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Living with lactose intolerance

So you’re lactose intolerant—and you need at least 1,000 milligram of calcium a day. No problem. You can meet your calcium needs simply by consuming a nutritious diet that includes about 10 cups of dandelion greens or 11/8 pounds of canned salmon (bones and all). That’s every day. Of course, some of the calcium in those foods isn’t well absorbed by your body, so you may want to increase those serving sizes a bit. Sound outrageous? Of course it is.

While fish bones and calcium-rich vegetables like kale and broccoli can boost your calcium intake, it’s unrealistic to expect anyone to eat bones and greens all day, every day. But lactose-intolerant people need not despair.

It’s possible for many to get enough calcium and calcium-rich dairy products without painful gas and diarrhea. Here’s how:

If you’ve avoided dairy products for years, increase your intake gradually over several weeks. Most people with lactose intolerance can enjoy dairy products—as long as they consume them daily and in moderate amounts.

Know what “moderate” means. Research indicates that up to 2 cups of milk may be tolerated daily—if divided up throughout the day. Consume no more than 1/2 to 1 cup of milk at one time, and it’s important to include other foods with your dairy intake. Fat and fiber will slow the passage of lactose through your intestines and improve digestion.

You may tolerate some dairy products better than others. A nutrition label that shows only a small amount of carbohydrate—as on aged cheese, for example—is a sign that the food contains little lactose. You may also find it easier to tolerate foods with active cultures, such as yogurt or cultured buttermilk.

Modern technology offers several options. You can buy lactose-reduced products, some of which are calcium fortified. Or add lactase drops to milk and refrigerate for 24 hours. Oral enzyme tablets also can provide relief. Try different brands since they relieve different symptoms.

Give soy milk a try. It comes in a variety of flavors and is widely available. Just be sure it’s calcium fortified.

Finally, if you take calcium supplements, take no more than 500 milligrams at a time between meals or at bedtime. (Make sure they’re lactose free.)