The best source of calcium in the diet, by a mile, is cheese! The most calcium rich cheeses contain 9 times more calcium than an equivalent amount of milk and more than 5 times more calcium than yoghurt. Compared to non-dairy foods the most calcium rich cheeses have up to double the amount of calcium than tinned fish such as sardines, and 7 or 8 times more calcium than plant based sources such as broccoli, kale or soy. But many people are concerned about the milk sugar, lactose, in dairy products, and whether they are sensitive to it, so avoid eating dairy as a result. However, many cheeses are not only high in calcium but very low (just trace amounts) in lactose, so are suitable for people with a mild to moderate lactose intolerance. Read on to find out more about calcium and lactose in health and the top 5 cheeses for high calcium and low lactose content....
Calcium is needed to strengthen bones and teeth. It is also needed for many other bodily functions such as blood clotting, muscle contraction and proper functioning of the nervous system. Men and pre-menopausal women need about 700mg of calcium per day, whilst post-menopausal women need around `1200mg per day. In the last 30 years calcium intake has increased, particularly in men who consume roughly 1000mg per day and women an average of 777mg per day (1). However, much of this calcium comes from fortified ultra-processed foods and high carbohydrate grain products, which overall are poor foods for health and contribute to obesity and other chronic health problems.
Lactose and lactose intolerance
Many people consume less of their calcium from natural sources such as dairy products because they choose to avoid the milk sugar, lactose. This may be because they have, or perceive themselves to have lactose intolerance. So what is lactose intolerance?
People become intolerant of lactose when they make insufficient lactase enzyme to break down lactose in the bowel. The undigested lactose travels into the colon and attracts water, leading to diarrhea, bloating and wind. Lactose intolerance can be primary or secondary.
Primary lactose intolerance
This occurs in infanthood or childhood when the gene that codes for lactase is permanently switched off and it becomes impossible to make the enzyme. Primary lactose intolerance is uncommon in white European and North American people but very common in other areas of the world (2)
Secondary lactose intolerance
This occurs when the lining of the intestine is unable to make sufficient lactase enzyme due to inflammation. The level of intolerance is usually dose dependent, i.e. small amounts of dairy products are tolerated but large amounts are not. Once gut inflammation is resolved, tolerance of lactose may return (2).
Calcium and lactose in cheese
Interestingly, the calcium and lactose content in cheese appears to have a reciprocal relationship: as the calcium content goes up, the lactose content goes down! Thus, the top 5 cheeses for calcium content virtually have no lactose in them at all, just trace amounts (this means the amount is so low that the chemical measuring equipment isn't sensitive enough to put a number on it). People with secondary lactose intolerance should be able to eat these cheeses in small regular amounts without getting diarrhea.
So, what are the top 5 cheeses?
All of the following cheeses contain only trace amounts of lactose!
This hard Swiss cheese made from cow's milk has it's origins in the 13th century and has a
mild, nutty flavour. It really packs a punch when it comes to calcium content with a whopping 1025mg per 100g of cheese. An average 40g portion size (match box size) contains 410g calcium, which is more than half the daily requirement for men and pre-menopausal women and a 1/3 of daily requirement for post-menopausal women.
Emmental also contains good supplies of zinc, magnesium, vitamins A, B3, B12 and phosporous.
Another hard Swiss cheese made from cow's milk! Gruyere has a slightly sweet and salty taste which becomes more earthy as the cheese matures.
In the calcium stakes it contains an impressive 950mg calcium per 100g cheese. That is 380g per 40g portion. It also contains reasonable amounts of vitamin A and zinc.
Edam is a semi-soft cheese originating from the Netherlands. It is usually sold in flat-ended
spheres with a pale yellow interior and rind of red paraffin wax. It keeps and ages well, going harder but not spoiling. A 100gms of Edam cheese contains 795mg calcium which is 318g per 40g portion.
It is also a good source of vitamin A and folate.
Another cheese from the Netherlands, Gouda is a sweet, creamy, yellow cow's milk cheese and is one of the worlds most popular cheeses! It's higher fat content makes it a good melting cheese.
The calcium content in 100g Gouda is 773mg, so a 40g portion contains 309g. It also has reasonable quantities of selenium, folate and vitamin A.
