Calcium Deficiency

People with Crohn’s disease are susceptible to not getting adequate calcium in their diet. They should take care to consume enough of this important nutrient to keep their bones healthy.

The Importance of Calcium

Calcium is the most abundant mineral in the body. It resides primarily in the bones. It’s also an essential nutrient that the body needs for a variety of other purposes. Bone depends on a ready supply of calcium to stay strong and healthy, but even the circulatory and nervous systems rely on calcium to function properly.

As a general guideline, adult men and women should aim for at least 1,000 milligrams of calcium per day. Adequate vitamin D is important to both immune system function and bone health. Vitamin D also regulates how much calcium circulates in the bloodstream and how much calcium the bones will use to maintain healthy structure.

People who don’t consume enough calcium or who have low vitamin D levels are at increased risk of developing brittle bones. This condition is known as osteoporosis. Worse, some corticosteroid drugs that treat Crohn’s inflammation may contribute to risk factors for osteoporosis.

Since Crohn’s patients often develop osteoporosis, a doctor may prescribe biphosphonates to prevent bone mineral loss. However, a recent study showed that taking one of these drugs wasn’t better at preventing bone mineral loss than taking daily vitamin D and calcium citrate supplements. This finding suggests that getting enough calcium and vitamin D should keep Crohn’s patients’ bones healthy. People with Crohn’s may find that taking supplements is the best way to ingest more calcium.

The Challenge of Lactose Intolerance

Milk and dairy products are among the richest dietary sources of calcium. Crohn’s patients often avoid dairy because they suspect they’re lactose intolerant. Lactose intolerance is when a person can’t break down the sugars (lactose) in milk due to the lack of the lactase enzyme.

Usually, humans are born with the ability to produce the enzyme and digest milk. However, many adults lose this ability as they mature. Someone who can’t digest milk will experience symptoms ranging from gas and discomfort to diarrhea and cramping if they consume milk products.

Yet even people who are lactose intolerant may be able to tolerate some dairy every day, though tolerance is highly variable from person to person. Some can tolerate up to two cups of milk per day, which supplies about 11 grams of lactose. Even better news is the exceptionally low amount of lactose in hard cheese. Parmesan, for example, contains less than one gram of lactose per teaspoon, yet it contains a relatively large amount of calcium. 

People who are truly intolerant to even small amounts of lactose should be aware that food manufacturers often add lactose to processed and packaged foods. Examples of these foods include:

  • packaged breads and baked goods
  • processed meats, such as sausage and hamburgers
  • soft drinks
  • breakfast drinks
  • slimming products

Alternatives to Dairy

People with Crohn’s who are concerned about lactose intolerance can experiment with calcium-fortified foods. These foods may help take the place of dairy in the diet. Soy products, such as soy milk with added calcium, are now widely available. Rarely, some people are allergic to soy. Alternatives to soy milk include rice milk, almond milk, flax milk, hemp milk or even coconut milk. Hard cheeses, such as Parmesan, contain very little lactose while supplying relatively large amounts of calcium.

Mild, soft cheeses, such as ricotta or cottage cheese, supply more than 300 milligrams of calcium per half cup. In contrast, one cup of low fat milk supplies about 300 milligrams of calcium. Eight ounces of plain fat-free yogurt supplies more than 450 milligrams of calcium. Greek yogurt provides up to 20 percent of the daily requirement for calcium in a single six-ounce serving. Of course, amounts vary by product, so check labels to be sure you’re getting enough calcium throughout the day.

What’s the Takeaway?

People with Crohn’s disease are particularly vulnerable to bone density loss and brittle bones. Many with Crohn’s must avoid dairy products to reduce irritation to their digestive systems. As a result, they may not consume enough calcium to sustain healthy bones. Doctors suggest taking calcium supplements, as well as vitamin D supplements. Dairy alternatives, such as soy and almond milk, also contain significant amounts of calcium. People with Crohn’s disease can benefit greatly from including these alternative sources of calcium in their diet.