Alternate Sources of Nutrients
Alternate Sources of Nutrients When Milk and Milk Products are Removed from the Diet
Adequate protein is readily available from meat, fish, soybeans and other legumes, nuts, grains, and vegetables, so removing milk and milk products from the diet is not usually a problem.
Calcium
Milk is the most abundant and readily available source of calcium in the normal diet. One cup of milk contains 290 milligrams of calcium. Table Dietary reference intake (DRI) values for Calcium and Vitamin D gives the dietary reference intake values for calcium and vitamin D.
Table Dietary reference intake (DRI) values for Calcium and Vitamin D
| Life Stage Group Malea and Female | Calcium Al (mg/day) | Vitamin D
Al (mcg/day) b,c |
| 0 to 6 months* | 210 | 5 |
| 6 to 12 months | 270 | 5 |
| 1 to 3 years | 500 | 5 |
| 4 to 8 years | 800 | 5 |
| 9 to 13 years | 1,300 | 5 |
| 14 to 18 years | 1,300 | 5 |
| 19 to 30 years | 1,000 | 5 |
| 31 to 50 years | 1,000 | 5 |
| 51 to 70 years | 1,200 | 10 |
| > 70 years | 1,200 | 15 |
| Pregnancya | ||
| 18 years or younger | 1,300 | 5 |
| 19 through 50 years | 1,000 | 5 |
| Lactationa | ||
| 18 years or younger | 1,300 | 5 |
| 19 to 50 years | 1,000 | 5 |
a Female-only for pregnancy and lactation values
b As cholecalciferol (1 microgram (mcg) = 40 IU vitamin D)
c In the absence of adequate exposure to sunlight
Al = Adequate intake
* Source of calcium is mother’s milk.
IMPORTANT MICRONUTRIENTS IN MILK
Milk and milk products are an important source of calcium, phosphorus, vitamin D, vitamin B12, riboflavin, pantothenic acid, potassium, vitamin A, and vitamin E (Vitamins D and A are added as fortification).
These nutrients must be obtained from other foods and supplements when all milk is removed from the diet.
CALCIUM ABSORPTION
♦ The percentage of the calcium contained in foods that is actually absorbed, used, and retained by the body is variable, depending on age, level of calcium intake, type of food eaten, and other nutrients eaten at the same time.
♦ An average adult will absorb approximately 40% of the calcium in their diet. This is increased during growth, pregnancy, and lactation, and it is reduced during aging. In general, the lower the intake, the more calcium is retained in the body (i.e., less calcium is excreted when intake is low).
♦ In order to efficiently absorb calcium, an adequate level of vitamin D in the body is necessary. Vitamin D is obtained from some foods (milk, liver, egg yolk), but the best source is the action of sunlight (UV light) on the skin.
♦ A diet high in phosphorus and protein (a traditional high-protein American diet) tends to reduce the amount of calcium retained in the body.
Alternative calcium sources include (Table Nondairy sources of Calcium):
♦ Canned fish such as sardines and salmon, with bones. (The calcium is in the bones; the canning process softens them, making them more easily digested.)
♦ Green leafy vegetables such as arugula, kale, beet and turnip greens, collards, mustard greens, and broccoli. However, the calcium in vegetables is not so readily absorbed by the body as that from animal sources.
♦ Some nuts and legumes also contain significant levels of calcium.
Table Nondairy sources of Calcium
NOTE: Do not eat any food which causes you to have an allergic reaction.
