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Calcium & Osteoporosis

  1. Where can I find a dietitian who works with people who have osteoporosis or don't get enough calcium? Answer
  2. Adelle Davis was a pioneer, way ahead of her time. Answer
  3. We would like to have documents, questionnaires or protocols about the detection of the amount of calcium needed daily for a person according to his age, gender and weight. Answer
  4. I have just fractured my radius and my patella. Other than a balanced diet and 3 glasses of milk a day should I be taking anything else? Answer
  5. I have intolerance to milk and dairy derivatives. Is calcium lactate a milk derivative? Answer
  6. I am in excellent health except for a mysterious leg ache that occurs only at night. I think it could be some kind of vitamin deficiency. Can you suggest something? Answer
  7. On the girls' very best days, I'm lucky if they drink 2 cups of milk. Answer
  8. I'm wondering whether my kids are getting enough calcium. Answer
  9. What nutrients form our bones? Answer

  10. We have been trying to force these lead-containing products off of the shelves or at least to force the manufacturers to disclose the contents to unsuspecting consumers of these products. Answer
  11. Is it important to take calcium with vitamin D or if you drink milk would you get a sufficient amount from that? Answer
  12. What type of calcium pills should a woman be taking? Answer
  13. You should eat one antacid a day and you will have your daily required calcium according to my friend's doctor. Is this true or false? Answer
  14. How do you get your daily requirement of calcium? Answer
  15. I'm concerned about getting enough calcium and am only 34 years old. Answer
  16. Does baking a custard affect the calcium in milk? Answer

Where can I find a dietitian who works with people who have osteoporosis or don't get enough calcium?

The Medical Nutrition and Nutrition Entrepreneurs dietetic practice groups of the Academy of Nutrition and Dietetics provide medical nutrition therapy based on your diagnosis. Dietitians often have their own private practice nutrition counseling services in addition to services provided in a clinic or hospital. You can find a dietitian at the Find a Registered Rietitian on the Academy of Nutrition and Dietetics . Include your zip code or city / state, the type of service you want (individual consultation) and expertise needed.

Don't be dissing Adelle Davis she had an MS in Biochemistry. What's yours in? Adelle Davis was a pioneer, way ahead of her time. Sounds like you've not even read her books. They're full of references to studies, etc. Don't you see how everything she said decades ago is all being corroborated now with more and more studies? She should be revered by you, not maligned. I can't get over the quaint way you maligned her. Makes me nauseated.

My undergraduate minor was in chemistry and I have taken biochemistry in college. Biochemistry classes focus on the chemical structure of biological compounds including vitamins and minerals rather than the relationship between food and health.

Adelle Davis sold a lot of books with some good info and some which has been proven to be wrong. Yes, I have read some of her books. If you disagree, that is your choice. Research does not support some of the recommendations she made including the one about bone meal for a calcium supplement. Heavy metals like mercury are stored in bone. Depending on the source of bone meal (usually slaughtered animals), it can contain mercury.

We are the Lebanese Osteoporosis Prevention Society (LOPS). Our concern among others, is to provide awareness to our society about osteoporosis and how to prevent it. We are very interested in your articles about osteoporosis and the optimal calcium intake. We would like to have documents, questionnaires or protocols about the detection of the amount of calcium needed daily for a person according to his age, gender, and weight. We will be very thankful if you can give us such information.

Calcium requirements in the U.S. are determined by the Food and Nutrition Board (FNB), National Academy of Sciences of the National Research Council. These recommendations are published on a periodic basis and the last RDAs were published in 2004. You can read about calcium requirements in the U.S. online or purchase the Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride

The best method to assess bone calcium is DEXA (dual energy x-ray absorptiometry). I would recommend you contact the US National Osteoporosis Foundation for coordination with your organization needs.

The U.S. also gathers information about food intake by its citizens which would include an assessment of calcium intake. The results of these nutritional surveys are available online or CD-ROM for the National Health and Nutrition Examination Survey (NHANES latest is 2009 -2010), the Continuing Survey of Food Intakes by Individuals (CSFII 1994 to 1998) and the Diet and Health Knowledge Survey (DHKS from 1994 -1996).