Roquefort is the only cheese made from sheep's milk to make the list! This French cheese is one of the world's best known blue cheeses. It is famous for its pungent smell and its white crumbly but moist texture.
The characteristic blue veins give the cheese a sharp tang!
A 100g of Roquefort contains a (still impressive) 530mg calcium or 212g per 40g portion. Again, it has vitamin A, B3 and folate in good amounts.
All nutrition data is from McCance and Widdowson's Composition of Foods Integrated Data Set: https://quadram.ac.uk/UKfoodcomposition/
Concerned about the fat in cheese?
There is no doubt that cheese contains a lot of fat, including saturated fats, but is this a problem for health? A few years ago it became apparent to scientists studying the effects of saturated fats on health that the fat content of foods could not be considered in isolation of the other nutrients present in that food (or meal) because they interacted with each other in ways not previously considered. This is called a food matrix. The effects of cheese and other dairy products on health was then revisited to establish how a cheese food matrix (3) affected health outcomes. Most studies to date reveal that fats from cheese and dairy products have either a neutral or beneficial effect on health, including heart disease (4,5,6), risk of stroke (7), diabetes, obesity, metabolic health (8) and some forms of cancer (9). This is particularly true for fermented dairy products such as cheese, yoghurt and kefir.
1. Misselwitz, B. (2019) ‘Update on lactose malabsorption and intolerance: Pathogenesis, diagnosis and clinical management’, Gut, 68(11), pp 2080-2091
2. Healthpedian.org (2020) The Role of Calcium in the Human Body https://www.healthpedian.org/the-role-of-calcium-in-the-human-body/
3. Feeney, E.L., Lamichhane, P. and Sheehan, J.J. (2021), The cheese matrix: Understanding the impact of cheese structure on aspects of cardiovascular health – A food science and a human nutrition perspective. Int J Dairy Technol. https://doi-org.apollo.worc.ac.uk/10.1111/1471-0307.12755
4. Hirahatake, K. M., Bruno, R. S., Bolling, B. W., Blesso, C., Alexander, L. M., & Adams, S. H. (2020). Dairy Foods and Dairy Fats: New Perspectives on Pathways Implicated in Cardiometabolic Health. Advances in nutrition (Bethesda, Md.), 11(2), 266–279. https://doi.org/10.1093/advances/nmz105
5. Hirahatake, K. M., Astrup, A., Hill, J. O., Slavin, J. L., Allison, D. B., & Maki, K. C. (2020). Potential Cardiometabolic Health Benefits of Full-Fat Dairy: The Evidence Base. Advances in nutrition (Bethesda, Md.), 11(3), 533–547. https://doi.org/10.1093/advances/nmz132
6. Karina Kvist, Anne Sofie Dam Laursen, Kim Overvad, Marianne Uhre Jakobsen, Substitution of Milk with Whole-Fat Yogurt Products or Cheese Is Associated with a Lower Risk of Myocardial Infarction: The Danish Diet, Cancer and Health cohort, The Journal of Nutrition, Volume 150, Issue 5, May 2020, Pages 1252–1258, https://doi-org.apollo.worc.ac.uk/10.1093/jn/nxz337
7. Laursen, A.S.D., Dahm, C.C., Johnsen, S.P. et al. Adipose tissue fatty acids present in dairy fat and risk of stroke: the Danish Diet, Cancer and Health cohort. Eur J Nutr58, 529–539 (2019). https://doi-org.apollo.worc.ac.uk/10.1007/s00394-018-1608-2
8. Mozaffarian D. (2019). Dairy Foods, Obesity, and Metabolic Health: The Role of the Food Matrix Compared with Single Nutrients. Advances in nutrition (Bethesda, Md.), 10(5), 917S–923S. https://doi.org/10.1093/advances/nmz053
9. UM, C. Y. et al. Associations of Calcium, Vitamin D, and Dairy Product Intakes with Colorectal Cancer Risk among Older Women: The Iowa Women’s Health Study. Nutrition & Cancer, [s. l.], v. 71, n. 5, p. 739–748, 2019. DOI 10.1080/01635581.2018.1539188. Disponível em: https://search-ebscohost-com.apollo.worc.ac.uk/login.aspx?direct=true&AuthType=ip,shib,cpid&custid=s6264444&db=ccm&AN=136401708&site=ehost-live&scope=site. Acesso em: 2 jun. 2021.