Listed according to calcium content Ca = calcium
| FOOD | PORTION | ||
| Metric | Imperial | ||
| More than 300 mg Ca | |||
| Sardines, with bones, canned | 85 g | 3 oz | |
| Rhubarb, frozen cooked* | 270 g | 1 cup | |
| Wheat flour, artificially enriched | 125 g | 1 cup | |
| Collards, frozen, cooked* | 170 g | 1 cup | |
| Arugula (rocket kale) | 170 g | 1 cup | |
| 250 to 300 mg Ca | |||
| Sockeye salmon, with bones, canned
(213g/can) (7.5 oz can) |
100 g | 1/2 can | |
| Rhubarb, cooked, fresh* | 270 g | 1 cup | |
| Spinach, cooked* | 190 g | 1 cup | |
| 200 to 250 mg Ca | |||
| Almonds | 125 mL | 1/2 cup | |
| Pink salmon, with bones, canned
(213g/can) (7.5 oz can) |
100 g | 1/2 can | |
| Oysters, raw, meat only | 250 g | 1 cup | |
| Sugar, brown, packed down | 220 g | 1 cup | |
| Turnip greens, cooked * | 165 g | 1 cup | |
| 150 to 200 mg Ca | |||
| Beet greens, leaves and stems, cooked* | 145 g | 1 cup | |
| Kale, frozen, cooked | 130 g | 1 cup | |
| Amaranth (cooked grain): uncooked weight | 100 g | (cooked) 1 cup | |
| 100 to150mg Ca | |||
| Baked beans, canned | 250 mL | 1 cup | |
| Brazil nuts | 125 mL | 1/2 cup | |
| Scallops | 7 medium | ||
| Sesame seeds | 125 mL | ½ cup | |
| Soya beans, cooked | 250 mL | 1 cup | |
| Tofu | (8 x 6 x 2 cm) | 1 piece | |
| Shrimp, meat only | 113 g | 4 oz | |
| Molasses, cane, blackstrap | 20 g | 1 tbsp | |
| Dandelion greens, cooked * | 105 g | 1 cup | |
| Mustard greens * | 140 g | 1 cup | |
| Okra pods, cooked | 160 g | 1 cup | |
| Brussels sprouts* | 156 g | 1 cup | |
| Broccoli, cooked | 250 mL | 1 cup | |
| 50 to 100 mg Ca | |||
| Asparagus, fresh, cooked, drained | 240 g | 1 1/2cups | |
| Lima beans, cooked | 180 g | 1 cup | |
| Green beans, cooked | 125 g | 1 cup | |
| Yellow or wax beans, cooked | 125 g | 1 cup | |
| Cabbage, fresh, cooked * | 217 g | 1 1/2 cups | |
| Chinese cabbage (bok choy)* | 76 g | 1 cup | |
| Sauerkraut * | 235 g | 1 cup | |
| Carrots, cooked | 234 g | 1 1/2cups | |
| Parsnips, cooked | 155 g | 1 cup | |
| Onions, cooked | 210 g | 1 cup | |
| Tomatoes, canned, solids and liquid | 241 g | 1 cup | |
| Chili con carne with beans | 250 mL | 1 cup | |
| Red kidney beans, cooked | 250 mL | 1 cup | |
| White beans, cooked | 250 mL | 1 cup | |
| Beans, dry, cooked and drained | 180 g | 1 cup | |
| Lentils, cooked | 200 g | 1 cup | |
| Garbanzo beans (Chickpeas) (cooked) | 250 mL | 1 cup | |
| Wheat germ | 113g | 1 tbsp | |
| Oats, puffed | 50 g | 2 oz | |
| Orange, raw | 1 medium | ||
| Orange sections | 180 g | 1 cup | |
| Hazelnuts, chopped | 28 g | 1 oz | |
| Cereal, All-Bran | 250 mL | 1 cup | |
| Cereal, 100% Bran | 250 mL | 1 cup | |
| Cereal, Branbuds | 250 mL | 1 cup | |
| Cereal, Granola | 150 mL | % cup | |
| 15 to 50 mg Ca | |||
| Cereals | |||
| Bran flakes and raisins | 250 mL | 1 cup | |
| Corn bran | 250 mL | 1 cup | |
| Cheerios | 250 mL | 1 cup | |
| Oatmeal, cooked | 250 mL | 1 cup | |
| Shredded wheat | (10 mg Ca each biscuit) | 2 to 5 pieces | |
| Shreddies | 250 mL | 1 cup | |
| Bread | |||
| Cracked wheat | (22 mg Ca per slice) | slice | |
| Mixed grain | (27 mg Ca per slice) | 1 slice | |
| Rye, light | (19 mg Ca per slice) | 1 slice | |
| White | (24 mg Ca per slice) | 1 slice | |
| Whole wheat 100% | (25 mg Ca per slice) | 1 slice | |
| Whole wheat 60% | (23 mg Ca per slice) | 1 slice | |
| White bun, hamburger or hot dog | (37 to 44 mg Ca) | 1 | |
| Pita, whole wheat, 16.5 cm diameter | (49 mg Ca) | 1 | |
| Tortilla, corn | (42 mg Ca) | 1 | |
| Vegetables | |||
| Cabbage, raw, shredded | 250 mL | 1 cup | |
| Carrot, raw, medium | 1 | ||
| Cauliflower, raw, cooked | 250 mL | 1 cup | |
| Celery, diced, raw | 250 mL | 1 cup | |
| Turnip, cooked | 250 mL | 1 cup | |
| Spinach, raw, chopped | 125 mL | A cup | |
| Olives, black | 5 large | ||
| Olives, green | 5 medium | ||
| Parsley, raw, chopped | 25 mL | 2 tbsp | |
| Peas, boiled | 250 mL | 1 cup | |
