OSTEOPOROSIS AND CALCIUM

Calcium Counts
Your skeletal calcium bank has to last through old age. Frequent deposits to this retirement account should begin in youth and be maintained throughout life to help minimize withdrawals. Recommendations for daily calcium intakes were established a few years ago by the Institute of Medicine. Most women get much less calcium than they need--as little as half.

Nutritionists recommend meeting your calcium needs with foods naturally rich in calcium. Adequate calcium intake in childhood and young adulthood is critical to achieving peak adult bone mass, yet many adolescent girls replace milk with nutrient-poor beverages like soda pop. "Bone health requires a lot of nutrients and you're likely to get most of them in dairy products," says Connie Weaver, Ph.D., who heads the department of foods and nutrition at Purdue University. "They're a huge package rather than just a single nutrient." With so many low-fat and nonfat dairy products available, it's easy to make dairy foods part of a healthy diet. People who have trouble digesting milk can look for products treated to reduce lactose. A serving of milk or yogurt contains about 350 milligrams of calcium. Fortified products have even more.

"People who don't consume dairy foods can meet their calcium needs with foods that are fortified with calcium, such as orange juice, or with calcium supplements," says Mona S. Calvo, Ph.D., a calcium expert in the FDA's Center for Food Safety and Applied Nutrition. Other good sources of calcium are dark-green leafy vegetables like kale and turnip greens, tofu (if made with calcium), canned fish (eaten with bones), and fortified cereal products.

The food label can help you identify foods that are a good source of calcium and other nutrients important for bone health, such as vitamin D. You can use the Nutrition Facts found on the label to see if a food is a good source of these nutrients--that is, if it has at least 10 percent of the Daily Value (DV) per serving. Also, if a food has at least 10 percent of the DV, the label may bear a claim that it is a good source of a nutrient. If it has 20 percent or more, the label can say that it is "high" in or an "excellent source." Some foods that are excellent sources of calcium may also bear a health claim about the role of diet and other factors in reducing the risk of osteoporosis.

But keep in mind that foods with smaller amounts (such as between 5 percent and 10 percent of the DV) can still make significant contributions to your daily calcium intake. This may be especially true if you often eat more than one serving of the food in a day, or if your actual serving size is typically larger than the one on the label.

Finally, remember that label values are based on a single Daily Value established by the FDA for food labeling purposes--1000 milligrams in the case of calcium. They do not take into account that some age groups have lower or higher recommendations for intake.

What about too much calcium? A few years ago, the Institute of Medicine established a level of 2,500 milligrams as an upper intake level for calcium for most people. While intakes considerably above this level may be safe for many, others may be particularly susceptible to calcium's potentially harmful effects at these levels. Those with higher sensitivities, such as people at risk of kidney stones, should discuss calcium with their doctors.

How Much Calcium Do You Need?
Calcium is critical, but even a high intake won't fully protect you against bone loss caused by estrogen deficiency, physical inactivity, alcohol abuse, smoking, or medical disorders and treatments.

Age	Recommended Intake
1-3	500 mg
4-8	800 mg
9-18	1300 mg
19-50	1,000 mg
51 and older	1,200 mg

Source
Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Institute of Medicine, Washington D.C.: National Academy Press, 1997

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