Can you meet your calcium needs with a dairy-free diet? Absolutely!

If you're cutting out dairy you might be wondering how you'll get enough calcium, but you're in luck. The dairy-free section of the grocery store gets bigger and bigger and many options have comparable nutrition profiles to cow's milk.




On your journey of following a plant-based diet you may have considered, or already are, limiting or eliminating dairy products from your diet. This could be for ethical, health or environmental reasons. I say "Good for you!" no matter what your reason is. I’ve been dairy-free for most of the last 20 plus years. I went back to dairy a couple of times but ultimately decided that dairy-free was more aligned with my values.


When limiting or eliminating dairy products it's important to know how you will meet your calcium needs. Dairy milk, cheese and yogurt are good sources of calcium. [1-2] There's no question about that. Canned fish like salmon and sardines with the bones are also good sources of calcium.[1-2] If you also limit or don't eat fish, then it’s important to be knowledgeable of plant-based sources of calcium. Note that dairy is a good source of other essential nutrients like riboflavin, protein and vitamin B12, but for this post I will focus on calcium. [1-2]


What is calcium?


Calcium is a mineral and it's the most abundant mineral in the body.[1] It’s categorized as a micronutrient since we need it in smaller amounts versus nutrients that we need in larger amounts, macronutrients, like carbohydrates, protein and fat.


Functions in the body


Calcium is well known as a major component in our skeletal structure. It also plays a key role in blood clotting, cell signaling, cardiac function, nerve transmission, secretion of hormones like insulin, constriction and relaxation of blood vessels, and smooth muscle contractility. Smooth muscle makes up the involuntary muscles like those for our internal organs and digestive system. [1]


How much do we need?


The amount each person needs depends on age and gender.


Table 2

The current Recommended Daily Allowances (RDAs) for calcium. [3]

Age

Male

Female

Pregnancy

Lactating

0 - 6 months

200 mg

200 mg

7 - 12 month

260 mg

260 mg

1 - 3 years

700 mg

700 mg

4 - 8 years

1,000 mg

1,000 mg

9 - 13 years

1,300 mg

1,300 mg

14 - 18 years

1,300 mg

1,300 mg

1,300 mg

1,300 mg

19 - 50 years

1,000 mg

1,000 mg

1,000 mg

1,000 mg

51 - 70 years

1,000 mg

1,200 mg

>70+ years

1,200 mg

1,200 mg



What foods are good sources of calcium? I'm glad you asked!


Table 2

Sources of Calcium [1-3, 5]

Food

Serving Size

Calcium content, milligrams (mg)

Orange

1 medium

61

Cooked broccoli

1 cup

62

Chia seeds

1 tablespoon

76

Canned garbanzo beans

1 cup

77

Almond butter

2 tablespoons

86

Canned kidney beans

1 cup

87

Cooked kale

1 cup

94

Dried figs

1/2 cup

121

Canned navy beans

1 cup

123

Tahini

2 tablespoons

128

Cooked bok choy

1 cup

158

Fortified almond milk*

1 cup

200

Cooked turnip greens

1 cup

209

Soy yogurt

6 oz

299

Milk, nonfat**

1 cup

299

Fortified orange juice*

1 cup

300

Fortified soy milk*

1 cup

300

Sardines, canned in oil, with bones

3 oz

325

Yogurt, plain, low fat**

8 oz

415

Firm tofu

1/2 cup

434


*Be sure to read the nutrition label when buying plant-based milk, yogurt and other products. The amount of calcium added varies among brands. Check that the product is also fortified with vitamin D as this vitamin is needed to aid in calcium absorption. More and more brands are also fortifying their products with vitamin B12, an essential nutrient, which will be listed on the nutrition label and/or in the ingredients list.


**Included for comparison



Sample meals and snacks:

  • Kidney or navy beans over rice with cooked greens and a fresh orange

  • Whole grain cereal with fortified soymilk

  • Almond butter (and jam or jelly) sandwich on whole grain toast

  • Stir-fried vegetables (include broccoli and bok choy) with tofu over rice

  • Soy yogurt with 1 to 2 tablespoons of chia seeds and a handful of almonds



Bioavailability of calcium from selected foods:


Bioavailability is the amount of a nutrient that is digested, absorbed and metabolized by the body. [1,4] Meaning the full amount of a nutrient that's eaten may not be completely utilized by the body. It's important to note that plant-based nutrients tend to have lower bioavailability than animal sources. [6] This is true for other vitamins and minerals aside from calcium. For example, if you have a mixed greens salad including kale and spinach with beans you might absorb about half of the calcium from the kale, a small fraction of the calcium from the spinach and about 20% from the beans.


