Calcium (and lack of it)
This is not as simple a topic as people may think. "Drink more milk" is what you've probably heard and your doctor probably still tells you. Of course there are many reasons why you may not be able to, or may not want to. And everyone knows why you need calcium right? Well, at least most people know you need calcium for healthy teeth and bones (among other things)! This came up today because I went to visit a doctor to tell her about our Intensive Dietary Management Program, and she pretty much made it clear that UNLESS I came up with a list of other foods that had calcium for her osteoporotic and female patients, she would not put them on an LCHF diet (this is what she had an issue with, NOT THE FAT, woohoo).
So why not milk? I am not even going to get into all the intricate details of this. I will just tell you what's important when it comes to an LCHF/Keto lifestyle. We don't recommend (high amounts) of milk on an LCHF diet because of the lactose. Not (only) because of the intolerance factor, but because lactose is a type of sugar, a type of carb, and so, on a low carb diet, I am not going to recommend something that has about 11-12 g of carbs (sugar) per cup. Drinking your sugars is even worse than eating your sugars. Low-fat milk has a higher amount of lactose, and this is obvious: if the fat percentage goes down, the sugar percentage goes up. But in reality, 2% vs. 3.5% (not a huge difference). Both a no-no as far as I'm concerned. At least for adults...
So if not milk, then what? Well, there are other dairy products that also contain calcium. For example, a 2-ounce piece of cheese has about 1 g of lactose/sugar (vs. 12 g in a cup of milk) and an equivalent amount of calcium. This is getting better. On an LCHF diet I often do recommend certain cheeses to certain people (with measure and with exception). There are also things like cream, full-fat yogurt, kefyr, but we will move on.
But what if you can't, or don't want to, have any dairy? Calcium is actually a very plentiful mineral. It is in a lot more things than just dairy. Some of these things I recommend and others I don't (legumes for example, not appropriate for some insulin resistant individuals, not the base of an LCHF diet, definitely not of a keto diet). But leafy greens (collard greens, kale, bok choi) are an excellent source of Calcium. I truly believe you should have at least one (or more) serving of greens per day (variation is the key to success). Broccoli is another, and here again a vegetable that has more vitamin C than oranges. Soft fish bones, like in canned salmon and sardines, are a very good source of calcium. Before some of you go off about heavy metal toxicity, salmon and sardines are lower on the scale than let's say tuna, so I just substitute tuna for these two in recipes. Almonds are also a source of calcium. If you follow an LCHF/Keto diet, you are likely to eat salmon, almonds and greens on a frequent basis, so Calcium (and other nutrient) -deficiencies are going to be extremely rare. Lastly, the food industry has been ever so generous in fortifying so many processed foods with calcium. So kind of them. So here is the question: if calcium is so common in our everyday foods, why are people calcium-deficient and why do they develop osteoporosis so frequently? The answer to that is actually quite simple.
You need vitamin D to absorb calcium! So is this what we are missing? Maybe. Where do we get vitamin D from? Foods, sunshine and supplements. Are we getting enough sunshine? Probably not (at least not without sunscreen). Are we getting enough foods with Vitamin D? On average? No! Guess who is getting enough vitamin D from their foods? People on an LCHF diet. Why? The simple answer to that is: Vitamin D, as well as vitamins A, E and K are fat-soluble vitamins. That means you need fatty substances to absorb them from your diet. Simple. What have you been told to do for the past 80 years? Eat a low-fat diet. Big mistake, BIG, BIG mistake (cue Julia Roberts strutting her stuff in Pretty Woman).
I hope I have clarified this one for you. My point here is, don't obsess too much about vitamins and minerals, (or counting macros and calories) (if you eat an LCHF/Keto type of diet, that is). You will get plenty of vitamins and minerals (hint EGGS - check last week's post) including the so very important fat-soluble vitamins A, E, D and K.
References:
https://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/lactose-intolerance/Pages/facts.aspx
http://www.health.com/health/gallery/0,,20845429,00.html#broccoli-4
http://www.stevecarper.com/li/list_of_lactose_percentages.htm
