefits + 6 Alternatives. Online article accessed 23 August 2018. https://draxe.com/dairy-free-diet/

Mannion, C.A., Gray-Donald, K., Koski, K.G., (2006). Association of low intake of milk and vitamin D during pregnancy with decreased birth weight. CMA, 174(9), 25 April 2006.

Osteoporosis Australia. https://www.osteoporosis.org.au/

Sanders, K.M., et al., (2009). Calcium and bone health: position statement for the Australian and New Zealand Bone and Mineral Society, Osteoporosis Australia and the Endocrine Society of Australia. MJA, Vol. 190, No. 6, 16 March 2009.

Thorning T.K., Raben, A., Tholstrup, T., Soedamah-Muthu, S.S., Givens, I., & Astrup, A., (2016). Milk and dairy products: good or bad for human health? An assessment of the totality of scientific evidence. Food and Nutrition Research, 60:1, 32527, DOI: 10.3402/fnr.v60.32527

Victorian Government, 2018. Better Health Channel- Calcium. https://www.betterhealth.vic.gov.au/health/healthyliving/calcium

Weaver, C.M., Proulx, W.R., and Heaney, R., (1999). Choices for achieving adequate dietary calcium with a vegetarian diet. The American Journal of Clinical Nutrition, Volume 70, Issue 3, 1 September 1999, Pages 543s–548s, https://doi.org/10.1093/ajcn/70.3.543s