Foods that have >50% absorption: cauliflower, watercress, cabbage, brussels sprouts, rutabaga, kale, mustard greens, bok choy, broccoli, turnip greens.


Roughly 30% absorbed: calcium fortified soy milk, calcium-set tofu, calcium fortified foods and beverages.


Roughly 20% absorbed: almonds, sesame seeds, pinto beans, sweet potatoes.


<5%: spinach, rhubarb, Swiss chard. [1]




Compounds that may increase or interfere with absorption:


Vitamin D helps by making calcium-binding protein which is needed for absorption. [1]


Sodium and phosphorus are minerals that we also need, however, in excess amounts they can interfere with the absorption of calcium.


Eating a lot of packaged or processed foods high in sodium and/or adding salt to your food can lead to excess sodium intake. This can contribute to a reduced amount of calcium that the body absorbs. [4]

Phosphorus can cause loss of calcium. This nutrient is found in milk, soft drinks, meats, and caffeine in coffee and tea. [4]


Phytates and oxylates are found in plant foods which bind with calcium creating calcium salts which then inhibits absorption. Phytates are found in whole grains, nuts, seeds and beans. Oxalates are found in spinach, beet greens, Swiss chard, sweet potatoes and rhubarb. [4]



Navigating the dairy-free market


The dairy-free market has come a long way since I first went dairy-free back in the late 90’s! It’s exciting to see new products come out with the demand increasesing as more people opt to reduce their dairy intake or go dairy-free altogether.


I encourage you to check out some of the brands I've listed below and discover what products and flavors you enjoy. Read the nutrition labels to be sure it has been fortified with calcium if you're trying to replace any dairy for plant-based milk, cheese or yogurt. Note that this is not an all-inclusive list and I am not affiliated with any of the brands mentioned. There are many more available than the ones I have listed. If you can’t find dairy-free milk or other dairy-free food items like cheese, yogurt, cream cheese, sour cream or ice cream at your local grocery store, then speak with the store manager. If there’s enough demand they might add it to the inventory. Some items are also available on Amazon if your local grocer is not an option.


Miyoko’s Miyoko's has been upping their game in products year after year. The block of cheddar is a staple in my refrigerator and I'll be trying the liquid mozzarella as soon as it's back in stock at my grocery store! There is also cream cheese available in multiple flavors like cinnamon raisin, everything, fish-free lox, classic plain and savory scallion. I picked up one of the Fresh French Style Winter Truffle Cashew Milk Cheese wheels for Friendsgiving later this week!

Daiya I find that people love or hate the cheese options, but I'm a fan of their frozen pizza!

Good Karma This company has a plant-based sour cream and a great variety of flax milk. In case anyone else noticed, yes, they discontinued their yogurt in the last year or so to focus on their other products.

Silk They have a great variety of plant-based milk and yogurt.

So Delicious I enjoy their yogurt and always make a bee-line for their products in the ice cream section!

Forager They have an extensive line of yogurt, cheese, milk and other products.

Kite Hill They have a variety of options including yogurt, milk, sour cream, cream cheese and other spreadable cream cheeses.

Ben and Jerry's - Yes, this is a post on calcium, but I would be doing a disservice if I didn't let you know that Ben and Jerry's dairy-free line of ice cream keeps getting bigger and bigger and is delicious! I've found that some grocery stores have dairy-free options in a different section so keep looking in case you don't see it right away. I encourage people to watch their excess or added sugar intake, but there is room for ice cream in a well balanced diet!


I hope you found this information helpful! I encourage you to work with a registered dietitian to help you create a meal plan to ensure you're getting enough calcium to meet your individual needs. If you'd like to take an deeper dive into calcium you can read more below.




Other interesting facts about calcium:


  • Most of the body’s calcium is in the bones where it provides a reservoir of calcium for the blood. Blood calcium levels will remain within normal range even when calcium in the diet is inadequate, but at the expense of bone loss. This can lead to osteoporosis (hollowing of the bones) over time. Blood tests do not assess calcium levels in the bone. A bone density test, or DEXA scan, is used for this and is not typically done until later in life around 65 to 70 years of age. [1,4]

  • The “active growth phase” for bone growth is between birth and 20 years old. The next phase of peak bone mass development occurs between the ages of 12 and 30. Ensuring adequate intake is important and then maintenance becomes key. Weight bearing exercise has shown to increase bone mass density. Think of sports that include activities like running and jumping versus a non-weight bearing exercise like swimming. [4]

  • While searching for current RDAs I came across an interesting article that interviews Dr. Walter Willett, former chair of the Department of Nutrition at Harvard T.H. Chan School of Public Health. He explains why as little as 500-700 mg of calcium a day may be adequate.

