The importance of calcium for us, the implications of insufficient calcium intake.

Milk and milk products like curd, cheese, etc are always associated with the intake of Calcium. However, there is a segment of people who cannot digest milk and products and they have to stay off them. Calcium has an important role to play in our bodies (mentioning here the fact that calcium has some role to play in weight loss diets makes it an important feature of weight loss programs). So, how does a person who is lactose intolerant make up for the lack of calcium in the diet. Are calcium supplements necessary?

CALCIUM - WHY IS IT IMPORTANT?

Calcium is the most abundant nutrient in the body. Our body needs calcium for:

• Healthy skeleton: Our bones store calcium and provide support to our body. If the intake of calcium is insufficient the body draws calcium from the bones leading to the thinning of bones
• Healthy heart: Calcium plays an important role in muscle contraction and stimulation. This includes the beating of the heart.
• Healthy brain function: Calcium delivers chemical signals from the outside to the inside of the cell.
• Weight Maintenance: There is good evidence that a diet high in Calcium helps in the reduction of weight.

IMPLICATIONS OF INSUFFICIENT CALCIUM INTAKE:

Calcium deficiency symptoms are not visible at an early stage but as it progresses certain signs like muscle cramps, dry and brittle nails, late puberty, tooth decay, frequent fractures and bone breakage, and insomnia are seen. Calcium deficiency, when left untreated, can lead to several health problems. Inadequate level of calcium is associated with the following ailments.

1. Osteopenia: is low bone mineral density and if left untreated will lead to osteoporosis.
2. Osteoporosis: is a condition wherein the bones become porous, brittle and fragile and are at greater risk of fractures and breakage. It is more common in women compared too men.
3. Malnutrition: When the food that you eat does not give the nutrients essential for a healthy functioning body it leads to malnutrition. If you're malnourished, wounds can take longer to heal and you may start to feel tired or depressed.

WHAT DOES BEING LACTOSE INTOLERANCE MEAN?

Lactose intolerance occurs when the body has trouble digesting the lactose, a natural sugar found in milk and dairy products. It is also called as lactase deficiency. Lactase is nothing but an enzyme that breaks down the lactose into glucose and galactose which can be absorbed and used as a source of energy by our bodies. Because of lactase deficiency the undigested lactose remains in the digestive system (large intestine) and gets fermented by the bacteria causing gas, bloating, abdominal cramping, diarrhea, and nausea.

Lactose intolerance is different than a milk or dairy allergy. The food allergy is caused when immune system reacts to a particular type of food immediately on consumption and causes rash, wheezing or itching. In an allergy, even a tiny particle of food can immediately trigger the symptoms, whereas some people with lactose intolerance can still tolerate small amount of lactose without any problems. However, it varies from person to person. Lactose intolerance can therefore be a very uncomfortable condition which causes the sufferers to avoid milk and milk products. Avoiding these foods that are a rich source of calcium can lead to major deficit in calcium and lead to its complications over a period of time and hence other non dairy dietary sources of calcium should be incorporated in the daily diet.

HOW DOES ONE FULFIL THE DAILY CALCIUM REQUIREMENTS WITHOUT DAIRY IN THE DIET?

There are some studies indicating that the intake of Calcium through supplements may increase the risk of kidney stones or heart disease. So, what is the best approach then? Food is what we say. If a person cannot digest dairy he / she can still fulfil the requirement of Calcium through the intake of certain foods:

1. Look for Lactose Free Milk: Regular milk is a well-known source of calcium and one of the best options to get adequate calcium. But, it has the sugar lactose. Lactose-free milk contains the same amount of lactose, but the sugar lactose is already pre-digested for you by the addition of the enzyme lactase by the milk producer, making it a safe option.
2. Eat your beans and lentils: Beans and lentils are high in protein, fiber and micronutrients. But, they also contain some amount of calcium. 1 cup cooked white beans provide about 13% of daily requirement of calcium.
3. Almonds: Of all the nuts, almonds are the highest in calcium. An ounce of almonds, or about 22 nuts, delivers 8% of the daily requirement of calcium. They are also rich in magnesium and vitamin E.
4. Leafy Greens: some of the leafy vegetables are rich in calcium like collard greens, kale, broccoli, and spinach. One cup of cooked collard greens contains 25% of your daily needs. However, there are some leafy green for example spinach that contain oxalates naturally that bind the calcium and make it unavailable to the body.
5. Ragi: Amongst all the whole grain cereals available, ragi is rich in calcium.
6. Amaranth: The seeds and leaves of amaranth are very nutritious. A cup of cooked amaranth grain provides 12% of the required daily intake of calcium.
7. Edamame and Tofu: One cup of edamame has 10% of the required daily intake of calcium. It is also a good source of protein and folate. Tofu fortified with calcium also gives around 86% of the daily requirement of calcium in ½ cup.
8. Figs: Dried figs apart from being rich in fiber and antioxidants contain more calcium compared to other dried fruits. A single ounce provides almost 5% of your daily needs for calcium.
9. Sesame Seeds: Sesame seeds are rich in calcium, magnesium, copper, vitamin B1, zinc and dietary fiber. Whole sesame seeds contain about 88 mg of calcium per tablespoon of seeds. Toasted or raw seeds (whole or hulled) can be added to steamed broccoli (a veggie rich in calcium), stir-fried green beans or put on top of salads and in dressings etc. Consume in moderation as they are also rich in fats with the above benefits.
10. Yogurt: though a dairy product but the lactose in it is already digested by the bacteria present in yogurt. Hence, a few lactose intolerant people can tolerate yogurt and it can be included in the diet as its rich in calcium.

If you are diagnosed with lactose intolerance, you might want to have a list of foods that you can eat and those that you cannot. Several weight loss programs suggested by dietitians in Mumbai and nutritionist in Mumbai can help you plan healthy meals taking into consideration what you can and what you cannot. Especially for sports persons, being lactose intolerant can affect the performance in the sport with the lack of sufficient Calcium in the diet. Look out for a sports nutritionist can help plan meals with the necessary Calcium in the diet. Moreover corporates can organize corporate wellness programs for their employees to educate them about such issues and how they can help employees and their families about healthy diet plans.

Arati Shah is an astute nutritionist having expertise in all types nutrition, she is one of the top 10 dietitians in Mumbai who can also guide one through corporate wellness programs with same efficacy