Got Calcium?

Calcium is a mineral that is important for growth and maintenance of your bones throughout life. About 99 percent of the calcium in the body is found
in the bones and teeth. Calcium is important for blood clotting, nerve transmission, maintaining muscle tone and regulating certain body processes. Recent research shows that adequate calcium also helps protect against heart disease, high blood pressure, osteoporosis, colon cancer, and other diseases.

Dairy foods are among the best calcium sources. A cup of milk, for example, contains about 300 milligrams of calcium. Calcium is found in other food groups, too. Adequate vitamin D helps the body absorb calcium.
Exposure to sunlight transforms a chemical in the skin to the active form of vitamin D. Milk and some other
foods are fortified with vitamin D. Maintaining strong bones also requires boron, magnesium and phosphorus, so eating a variety of foods is important.

Calcium intake is important throughout life, but calcium needs vary depending on age and other factors. The current recommendations are listed below.

*Source: National Institutes of Health – Office of Dietary Supplements

You can use the table below to estimate the number of servings and the total number of milligrams of calcium corresponding to the calcium-rich foods you ate yesterday. Add up your total.

*Products will differ in their calcium content, so check the Nutrition Facts label on your favorite brands.

Total

Total Calcium Intake _______ – Calcium Recommendation ________ = _________

If you have a negative number, increase your calcium intake by that amount to meet your calcium recommendation.

Meeting your calcium needs may seem challenging. These are a few tips to help you meet your calcium needs.

• Use milk in scrambled eggs, hot cereal, and hot cocoa.
• Add cheese to potatoes, salads, pizza, spaghetti sauce, casseroles, and hamburgers.
• Prepare smoothies by blending fruit, juice and milk for a quick snack.
• Use plain yogurt for sour cream.
• Add non-fat dry milk to bread, meatloaf, meatballs, hot cereal, pancake mix, gravy, pudding, and whipped cream.
• Serve pudding or pudding pops made with milk for dessert.
• Choose fortified foods such as calcium-fortified milk, juices, cereal or cereal bars.
• Keep string cheese, yogurt, and milk handy for a snack.

Some people do not tolerate milk-containing foods very well, because they lack the enzyme (lactase) that breaks down milk sugar (lactose). Milk is not fully digested, resulting in uncomfortable side effects such as gas, bloating, diarrhea, nausea, and cramps. The symptoms usually appear about 30 minutes to two hours after eating or drinking foods containing lactose. Some researchers have found that small amounts of milk (Eg. ½ cup at a time) are tolerated. Try these tips to cope with lactose intolerance:

• Consume dairy foods in small amounts (¼ to ½ cup) and slowly increase until you reach your tolerance level.
• Drink milk with other foods to allow more time for digestion.
• Choose aged cheeses such as Cheddar, Colby, Swiss, and Parmesan, which contain lower amounts of lactose.
• Consider using lactase enzymes, available in liquid form for use with milk and as chewable tablets for solid foods.
• Try lactose-reduced milk and other products.
• Choose cultured milk such as yogurt or buttermilk, which contain bacteria that aid in the breakdown of lactose. Look for the designation “Live and Active Cultures” on food labels.
• Try calcium-fortified juices and cereals to help meet your calcium needs.

Osteoporosis is a disease in which the amount of bone gradually decreases, weakening the bones to the point where breaks or fractures could occur. The hip, wrist, and spine are common areas of fracture. Answer the questions on this page. “Yes” answers generally indicate a higher risk for osteoporosis. Medications are available to help slow the progression of osteoporosis.

Preventing osteoporosis and treating osteoporosis are similar in many respects: maintain a calcium-rich diet with adequate vitamin D, engage in weight-bearing exercise, don’t smoke and limit alcohol intake.

Post-menopausal women should discuss benefits and risks associated with hormone replacement therapy (HRT) with their physician. HRT may reduce fractures and have some other health benefits. Drugs such as Evista (raloxifene), Fosamax (alendronate), Miacalcin (calcitonin) and Actonel (risedronate sodium) are available for the treatment of osteoporosis.

A new treatment being studied, percutaneous vertebroplasty (PV), involves injecting liquid cement into fractured vertebral sections of osteoporosis patients. PV may help rebuild collapsed spinal bone and relieve some pain and pressure. It’s important to discuss treatment options with your healthcare provider.

Aim for 30 minutes of moderate physical activity five or more times a week. Weight-bearing activity such as walking, dancing and climbing stairs can help increase bone strength and calcium utilization. Weight-bearing physical activity stimulates bone formation/remodeling and strengthens muscles that pull on bones. Swimming and cycling are not considered weight-bearing exercises because you are not supporting your weight against the force of gravity.

If you find you have difficulty meeting your calcium needs with food alone, you might consider a calcium supplement. Many types of supplements are available. They differ in concentration, ability to interfere with other nutrients, presence of contaminants, and costs. The best supplement for you to take is one that meets your needs based on tolerance, convenience and availability. Inform your physician or healthcare provider if you are taking supplements of any type. Some supplements may interfere with the action of medications.

• Choose generic or brand name supplements that carry the USP (United States Pharmacopoeia) or NF (National Formulary) symbol. Products carrying these designations must meet certain standards for quality and purity; however, some products that meet these standards do not necessarily carry this designation on their label.
• Avoid “natural” calcium supplements such as oyster shell, bone meal, and dolomite, which might contain toxic ingredients such as lead, aluminum, arsenic, mercury, and cadmium. Most claims such as “no starch, no sugar, no preservatives, recommended by pharmacists, high potency, premium quality, free of milk, free of yeast, and natural” can be made for any supplement.
• Test solubility by dissolving the calcium-containing tablet in ¾ cup (6 oz) of vinegar for 30 minutes. Chewable and liquid supplements generally are well absorbed.
• For better absorption, consider taking calcium supplements in “doses” of 500 mg or less over the course of the day. If taking only one dose, evening appears to be the best time. Check with your physician or other health professional for their recommendation.
• Talk with a physician or pharmacist about possible interactions with medications you are taking.
• Check to make sure the milligrams are for elemental calcium and NOT the milligrams of the compound.
• If side effects such as constipation or stomach upset occur with the type of calcium supplement you are using, try increasing fluid intake or changing supplement type. Visit with your doctor or pharmacist to learn more.

*Eg. 1,000 mg of Calcium Carbonate would contain 400 mg of elemental calcium (1,000 x 0.4).

**Use of brand names does not imply endorsement.

Note: Calcium Gluconate and Calcium Lactate are two other types of calcium supplements. Check the Supplement Facts label to learn more.

For Additional Information

• National Osteoporosis Foundation
• National Institute on Aging
• NDSU Extension Health and Nutrition website