Hi, I have just fractured my radius and my patella other than a balanced diet and 3 glasses of milk a day should I be taking anything else? I am a 32 year old male in good health.

So sorry to hear about your broken forearm and kneecap. I imagine your arm and affected leg are both immobilized so you may see some shrinking of the muscles under your casts or brace. Make sure you get physical therapy after they are removed to strengthen the muscles weakened by immobilization.

A balanced diet and 4 servings of milk, yogurt or cheese a day should provide you with the calcium and vitamin D to support healing these broken bones.

I hope you can help me. I have intolerance to milk and dairy derivatives. Of course, I now have to check labels for all kinds milk ingredients. One ingredient I am not sure of is calcium lactate. I am wondering if you can tell me if calcium lactate is a milk derivative. Thanks.

Calcium lactate is the form of calcium found in milk. So yes, it can be derived from milk. It is usually found in a calcium supplement most often prescribed for pregnant women. If you have an intolerance to milk and dairy foods, then you probably are not allergic to calcium lactate, but the lactose in milk. Lactose is the sugar found in milk which causes milk allergy in adults. Babies that are allergic to cow's milk are allergic to the protein in milk (lactalbumin) which they often outgrow as toddlers.

I had been on Phen/Fen about a year- just working out to try to get my weight down. I am in excellent health except for a mysterious leg ache that occurs only at night. I think it could be some kind of vitamin deficiency- can you suggest something? Please reply.

If you get muscle cramps in your legs (calves especially) at night, your blood may be low in calcium rather than potassium. If you are not eating calcium rich foods on your weight loss eating plan, I would highly recommend you start eating dairy foods (3 - 4 cups of fat-free skim milk per day or 3 - 4 ounces of low fat cheese) or taking calcium supplements - 1,000 milligrams for adult men and menstruating women (19 to 50 years of age) or 1,200 milligrams for menopausal women and senior men (51+ years of age) per day.

In case you haven't heard, Phen / Fen have been found to cause heart valve problems requiring surgery or in some cases death when undiagnosed. These drugs were withdrawn by the FDA in September 1997 after the Mayo Clinic and a doctor in Fargo ND identified the heart valve problems of people on these drugs. I would highly recommend you ask your doctor about this immediately and whether or not you should be taking these drugs.

On the girls' very best days, I'm lucky if they drink 2 cups of milk. It's usually MUCH less. More like 1 cup and 2 out of 3 days, an ounce of cheese. I can figure out how much yogurt etc might help with the cause, but what about calcium-rich veggies/fruits?

My 9th grade health class memories (which are eons old) tell me that broccoli may be a good source, but how nutrient rich is it?

Also, is there a supplement I can give them to increase the odds of them getting at least the minimum amount? I've heard, for instance, that Tums is a good approach. True?

Neither one will swallow pills. They hate the liquid calcium, unless I add it to pancakes or muffins (not a regular occurrence) and there don't seem to be very many whole grain breads that are calcium fortified. (I have an aversion to Wonderbread -- too fake.). Any way, you see my dilemma. If they loved orange juice, that might work. But they aren't big fans, and I tend to give them water more than juice anyway.

So, the short version of this is: Are there any good supplements for little kids out there that don't cost an arm and a leg? And are there any foods that are easy to add to their diet with good calcium content, besides those I have mentioned? Thanks again for your time.

Besides milk, yogurt and cheese, milk can be cooked into foods such as pudding, custard, mashed potatoes, cheese sauce made with real cheese (not cheese food), au gratin potatoes and cream soup. Add cheese to tacos and top hamburgers to make a cheeseburger. Vegetables high in calcium are greens (collards, spinach and turnip). Broccoli has about 62 milligrams of calcium per 1 cup serving so compared to milk, it has about 20% as much calcium. Fortified cereals like Total (corn flakes, whole grain or raisin) usually have 100% of the RDA (Recommended Dietary Allowance) for calcium. Some orange juice is fortified with calcium which may help add calcium to your daughter's intake.

