Growing up, I guzzled milk with every meal—I was in love with it. In college, I switched to skim, trying to avoid the “Freshman 15,” but I still made sure I drank a glass every day. Soon after graduation, I noticed a change. My stomach would gurgle and bubble after snacking on Gouda cheese. Then, immediately after downing my daily cup of coffee with half and half, I was sprinting for the bathroom. It was time to admit the obvious—I had become lactose intolerant.

Initially, I was sad. Without my yogurt, cheese and the occasional scoop of chocolate ice cream, how else was my body going to get calcium? Calcium does more than build strong bones and teeth; it can help lower cholesterol levels, lower risk of kidney disease and even help fight prostate and colon cancers.

After doing some research, I began to feel better because I wasn’t alone—experts claim that 70 to 80 percent of African Americans are lactose intolerant. And with so many products out there, this doesn’t have to be such a downer. To get the lowdown on lactose intolerance and a few dairy-free recipes, I sat down with health guru and author of Dr. Ro’s Ten Secrets to Livin’ Healthy, Rovenia M. Brock, PhD (best known as “Dr. Ro”), who is also lactose intolerant.

Real Health: What are misconceptions that people have about lactose intolerance?
Dr. Ro: Many people confuse lactose intolerance with food allergies, when, in fact, they are two completely different things. Food allergies are [rare], and the symptoms are much more serious. Lactose intolerance is when the body lacks the enzyme lactase, which digests and absorbs lactose (milk sugar). The symptoms include gas, bloating, diarrhea and sometimes even vomiting.

Another one is that people believe that if they are lactose intolerant this means that they cannot have any dairy at all. Some people find that after drinking milk, they get sick, but [they] can eat yogurt and cheese and be fine. Many people fall into this range.

Is it possible to have a diet rich in calcium without dairy?
Definitely. You can find calcium in fortified orange juice, tofu and soy. It can also be found in certain leafy greens and in canned boneless fish, such as salmon.

Does being lactose intolerant mean having to avoid your favorite foods that contain dairy?
Not at all. There are so many products, such as lactose-free milk like Lactaid, which you can add to cereal or coffee. Also, there are pills [Dairy Care or Lactaid] that you can take before eating [dairy products]. I drink Lactaid and have since it came out.

If you have mild symptoms, you will be able to tolerate dairy whether it is milk in your cereal or in teas. You can keep eating any of your favorites by using these types of products. Also, let’s just say that if it’s ice cream that you really want, but it causes your stomach to gurgle, then take a pill that can either allow you to digest lactose or build up the enzyme again so you can tolerate dairy. [Editor’s note: RH recommends you check with your doctor before using any OTC or prescription medicine.]

The main message I want to get across is that you don’t have to be afraid; you don’t have to stop drinking milk or stop eating dairy foods. With everything that is available to us now, calcium deficiency does not need to be a problem for lactose intolerant people.

Dr. Ro shares four of her favorite dairy-free recipes:

Mac and Cheese
2 tablespoons reduced-fat, transfat-free soft tub margarine
1 11½ ounce package elbow macaroni (whole wheat noodles)
Salt (optional)
White pepper to taste
1 8-ounce package low-fat soy cheese
5 cups fat-free soy milk or Lactaid
½ cup water
½ cup finely chopped softened sun-dried tomatoes
Paprika

Preheat oven to 350°. Melt the margarine in a 2-quart casserole dish. Add the dry pasta and stir to coat with the margarine. Add the salt and pepper, if using. Mix together half of the cheese, the milk, ¼ cup water and the tomatoes. Pour over the macaroni. Reserve a small amount of the shredded cheese. Add ¼ cup water and the remaining ingredients and mix well. Sprinkle the reserved cheese over the top of the dish. Sprinkle with a hint of paprika (’cause you wouldn’t be black if you didn’t). Bake for 1 to 1½ hours until the liquid is fully absorbed. Serves 10.

