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Calcium Needs For Bone Health

The foods we eat contain a variety of vitamins, minerals, and other important nutrients that help keep our bodies healthy. One nutrient in particular -- calcium -- is needed for strong bones.

One of the reasons calcium is removed from the bones is that other parts of your body need calcium for other uses. It is needed for our heart, muscles, and nerves to function properly, and for blood to clot normally.

The food industry is out to help with an ever-expanding array of options. From antacids and orange juice to cereals and chocolate chews, there are more sources than ever, but some are better than others. And you have to be careful not to overdo it.

The Role of Calcium

An inadequate supply of calcium is thought to play a significant role in contributing to the development of osteoporosis. Many studies show that low calcium intakes are associated with low bone mass, rapid bone loss, and high fracture rates. National nutrition surveys have shown that many women and young girls consume less than half the amount of calcium recommended to grow and maintain healthy bones. To find out how much calcium you need, see the accompanying Recommended Calcium Intakes Chart, and the Selected Calcium-Rich Foods list to learn how you can include more calcium in your diet without adding fat and calories. Remember, calcium is not a substitute for medication that may be needed to curb excessive bone loss.

Calcium Culprits

A diet high in caffeine containing foods, such as coffee, appears to increase bone loss, especially in those who have low calcium intakes. High levels of protein and sodium in the diet are also thought to increase calcium excretion. Excessive amount of these substances should be avoided.

Lactose intolerance can lead to inadequate calcium intake. Those who are lactose intolerant do not have the enzyme lactase that is needed to break down the lactose found in dairy products. In order to include dairy products in the diet, lactose-containing foods can be treated with lactase drops or pills. There are even some milk products on the market that have been pre treated with lactase.

Calcium Supplements

If you have trouble getting enough calcium in your diet, you may need a calcium supplement. The amount of calcium you will need from a supplement depends on how much calcium you obtain from food sources.

Calcium comes in various compounds, most often calcium carbonate and calcium citrate. Both are easily absorbed.

Calcium carbonate, the type in antacids and flavored chews, contain more calcium but need to be taken after eating food, as it needs stomach acid to be absorbed.

Calcium citrate, the kind added to orange juice, can be taken without food.

The other sources of calcium include oyster shells, bone meal and dolomite. Despite the appeal because they are "natural", experts say these supplements aren't any more effective and may contain impurities like lead, so they're best avoided.

It is necessary for the calcium tablet to disintegrate in order to be absorbed into the body. If you are unsure whether a tablet will break down, you can test how well it disintegrates by placing it in 6 ounces of vinegar or warm water, stirring occasionally for 30 minutes. If the tablet has not almost completely disintegrated at this time, it probably will not do so in your stomach.

The typical American diet includes about 600 mg of calcium a day. Generally, we need twice that much (1,000 - 1,200 mg), to help guard against brittle bones. But consuming more than 2,000 mg a day can lead to kidney stones and kidney damage, among other things. Because calcium is best absorbed at small doses, don't take more than 500-600 mg at once. Larger amounts aren't absorbed as well. That is why it is important to check labels and tally up how much calcium you're getting from various sources.

As for price, calcium carbonate is generally cheapest. A month's supply of calcium carbonate supplements (500 mg/day) costs less than $5.00. Don't assume that more expensive brands are better. If you don't like the idea of taking pills, antacids are a good alternative and equally inexpensive. Fortified foods are much pricier, but you get more than just calcium.

Don't take calcium with meals rich in wheat bran or soybeans or other legumes. These contain substances known as phytates, which can interfere with the absorption of calcium.

Make sure your get enough Vitamin D (1000 IU/day) and Magnesium, both of which are important for the absorption of calcium, though there is no need to buy products that combine them with calcium. Milk fortified with Vitamin D (400IU/quart) is an excellent dietary source of Vitamin D supplementation. It is important to remember that supplemental calcium and Vitamin D help maintain bone mass and reduce fracture risk.

Keep in mind that calcium supplements can reduce the absorption of iron pills and tetracycline antibiotics; so don't take them at the same time.

The best way to get calcium, though, is through foods like yogurt, broccoli, almonds, and canned sardines and salmon with fine bones - sources that are certainly tastier than Tums.

 Birth - 6 months 400mg
 6 months - 1 year 600mg
Children / Young Adults  
 1 - 10 years 900 - 1,200mg
 11 - 24 years 1,200 - 1,500mg
Adult Women  
 Pregnant & Lactating - under age 24 1,200 - 1,500mg
 Pregnant & Lactating - over age 24 1,200mg
 25 - 49 years (pre-menopausal) 1,000mg
 50 - 64 years (post-menopausal taking estrogen) 1,000mg
 50 - 64 years (post-menopausal not taking estrogen) 1,200 - 1,500mg
 65+ years 1,200 - 1,500mg
Adult Men  
 25 - 64 years 1,000mg
 65+ years 1,200 - 1,500mg
Source: National Institute of Health Consensus Panel, Optimal Calcium Intake, 1994

Common Calcium Supplements

Form % Elemental Calcium
Calcium Carbonate 40
Calcium Phosphate (tibasic) 39
Calcium Phosphate (dibasic) 30
Calcium Citrate 21
Calcium Lactate 13
Calcium Gluconate 9

Food Item Serving Size Calcium Content (mg) Calories
Whole 8 oz. 291 150
Skim 8 oz. 302 85
Calcium Enriched Fruit Juices 8 oz. 150 - 300 varies
Yogurt (with added milk solids)      
Plain, low-fat 8 oz. 415 145
Fruit, low-fat 8 oz. 343 230
Frozen, fruit 8 oz. 240 223
Frozen, chocolate 8 oz. 160 220
Mozzarella, part skim 1 oz. 207 80
Muenster 1 oz. 203 105
Cheddar 1 oz. 204 115
Ricotta, part skim 4 oz. 335 190
Ice Cream, Vanilla (11% fat)      
Hard 1 cup 176 270
Soft serve 1 cup 236 375
Ice Milk, Vanilla      
Hard (4% fat) 1 cup 176 185
Soft serve (3% fat) 1 cup 274 225
Fish and Shellfish      
Oysters, raw (13-19 med.) 1 cup 226 160
Sardines, canned in oil, drained, including bones 3 oz. 372 175
Salmon, pink, canned, including bones 3 oz. 167 120
Shrimp, canned, drained 3 oz. 98 100
Bok Choy, raw 1 cup 74 9
Broccoli, cooked, drained, from raw 1 cup 136 40
Broccoli, cooked, drained, from frozen 1 cup 100 50
Soybeans, cooked, drained, from raw 1 cup 131 235
Collards, cooked, drained, from raw 1 cup 357 65
Turnip greens, cooked, drained, from raw 1 cup 252 30
Tofu 4 oz. 108* 85
Almonds 1 oz. 75 165
*The calcium of tofu may vary depending on processing methods. Tofu processed with calcium salts can have as much as 300 mg calcium per 4 oz. Often, the label or the manufacturer can provide more specific information

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