  • Here you can learn more about variations in calcium recommendations between Australia, the United Kingdom, the European Union, the United States and Canada.

  • Calcium deficiency can lead to tetany which is involuntary muscle contractions or muscle spasms. High calcium levels can cause calcium rigor, which is when muscles contract and cannot relax. [4]

  • Calcium supplements -- you can have too much of a good thing: A study by Bolland and others reported that calcium supplements can cause kidney stones, hypercalcemia, acute gastrointestinal symptoms leading to hospitalization, and increased cardiovascular disease (CVD) risk. [7]



Food for thought:

Consumption of dairy as a calcium source is so deep-rooted in our culture, due to strong marketing and lobbying by the dairy industry, that many believe this is the only way to achieve adequate intake. Humans are the only species that consumes breast milk (cow’s milk) beyond the stage of infancy and are also the only species that consumes the breast milk of another species. Breast milk is intended to nourish a growing baby until they naturally wean off to eat whole foods. That could be in reference to humans or other mammals whether they are carnivores or herbivores. How is it that humans have such a difficult time maintaining calcium levels after infancy? I imagine some would argue that there are situations where young animals are rehabilitated with the breast milk of other species in a sanctuary environment, however, that is not what I’m referring to here.


An immeasurable number of cows are mistreated in order to obtain dairy and veal. Yes, consuming dairy supports the veal industry. Female cows need to be impregnated in order to produce milk just like humans. Male calves are not considered profitable in many cases so they are either killed or sent to veal farms. No, cows don’t produce milk simply because they eat grass. I've had a number of conversations with people who argue that they know of a farmer that takes very good care of their cows. I don't doubt that there are incredible farmers. I'm referring to the greater portion of the dairy industry which prioritizes profit over the well-being of these incredible animals which deserve far more than being exploited for profit and taste buds.




Food politics:

The Dietary Guidelines for Americans comes out every 5 years and is published jointly by the United States Department of Agriculture and the U.S. Department of Health and Human Services. The guidelines are intended to be the standard of how to follow a healthy diet. These are not unbiased guidelines. Members of the dairy industry are very much involved in what is defined as "healthy" for Americans. For example, members of the Dietary Guidelines 2000 Advisory Committee had industry affiliations in the following dairy industry groups: Dannon Company, National Dairy Council, National Dairy Promotion and Research Board, Mead Johnson Nutritionals (milk-based infant formulas), Nestle (milk-based formulas, condensed milk, and ice cream) and Slim-Fast (milk-based diet products). The profits of many industries depend on the high consumption of dairy products by Americans. Multiple servings of dairy each day are recommended despite the fact that most people in the world over the age of 5 years cannot digest lactose, a sugar in milk. [8] Remember, breast milk is for infants. The body doesn't need lactase, an enzyme in our body that breaks down lactose, the sugar in milk, after infancy. So why does our Dietary Guidelines emphasize the importance of dairy to meet our calcium needs? Profit over health. That's only a small fraction of food politics. Marion Nestle's book, Food Politics: How the food industry influences nutrition and health, is an excellent book if this topic interests you.


The information I presented here is for educational purposes only. It is not medical advice and it is not intended to diagnose nutritional adequacy, deficiency or toxicity. The information provided here is not intended to be personal nutrition advice for any one particular individual. You should consult with a registered dietitian for a proper diet analysis to ensure you are getting the appropriate amount of any particular nutrient to meet your needs.




Resources:


  1. Whitney E, Rolfes S. Understanding Nutrition. 12th ed. Belmont, CA: Cengage; 2013.

  2. Havala Hobbs S. Living Dairy-Free for Dummies. Hoboken, NJ: Wiley Publishing; 2010

  3. Calcium Fact Sheet for Health Professionals. National Institutes of Health Website. https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/. Published November 17th, 2011. Accessed November 19th, 2021.

  4. Thompson J, Manore M. Nutrition: an applied approach. 3rd ed. Glenview, IL: Pearson; 2012.

  5. FoodData Central. United States Department of Agriculture Website. https://fdc.nal.usda.gov/. Accessed November 13th, 2021

  6. Gibson, R., Perlas, L., & Hotz, C. Improving the bioavailability of nutrients in plant foods at the household level. Proceedings of the Nutrition Society. 2006; 65(2), 160-168. doi:10.1079/PNS2006489

  7. Bolland MJ, Grey A, Reid IR. Should we prescribe calcium or vitamin D supplements to treat or prevent osteoporosis? Climacteric. 2015;18(Suppl 2):22-31.

  8. Nestle M, Food Politics: how the food industry influences nutrition and health. 10th ed. Berkeley and Los Angeles, CA; 2013.

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