A few days ago, I received a message from the mother of a lactose-intolerant little girl. The mother felt her child was losing out on essential nutrition due to her intolerance, and wondered how she could make up for that nutrition loss using other foods.
The RDA/AI mentioned in this article are for children aged 4 to 8 years.
Let’s start from the top. What are the nutrients in milk? This information refers to whole, or full-fat milk. 100 grams of milk delivers 64 calories along with the following macro-nutrients:
- Carbs: 4.65 grams
- Protein: 3.28 grams
- Fat: 3.66 grams
Minerals
Milk contains the following minerals [1]. The table below lists the Recommended Dietary Allowances (RDA) or Adequate Intakes (AI) for each of the present minerals, for a child of 4 to 8 years of age, alongside the percentage of that RDA/AI present in milk.
| Mineral | in Milk | RDA/AI | % RDA |
| Calcium [3] | 119 mg | 1000 mg | 11.9% |
| Iron [4] | 0.05 mg | 10 mg | 0.5% |
| Magnesium [5] | 13 mg | 130 mg | 10% |
| Phosphorous [6] | 93 mg | 500 mg | 18.6% |
| Potassium [2] | 151 mg | 2,300 mg | 6.5% |
| Sodium [2] | 49 mg | 1,000 mg | 4.9% |
| Zinc [7] | 0.38 mg | 5 mg | 7.6% |
Vitamins [1]
Milk contains the following vitamins [1]. The table below lists the Recommended Dietary Allowances (RDA) or Adequate Intakes (AI) for each of the present vitamins, for a child of 4 to 8 years of age, alongside the percentage of that RDA/AI present in milk.
| Vitamin | in Milk | RDA/AI | % RDA |
| Vitamin C [8] | 1.5 mg | 25 mg | 6% |
| Thiamin [9] | 0.038 mg | 0.6 mg | 6.3% |
| Riboflavin [10] | 0.161 mg | 0.6 mg | 26% |
| Niacin [11] | 0.084 mg | 8 mg NE | 1.05% |
| Vitamin B-6 [12] | 0.042 mg | 0.6 mg | 7% |
| Folate, DFE [13] | 5 mcg | 200 mcg DFE | 2.5% |
| Vitamin B-12 [14] | 0.36 mcg | 1.3 mcg | 27.6% |
| Vitamin A, RAE [15] | 33 mcg | 400 mcg RAE | 8.25% |
Substitutes
The following foods may be a good choice to gain the same nutrients as milk. When substituting foods, keep the concept of bioavailability in mind. Broadly, this refers to the extent of nutrient absorption possible from different sources. Absorption of some nutrients, such as Calcium and Iron may be limited due to the presence of some anti-nutrients [16][18], such as Calcium oxalate, Phytate, Tannins, Lectins and Protease Inhibitors.
Other dairy products: Quite a few lactose-intolerant individuals can easily digest dairy products such as hard cheeses and yogurt among others. If this works for you, they are an excellent choice to obtain some of the vital nutrients present in milk. Probiotic and full-fat yogurts come highly recommended. Additionally, whey protein isolate can also be considered for the purpose of obtaining protein. [17][19]
Vegetables for Calcium: Some vegetables contain a fair amount of calcium among other nutrients, especially green, leafy vegetables. Spinach for example, contains quite a few nutrients, that significantly overlap with milk, though the bioavailability of some, including calcium and iron, is quite low and need to be eaten in significant quantities to be viable sources of those nutrients. Consider Broccoli, Chinese cabbage, Kale, Chinese mustard greens and pok choy, which have greater bioavailability of Calcium. [19]
Sources of protein include tofu, whole grains and eggs, all of which come together quite nicely in a meal. Whey protein isolate is also a viable option.
Watch your B-12, as it is difficult to detect a B-12 deficiency on an all-plant diet until problems begin occurring. This nutrient is quite difficult to obtain from plant sources. So, unless you eat yogurt among other dairy products, you may want to consider supplements and fortified products. [20]
Most minerals can easily be obtained by following a normal, balanced diet in sufficient quantities, so I wouldn’t worry about that.
Conclusion
It is possible to get most milk-equivalent nutrition from sources that do not trigger an individual’s lactose intolerance, though the amount of care to be taken, quantities to be consumed, varieties to be included and attention paid to detail are quite high.
References:
- USDA Food Composition Database
- Dietary Reference Intakes for Sodium and Potassium, The National Academies Press
- Dietary Reference Intakes for Calcium and Vitamin D, The National Academies Press
- https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/
- https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/
- https://lpi.oregonstate.edu/mic/minerals/phosphorus
- https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/
- https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/
- https://ods.od.nih.gov/factsheets/Thiamin-HealthProfessional/
- https://ods.od.nih.gov/factsheets/Riboflavin-HealthProfessional/
- https://ods.od.nih.gov/factsheets/Niacin-HealthProfessional/
- https://ods.od.nih.gov/factsheets/VitaminB6-HealthProfessional/
- https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/
- https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/
- https://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/
- https://www.healthline.com/nutrition/how-to-reduce-antinutrients
- https://www.healthline.com/nutrition/dairy-foods-low-in-lactose
- https://www.eufic.org/en/food-today/article/nutrient-bioavailability-getting-the-most-out-of-food
- https://academic.oup.com/ajcn/article/70/3/543s/4714998
- https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/vegetarian-diet/art-20046446
