Is a Low FODMAP Diet a Lactose-Free Diet? 5 Tips to Get Enough Calcium

It is a common misconception that a low FODMAP diet is a lactose or dairy free diet. It can be (if you have established that you are lactose intolerant or have a milk protein allergy) but it doesn’t have to.

A low FODMAP diet needs to be low in lactose as this is one of the short-chain carbohydrates that may trigger symptoms in people with Irritable Bowel Syndrome (IBS). If your body does not produce enough lactase – the enzyme that can split the lactose molecule into its singles sugars (glucose and galactose) – the unabsorbed lactose attracts water and travels to the large intestine undigested. There, our friendly bacteria ferment it, leading to unpleasant symptoms such as bloating, gas, stomach cramps, and diarrhea.

Calcium (together with vitamin D) is an important nutrient that helps build and maintain strong bones and teeth and has a role in keeping our muscles working (including our heart) and in helping nerves carry messages from the brain to other parts of our body. If you don’t get enough, we may become at risk for osteoporosis and fractures later in life. So, how can you make sure to get enough calcium on a low FODMAP diet? Here are a few tips.

1. Include some dairy products if you can

Small portions of certain dairy products, such as hard cheeses and cream cheese, contain minimal amounts of lactose and can be tolerated even by people with lactose intolerance. If you include lactose-free milk, yogurt, or kefir in your diet, you are less likely to be deficient in calcium. If you don’t, no worries: it is feasible to get enough calcium in your diet even without eating dairy. There are many other foods that are high in calcium.

2. Eat low FODMAP legumes

Beans and lentils contain good amounts of calcium. While on the elimination diet, you can only safely eat small portions of canned chickpeas and lentils. Soy beans and soymilk are high in FODMAP but edamame and firm tofu (drained) are excellent low FODMAP sources of calcium. If you have completed the re-challenge phase and know you tolerate them, you can experiment with other beans such as black, kidney and others and different kinds of lentils.

5. Go fishing

Well, you don’t really need to go fishing yourself. But if you are a pescatarian, you can enjoy canned fish with bones, especially salmon and sardines. The bones are small and soft and are edible, so throw them on a salad for an easy lunch.

3. Don’t forget the nuts and seeds…

Almonds and brazil nuts are high in calcium even at the low FODMAP serving of about 10 nuts. Nuts and seeds are also used to make non-dairy milk. In addition to almond milk, other low FODMAP varieties are hemp and macadamia. Although most kinds of non-dairy milk are fortified with calcium (and vitamin D), check the labels as some are not. I talked previously about chia seeds as a fiber superstar but this tiny seed is also high in calcium. If you haven’t yet, check out my recipe for Cocoa Chia Pudding (it has almond milk too!).

4. …and the vegetables!

Kale does not need a PR campaign as a superfood (one of its many benefits is that it is high in calcium) but the less-known Bok Choy certainly does. The baby variety is very easy to handle and prep fast. See this delicious, easy recipe for my Colorful Asian Stir-fry (guess what? It also has tofu!).

If you are not sure you are meeting your calcium needs, ask for the help of a dietitian who is versed in the low FODMAP diet. He/she can help you maximize your intake without risking unpleasant symptoms.

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Colorful Asian Stir-Fry

Ingredients

1 tablespoon high sunflower or avocado oil

8 oz. firm or extra firm tofu, cut into cubes

1-inch piece ginger, minced (about 2 teaspoons)

2 cups chopped (6 oz.) baby Bok Choy, stems and leaves separated, chopped

1 medium red or orange bell pepper (6 oz.), thinly sliced

1 medium carrot (2 oz.), thinly slices on the diagonal

1 tablespoon oyster sauce*

½ teaspoon toasted sesame oil

½ teaspoon sesame seeds (optional)

*gluten-free, if following a gluten-free diet

Procedure

1.     Heat a large heavy-bottomed skillet or wok on medium-high heat, add 1 teaspoon of the oil and the tofu. Let it cook for about 3 minutes or until browned, then turn the tofu pieces with a spatula and let them brown (2-3 minutes). Set aside.

2.     Add the remaining oil to the skillet or wok and, when hot, add the ginger. After 30-60 seconds, add the Bok choy stalks, bell pepper, and carrot (make sure the skillet is wide enough so not to overcrowd it or the vegetables will steam instead of stir-fry). Cook for 1- 2 minutes, stirring often until vegetables are crisp-tender.

3.     Add the baby Bok choy leaves and stir-fry for another 30-60 seconds, or until just wilted.

4.     Add oyster sauce and tofu and stir until the vegetables and tofu are coated. Turn the heat off and add the toasted sesame oil.

5.     Serve on top of brown rice and sprinkle with the sesame seeds, if desired.

Yield: 2 servings

Storage: Store in an air-tight container in the refrigerator for up to 3 days.

Author: Antonella Dewell, Registered Dietitian Nutritionist & Natural Chef