| 15 to 50 mg Ca | |||
| Fruit | |||
| Grapefruit, raw | 1 medium | 1 medium | |
| Kiwi | 1 large | 1 large | |
| Fig, dried, uncooked | 1 medium | 1 medium | |
| Pear, raw | 1 medium | 1 medium | |
| Raisins | 125 mL | ½ cup | |
| Other | |||
| Chocolate | 30 g | 1 square | |
| Egg, whole, cooked | 1 large | 1 large | |
| Maple syrup | 15mL | 1 tbsp | |
| Peanuts, oil roasted | 50 mL | 1/4 cup | |
| Sunflower seeds, kernel | 50 mL | 4 tbsp | |
| Soy milk, liquid | 250 mL | 1 cup | |
* Contains oxalic acid, which impairs calcium absorption. Although the calcium is present in the food at the given level, the actual amount absorbed is significantly less.
Calcium Supplements
If all milk and dairy products are removed from the diet, it is often difficult to obtain sufficient calcium from these alternative sources on a regular basis. A supplement is then necessary. Calcium gluconate, calcium citrate malate, and the Kreb’s cycle derivatives (citrate, fumarate, malate, succinate, glutamate) are the most well absorbed and utilized forms of calcium, and they are superior to calcium carbonate as a source of the mineral. These terms will appear on the label of the supplement, so you should become familiar with them when selecting an appropriate calcium supplement. The use of calcium-based antacids is not recommended. Antacids are designed to neutralize stomach acid, which is necessary for the first stage of protein digestion (acid hydrolysis). In addition, the antacid produces an alkaline environment that may reduce the absorption of a variety of minerals, such as iron, zinc, copper, and calcium itself, which require an acidic environment for efficient absorption.
CALCIUM SUPPLEMENTS
♦ Calcium carbonate provides 625 to 750 milligrams of elemental calcium per 2.5 millileters ( ½ teaspoon).
♦ However, calcium citrate malate and calcium gluconate appear to be more effective supplements than calcium carbonate. In addition, some research studies indicate that they may interfere less with the absorption of iron than calcium carbonate.
Heating and Processing of Milk
Heating or boiling milk will not make it non-allergenic, although a few of the proteins may be decomposed, reducing their allergenicity to some extent. Only those persons who are allergic to heat-labile proteins (see earlier discussion) will tolerate boiled milk and will also be able to tolerate canned milk (evaporated milk) that has been extensively heated. Milk as an ingredient in cooked products is sometimes tolerated when unheated milk is not. However, some allergenic milk proteins that are heat-stable will cause allergy in sensitive people, even after cooking. The cow’s milk in infant formulas remains allergenic and will induce an allergic reaction in milk-allergic infants.
Milk from Other Animals
Goat’s milk may be tolerated by a small number of people who are allergic to cow’s milk. However, the incidence of allergy to goat’s milk in these people is quite high: In two separate studies, 25 out of 44, and 22 out of 28, children allergic to cow’s milk reacted to goat’s milk. Also, immunological studies have indicated that cow’s milk and goat’s milk proteins are antigenically very similar. The chances of developing an allergy to goat’s milk if a person is allergic to cow’s milk is obviously quite high.
GOAT’S MILK
♦ Goat’s milk proteins closely resemble those in cow’s milk.
♦ Most people who are allergic to cow’s milk proteins demonstrate, or soon develop, similar sensitivity to goat’s milk proteins.
♦ Many goat’s milk proteins cross-react with cow’s milk proteins.
♦ The majority of children allergic to cow’s milk are or will become allergic to goat’s milk.
♦ Goat’s milk is deficient in folate.
MARE’S MILK
♦ Fewer proteins are similar to cow’s milk proteins.
♦ In a recent research study, only 1 of 25 cow’s-milk-allergic children were allergic to mare’s milk.
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