Help me make sense of this:
People with IBD are at increased risk for low bone density and osteoporosis.
Inadequate calcium intake is a leading contributor.
Dairy remains the number one source of calcium in the U.S. diet.
🤔 So why are so many people with IBD told to avoid dairy?
In one day alone, I met with two women who were told to go dairy-free—without seeing a dietitian, without clear reasoning, and without a plan to ensure adequate calcium intake.
One of them—who has avoided dairy for years based on a passing recommendation—paid out of pocket for a bone density scan after I shared concerns about her bone health.
She’s in her early 30s and just found out she has significant bone loss.
I’m not suggesting her dairy-free diet is the sole cause, but inadequate calcium intake following this recommendation likely played a meaningful role.
Why going dairy-free isn’t a one-size-fits-all recommendation in IBD:
1️⃣ It often leads to inadequate calcium intake
Dairy is the primary source of calcium in the U.S. diet.
When people eliminate dairy, calcium intake often drops—and the risk of bone loss increases.
This is especially concerning for people with IBD, who already face higher risk due to:
- Chronic inflammation
- Steroid use
- Malabsorption
- Poor overall dietary intake
No single dietary change explains everything, but avoiding dairy long-term without adequate replacement doesn’t help.
2️⃣ It can reduce quality of life without improving symptoms or inflammation
In practice, I often see good tolerance to small amounts of low-lactose dairy, such as:
- Plain yogurt
- Kefir
- Aged cheeses
- Lactose-free cottage cheese
These foods are:
- Whole foods
- Quick, reliable protein sources
- Often easier to tolerate than many “dairy-free” substitutes
Removing them ‘just in case’ can make eating feel more restrictive and stressful—without clear symptom improvement.
It’s also worth noting that concerns about dairy and inflammation aren’t strongly supported by evidence.
Research suggests dairy products and dairy proteins have neutral to potentially beneficial effects on inflammatory markers (this research is not specific to IBD).
In addition, human studies have not linked dairy intake with an increased risk of IBD flares.
3️⃣ Even many IBD diets include dairy
This surprises some people.
Several evidence-based IBD dietary approaches allow some forms of dairy, including:
- Exclusive Enteral Nutrition
- The Specific Carbohydrate Diet
- IBD-AID
- The Mediterranean Diet
The point isn’t that everyone with IBD needs dairy—it’s that cutting it out isn’t always necessary or helpful.
🚫 What if someone really can’t eat dairy?
Then a plan matters.
That may include calcium supplementation when appropriate and/or an emphasis on non-dairy calcium sources, such as:
- Bok choy, kale, collard greens
- Calcium-fortified tofu
- Calcium-fortified plant milks or yogurts
- Canned salmon or sardines with bones
- Chia seeds, tahini, almonds
Meeting calcium needs without dairy is possible—but not always easy for people with IBD.
✨ Bottom line
People with IBD are already at increased risk for low bone density and osteoporosis.
Any recommendation that may restrict calcium intake deserves careful consideration—and a plan.
Some people absolutely benefit from avoiding dairy altogether.
Others do well with some dairy, such as low-lactose options, fermented dairy, or sheep’s or goat’s milk products.
What we don’t have is evidence to support “go dairy-free” as a universal recommendation for people with IBD—especially when bone health is already at stake.
