Dietetic Care Services

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Dairy Allergy or Intolerance and Osteoporosis

Part 2 of the Dietetic Care article series focuses on Osteoporosis, calcium requirements for all ages and ways of obtaining calcium for people with dairy allergies or intolerances.

What is Osteoporosis?

Osteoporosis is a disease/condition where bones lose minerals such as calcium faster than the body can replace them and this causes fragile ‘brittle’ bones1. Bone tissue is constantly being renewed/replaced and calcium is essential in the formation of strong healthy bones. If we don’t get enough calcium from a healthy balanced diet osteoporosis can occur - see table 1.

In people with osteoporosis even a minor fall or accident can cause serious fractures. Every 8 minutes someone is admitted to an Australian hospital with fractures due to osteoporosis (osteoporotic fracture). This is expected to rise to every 3-4 minutes by the year 2021, as the population ages and the number of osteoporotic fractures increase2.

Risk Factors for Osteoporosis:

Osteoporosis is far more common in women than in men and there are a number of genetic and lifestyle factors that can lead to an increased rate of bone loss, including:

  • Family history of osteoporosis (mother, sister or grandmother)
  • Not eating enough calcium-rich foods
  • Low vitamin D levels (Vitamin D helps bones absorb calcium)
  • Cigarette smoking
  • Heavy and regular alcohol consumption
  • Excessive intake of caffeine (tea, coffee or equivalent)
  • Lack of physical activity (weight bearing activity is recommended)
  • Early menopause before the age of 45
  • Long-term use of steroidal medications for rheumatoid arthritis and asthma

Medical conditions such as hyperthyroidism, rheumatoid arthritis, chronic liver and kidney disease, Coeliac disease and other inflammatory bowel conditions also increase the likelihood of developing osteoporosis.

The most effective way to reduce the risk of osteoporosis is to build up calcium stores in early adulthood and reduce the rate of bone loss (through the lifestyle factors listed above) later in life.

Table 1. Recommended Dietary Intake (RDI) for calcium throughout the life stages

Age Group and Gender AI (Adequate Intake) / RDI
Calcium (mg/day)
Infants 0-6months 210 (AI)
7-12 months 270
Children
1-3 years 500
4-8 years 700
Boys
9-13 years 1000-1300*
14-18 years 1300
Girls
9-13 years 1000-1300*
14-18 years 1300
Men
19-30 years 1000
31-50 years 1000
70+ years 1300
Women
19-30 years 1000
31-50 years 1000
70+ years 1300
Pregnancy
14-18 years 1300
19-30 years 1000
31-50 years 1000
Lactation
14-18 years 1300
19-30 years 1000
31-50 years 1000

*For calcium there are separate recommendations for children aged 9-11 years and 12-13 years because of growth needs. Children 9-11 years who are growing and maturing at much greater rates than average may need the intakes for 12-13 year old adolescents.

Source: Commonwealth Department of Health & Ageing Australia, Ministry of Health, New Zealand, Nutrient Reference values for Australia & New Zealand including Recommended Dietary Intakes. Australian Government Publishing Service, 2005

Dairy Allergy/Intolerance and Calcium Intake

Food allergies involve the immune system and occur when someone is allergic to the proteins in certain foods. Reactions can range from a mild rash to a life threatening anaphylactic reaction. For example, people who are allergic to the protein in cow’s milk need to avoid all traces of cow’s milk to prevent a potentially serious reaction3. Food intolerances are different to food allergies and do not involve the immune system. They are triggered by food chemicals found in foods and drinks, and in some cases, having only a small amount may not cause a reaction.

Dairy products are by far the richest dietary sources of calcium and current dietary recommendations are to eat three serves of dairy or calcium rich alternative a day. One serve is equal to 250mls milk, 200g yoghurt or 40g hard cheese. For people who are allergic or intolerant to dairy products it is extremely important to choose dairy alternatives that are calcium enriched such as rice or soy based products (i.e. milk, yoghurt, custard and ice cream). Most soy cheeses contain a small amount of dairy and these are not recommended for people with dairy allergy. When choosing an alternative to cow’s milk look for products that have approximately 300mg of calcium per 250ml serving. Other foods that are high in calcium include tinned salmon and sardines, especially if you eat the soft bones.

Table 2. Best non-dairy sources of calcium

Source and serving size Approximate calcium content (mg)
Calcium Enriched Soy Milk
250mls
300
Calcium Enriched Rice Milk
250mls
300
Calcium Enriched soy yoghurt
200g
250
Tinned sardines
100g
460
Tinned Salmon
100g
385

If you suffer from food allergies or intolerances it’s important to make sure that you eat a healthy balanced diet and have an active lifestyle to help prevent disease. These days there are many foods and drinks available for people who require special diets, and your local Accredited Practising Dietitian (APD) can tailor an eating plan that is right for you. If you think you may have a food allergy or intolerance see your GP as it’s important to have it properly diagnosed.

To find an APD in your area, go to the Dietitians Association of Australia website www.daa.asn.au and click on ‘Find an APD’, call the APD hotline on 1800 812 942, call your local hospital or check the yellow pages under ‘D’ for Dietitian. For people living outside Australia contact the Dietitians Association in your country.

REFERENCES:

  1. Thomas, B, Manual of Dietetic Practice, Blackwell Publishing
  2. Osteoporosis Australia 2007 website - http://osteoporosis.org.au/osteo_osteoporosis.php
  3. Royal Prince Alfred Hospital, Friendly Food, Murdoch Books

Kyann Calvi is an Accredited Practising Dietitian (APD) who specialises in Food Allergy/Intolerance, Coeliac Disease and other gastrointestinal disorders such as Irritable Bowel Syndrome. For the past seven years she has helped people with food allergies/intolerance meet their nutrient needs through special diets. Kyann works in private practice locations in the Eastern suburbs of Melbourne.Contact Us

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