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Nutrition Notes 
February 2013
 
Lactose Intolerance
 

Calcium and Vitamin D Supplementation

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Did You Know...... 

  

Lactose intolerance is not an allergy. It is the result of not having enough lactase, the enzyme used to digest lactose, the natural sugar found in milk. The amount of lactase you produce is genetic. But most people who are lactose intolerant can digest small amounts of dairy products. Try these strategies if you like milk but sometimes experience gas, bloating, or diarrhea when you drink it: 

  • Start small: try starting with 1/4 cup, then slowly increase the serving size. Many people can tolerate up to 1 cup, especially when consumed with other foods.
  • Try lactose free milk: it is regular milk, just without the lactose.
  • Go with yogurt: the live cultures help to digest lactose.
  • Lactase pills may help: these pills contain the enzyme lactase; when taken with your first bite of a dairy food, it helps you digest the lactose.
Calcium and Vitamin D Supplementation
 
Several recent research studies, including one just published in the Annals of Internal Medicine, have questioned the value of calcium and vitamin D supplementation. The newest findings by the United States Preventive Services Task Force (USPSTF) conclude:

 

  • The combination of 400 IU of vitamin D and 1,000 mg of calcium has no effect on fracture risk in healthy postmenopausal women.
  • Evidence is insufficient to support higher doses of the supplements in this segment of the population for fracture prevention.
  • Health care providers should advise healthy adults to avoid supplementation.

The panel emphasized that these recommendations do not apply to adults with a history of fractures, adults ages 65 and older who are at increased risk for falls, and those with osteoporosis or vitamin D deficiency.

 

Even the optimal calcium dose is yet to be determined. In the US, the common recommendation for adults ages 51+  and post-menopausal women is 1200 mg daily. Dr. Walter Willet, nutrition chair at Harvard School of Public Health, suggests the World Health Organization recommendation of 500 mg probably makes more sense. As for vitamin D, he says more research is needed to determine the optimal supplement dose but 1000-2000 IU daily is probably appropriate for people who get inadequate exposure from sunlight. In addition, 800 IU daily has been shown to reduce the risk of falls in at-risk seniors.

 

Talk to your health care provider to determine what's best for you regarding supplementation. From a dietary perspective, the highest calcium sources are listed below.

 

Food                                          Approximate Calcium in mg.

 

Milk, 8 oz                                                    300

Yogurt, 8 oz                                                300-400

Cheese, 1 oz                                              200    

Cottage cheese, 1/2 cup *                        150

Salmon, canned with bones, 3 oz            200

Sardines, canned with bones, 3 oz          325

Spinach, collard, turnip greens,                250-350

     1 c. cooked       

Orange juice, calcium fortified, 8 oz        300

Soy milk, calcium fortified, 8 oz.               300

Almonds, 1/4 cup                                       150

Soybeans, edamame, 1/2 cup                 250

Tofu, 1/4 block                                            150  

 

Although the best source of vitamin D comes from exposure to sunlight, there are a few foods rich in vitamin D. They include salmon, sardines, goat milk, milk from grass fed cows, eggs, and shitake mushrooms. 

 

* My favorite brands of cottage cheese with no additives and decent sodium levels (compared to the other brands) are Daisy, Breakstone, and Friendship. 

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Breakfast Basics Makeover

 

Are you tired of the same old thing for breakfast? Then give these a try to perk up your morning!     
 
Apple Walnut Parfait    
  • 1/2 cup cottage cheese
  • 1/2 cup unsweetened applesauce
  • 1/4 teaspoon cinnamon
  • 1/4 teaspoon nutmeg
  • 1 tablespoon chopped walnuts
  • 4 sliced grapes
  • 1 tablespoon quick oatmeal or granola
Layer the cottage cheese and the applesauce in a dish. Sprinkle with cinnamon and nutmeg. Garnish with cut grapes, walnuts, and oats or granola.  Serves 1: 230 calories, 17 g protein

  

Adapted from http://daisybrand.com/recipes/recipe.aspx/214/Apple+Walnut+Breakfast 

 

Egg and Cheese Burritos 

  • 1 cup cottage cheese
  • 4 tablespoons plain Greek style yogurt
  • 4 slices turkey bacon
  • 4 large eggs
  • dash salt & pepper
  • 4 tablespoons shredded jack cheese
  • 1/4 cup chopped bell pepper
  • 1 tablespoon salsa
  • 4 small corn tortillas, warmed
Mix the cottage cheese and yogurt together in a small bowl. Prepare the turkey bacon according to package instructions. Remove to a cutting board and rough chop the bacon; set aside. Crack the eggs into a small mixing bowl and whisk thoroughly, season with salt and pepper. Combine the eggs, cottage cheese mixture, bacon, cheese, bell peppers, and salsa. Spray skillet with nonstick cooking spray and add the egg mixture. Cook the mixture, stirring constantly to create light and fluffy eggs; approximately 1-1 ½ minutes. Remove from heat. Top each warm tortilla with ¼ egg mixture and serve immediately. Serves 2-4.  
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Here in Minnesota the sun is climbing higher in the sky and even when it's only 35 degrees, the warmth of the sun gives a preview of the spring that's around the corner!   
Be well,

 
Sharon Lehrman, MPH, RD, LD
Nutrition Health and Wellness  

 

Copyright 2013 Sharon Lehrman, All Rights Reserved.

This website is for informational and educational purposes only. The information provided is not intended as a substitute for the care of a doctor. If you suspect that you have a health problem, we urge you to contact your physician or local hospital for care.
In This Issue
Calcium and Vitamin D Supplementation
Breakfast Basics Makeover: Apple Walnut Parfait, Egg and Cheese Burritos
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