Per 3.5-ounce serving: 239 calories, 7 mg of cholesterol (may vary according to brand of cheese), 3.4 grams of fat (may vary according to cheese), 300 mg of sodium (may vary according to salt use), 102 mg of calcium.

Spicy Salmon Burgers
1 14.75 oz. can pink or red salmon
2 tablespoons lemon juice
1½ teaspoons Dijon mustard
1 tablespoon red pepper flakes
1 teaspoon crushed garlic
¾ cup whole-grain dried bread crumbs
½ cup chopped green onions 
½ cup chopped red and green bell pepper combined
3 egg whites

Drain and flake salmon with fork and crush bones. Combine lemon juice and mustard and blend all ingredients, except eggs and breadcrumbs. Mix egg whites until well blended. Form mixture into four burgers and coat with breadcrumbs then set aside. Coat grill or non-stick sauté pan with vegetable spray. Sauté over medium heat until golden brown on both sides. Serve on toasted whole-grain bun with lettuce, tomato, alfalfa sprouts and dressing.

Dressing
Mix ½ cup fat-free mayonnaise with 2 tablespoons of lemon juice, 1 tablespoon Old Bay seasoning; whisk to a smooth, creamy consistency.

Per 3–4 ounce serving: 90 calories, 12 grams of protein, 147 mg of calcium.

Lean Greens
2 bunches of greens (collards, kale, mustard or turnip)
1 tablespoon olive oil
1½ cups defatted chicken or vegetable broth
¼ cup water
½ cup finely chopped spring onions
½ teaspoon minced garlic
1/8 teaspoon salt (optional)
¼ teaspoon chopped fresh thyme
¼ teaspoon chopped fresh basil
¼ teaspoon liquid smoke (optional, if you like smoked greens)

Cut the greens into strips. Add the oil to a large pan, then sauté the greens until wilted, tender and bright green. Add the broth, ¼ cup water and the remaining ingredients. Simmer for about 15–30 minutes. The greens should be firm, tender and bright green, preserving nutrients, flavor and texture. Serves two.

Per 3-ounce serving: 58 calories, about 5 grams of fat, 182 mg of sodium, 52 mg of calcium.

Soy Fruity Smoothie
½ cup strawberries, fresh or frozen
1 ripe banana
¼ cup blueberries
3 tablespoons orange-peach-mango frozen juice concentrate
½ cup ice
1 scoop sugar-free, vanilla-flavored soy powder

Add fruit and ice in blender, then add water as needed for consistency; puree until smooth and frothy. For an extra nutritional boost, add 1 tablespoon flaxseed or 1 handful of chopped raw almonds. Makes two
16 oz. cups.

Per 16-ounce serving: 250 calories, 17 grams of protein, 1 gram of fat, 250 mg of calcium.

See more of Dr. Ro’s healthy recipes at askdrro.com.

BRITTLE BONES NO MORE
You already know that calcium is the main component that keeps your bones strong, yet it’s estimated that more than half of Americans don’t get enough of it every day. After age 35, you need more dietary calcium because your bones are beginning to thin and this could lead to more serious issues, such as bone density loss and osteoporosis (tiny holes in the bones).

But getting enough calcium can be difficult for people who are lactose intolerant. How much calcium is really necessary? The recommended daily amount is 1,000 milligrams for people younger than 50 and 1,200 mg for those older than 50. In addition to eating two to three servings of low-fat or fat-free dairy foods a day, Dr. Ro suggests taking a multivitamin that has calcium and vitamin D-3. “You need vitamin D-3 [to absorb the calcium] to get the full use of it in your diet.”          

POPULAR SOURCES OF CALCIUM

 Food Serving size Calcium (milligrams) 
Yogurt w/fruit 8 oz. 245–384
Sardines, bones included  3 oz. 324
Milk, lactose treated 8 oz. 285
Orange juice, calcium fortified  8 oz. 200–260
Salmon, bones included  3 oz. 181
Spinach, cooked 3 oz.  120
Tofu, firm ½ cup  138
Soy or rice milk, calcium added  1 cup 80–500
Broccoli, raw ½ cup  21