Lactose intolerance in osteoporosis

What is osteoporosis?

Osteoporosis is a disease that affects the entire skeleton characterized by a low bone mass and a deterioration of the microarchitecture of the bone tissue, which causes an increase in fragility and a greater sensitivity to fractures. It is the main risk factor for suffering fragility fractures and its prevalence does not stop growing due to the aging of the population. It causes pain, functional limitation and alterations in the quality of life of those who suffer from it, being an important public health problem and therefore its prevention is very necessary. Adequate calcium intake is clearly associated with bone health, and it appears that people with it are at greater risk of suffering from osteoporosis by eliminating the main source of calcium from our diet: dairy. Knowing how to maintain proper bone health and those foods rich in calcium or those dairy products with less lactose content can help prevent it.

How to maintain proper bone health?

To maintain proper bone health, the loss of bone mass must be reduced. To achieve this it is not only about consuming foods rich in calcium, but different tips should be taken into account:

• Follow one healthy nutrition paying special attention to essential nutrients for bone: calcium, vitamin D and phosphorus.
• Perform adequate physical exercise such as: exercise to strengthen the muscles, aerobic activities that involve weight bearing, flexibility exercises, and stability and balance exercises. It is important that the exercise is adapted to each person, in the case of already suffering from osteoporosis it is important to know the degree and thus the risk of fracture to further adapt the exercises.
• Perform frequent outdoor activities to ensure adequate sun exposure for effective skin synthesis (a sufficient amount of type B UV photons must reach the epidermis).

Calcium

The calcium, provided through food, it is essential to achieve adequate mineralization of the bone and to maintain its quality and quantity. The stored in the bone is transferred on many occasions for cellular biological functions or if, at the intestinal level it is "stolen", thus deteriorating bone mass. That is why calcium consumption is so important, and reaching a contribution of 1000-1200 mg daily.

The match

It is abundant in the diet and its intestinal absorption is usually not limited, so it is rarely a nutritional problem, but if it is taken in excess it worsens the absorption of calcium.

The vitamin D

It is essential for the absorption and metabolism of calcium, and if there is not enough there is a high risk of osteoporosis. Vitamin D not only participates in calcium homeostasis, it also influences muscle tone and contraction, so that a vitamin D deficiency produces muscle weakness that in turn increases the risk of falls, further increasing the risk of fractures The body obtains 90% of vitamin D through exposure to the sun and the remaining 10% from the diet. In our country, during the summer months an adequate dose is easily achievable, but not in winter. In addition, there are other factors that limit skin synthesis, such as skin aging or sunbathing with protective creams. Even with one, it is difficult to achieve a vitamin D intake of more than 200 IU (5 µg) per day, a far cry from the 800 IU (20 µg) per day that tend to be recommended today.

What foods help improve osteoporosis?

The main foods that help improve osteoporosis are those that provide the nutrients that participate in its formation and maintenance:

Dairy products.

They are the foods with the best calcium content and absorption ratio: natural yogurt, cow's milk, goat's milk, sheep's milk, cheeses… due to their high calcium content, therefore two to three daily servings are recommended. In the case of lactose intolerance It is important to know the degree of intolerance, since in many cases it is not possible to drink milk or fresh cheese, but it is fermented dairy products such as yogurt, curd, fermented milk, cured cheese, semi-cured ... They are better tolerated because in the fermentation process lactic ferments (bacteria) hydrolyze lactose producing lactic acid and reducing its presence, but providing the same amount of calcium, even more in the case of cured cheeses.

Even if you do not want to give up dairy, for a few years now you can find brands of milk whose lactose has been partially eliminated or hydrolyzed previously called "low in lactose" or totally called "lactose free". An offer that has been complemented with dairy products such as cheeses in different varieties, yogurts, etc.

Non-dairy foods rich in calcium:

• • Legumes: beans and white or pint beans, chickpeas ...
  • Whole grains: rice, pasta ...
  • Nuts and seeds: hazelnut, almond, Brazil nuts, sesame seeds, chia ... (a handful a day is recommended)
  • Vegetables: spinach or cruciferous family such as broccoli, cauliflower, cabbage, turnip greens ...
  • Small fish that is usually eaten with thorn: sardine, anchovy, anchovy ... (the calcium is in the thorn and in the canned oil).
  • Vegetable products enriched with calcium: vegetable drinks such as oats or soybeans, breakfast cereals ...

The phytates, oxalates and fibers present in vegetables hinder the absorption of calcium (only 5% is absorbed), that is why it is advisable not to try to reach the calcium rations based on spinach or.

Foods rich in vitamin D that promote calcium absorption

• Blue fish: tuna, sardine, mackerel, salmon ...
• Nuts: hazelnuts, walnuts, almonds, peanuts ...
• Eggs
• Vegetable foods enriched with vitamin D: vegetable drinks such as oatmeal or soy, breakfast cereals ...
• Dairy products (assess individual tolerance): natural yogurt, cow's milk, goat's milk, sheep's milk, cheeses ...

Nutrients and habits that disadvantage bone tissue

We must not only take into account the nutrients that improve bone tissue, but we must also avoid those that disadvantage it:

High sodium diet

High sodium intake leads to increased urinary calcium excretion which, in a sustained manner, could contribute to accelerating bone loss. Therefore it is advised:

• • Dispense with table salt (normal, marine, iodized) and cook food without salt.
  • Avoid foods very rich in salt such as: chips, pickles and commercial sauces, cold cuts / sausages, canned, salted or smoked, extracts, precooked (croquettes, sausages, dumplings ...), salted nuts ...
  • Avoid eating precooked dishes due to their high fat and sodium content.

Foods very rich in phosphorus

Calcium / phosphorus intake should have a 1: 1 ratio. Phosphorus is in very high amounts in processed foods such as prepared sauces or cola drinks, so they should not be consumed regularly, since if phosphorus increases a lot the risk of decalcification increases.

Unhealthy habits:

Alcohol, tobacco and a sedentary lifestyle cause bone loss, which is why they should be avoided.

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• To be able to stop osteoporosis, it is necessary to adopt healthy lifestyle habits, including a varied and balanced diet that ensures the supply of essential nutrients for bone health and the prevention of osteoporosis, especially calcium and vitamin D.
• In the case of lactose intolerance, it is important to know the degree of intolerance, and opt for lactose-free dairy products or take other foods rich in calcium (not dairy) daily, without forgetting to follow a healthy lifestyle by practicing adapted physical exercise.
• It is also important to walk outdoors to achieve, through the UV radiation of the sun on the skin, the formation of vitamin D, which can help slow or improve osteoporosis, since bone does not live on calcium alone.

Diploma in Human Nutrition and Dietetics

Master in Pediatric Nutrition and Sports Nutrition