Regarding calcium supplements, a one a day multivitamin for kids should have 100% of their RDA of calcium. Look for calcium carbonate when you compare prices in your local pharmacy. I would talk to your daughter's doctor to see if he would recommend Tums or other antacids as a calcium source as it may be more expensive than a multivitamin so compare costs.

I'm wondering whether my kids are getting enough calcium. How much do they need and about how much milk, cheese, yogurt, etc. is that?

I have a girl, 6 years, another girl, 3 years and a boy, 1-year. Thanks for your help!

Your 6 year old child needs 800 milligrams of calcium per day. Your 3 year old needs 500 milligrams of calcium per day and your 1 year old needs 270 milligrams of calcium per day.

One cup of milk (depending of fat content) contains from 276 to 306 milligrams of calcium. Your 6 year old needs 3 cups of milk, 3 year old 2 cups and 1 year old 1 cup each day which will provide each of your children with sufficient calcium. Or substitute 1 1/2 oz of hard cheese for 1 cup of milk.

One cup of low fat yogurt with fruit has 338 milligrams calcium. Most yogurts with fruit are high in sugar containing around 40 to 42 grams of carbohydrate per 1 cup serving with approximately 12 grams of carbohydrate coming from the milk. Unless your children have diabetes or they are very overweight (BMI >35), they don't need sugar-free yogurt. Milk would be a better low sugar choice unless you buy plain yogurt and stir in fresh fruit for a calcium rich snack.

What nutrients form our bones?

Your bones contain mostly calcium and phosphorus which are minerals that give bone its rigidity. Your bones have the breaking strength of cast iron. In other words, as much pressure as it would take to break a cast iron pan, it would take that much force to break a bone assuming your bones are normal density. Pretty amazing for a body part!

Thank you for your common sense approach to calcium supplements. We have been trying to force these lead-containing products off of the shelves or at least to force the manufacturers to disclose the contents to unsuspecting consumers of these products. I am interested in any information that you may have on this topic.

Bone meal from crushed animal bones that may contain toxic metals such as arsenic, mercury, lead, cadmium and others or dolomite can be a source of lead and mercury poisoning when used as a calcium supplement. Probably the biggest advocate of bone meal was Adelle Davis who is now deceased. Unfortunately, her books are still in circulation and influencing people's poor choices of bone meal for calcium supplements.

Thanks for your comments.

Is it important to take calcium with vitamin D or if you drink milk would you get a sufficient amount from that? I am nearing 70.

Since you are almost 70 years old, I recommend you drink 4 cups of milk or the equivalent in calcium rich foods per day so that you consume 1,200 milligrams of calcium. Drink one cup milk with each meal and one cup with a snack at night.

Dairy products like milk, yogurt, kefir and cheese are still the best sources of calcium and yield a more favorable effect on bone health than supplements in postmenopausal women. Choose from the following dairy products:
  • whole milk (276 milligrams calcium)
  • 2 percent or reduced fat milk (285 milligrams calcium)
  • 1 percent or low fat milk (290 milligrams calcium)
  • skim or fat free milk (306 milligrams calcium)
  • buttermilk (284 milligrams calcium)
  • yogurt (low fat with fruit has 338 milligrams calcium)
  • kefir with robotic cultures (plain or with fruit 300 milligrams calcium)
  • 1 1/2 ounce hard cheese i.e. brick, cheddar, Colby, Monterey, mozzarella, muenster, provolone, Swiss (average 306 milligrams calcium)
  • 1 ounce hard cheese Parmesan, Romano (336 milligrams and 302 milligrams calcium respectively).
If you don't tolerate milk or milk products, you could substitute 1 1/2 cups calcium fortified soymilk (199 milligrams calcium per cup) or 1 cup calcium fortified orange juice (351 milligrams calcium) to get the recommended 1,200 milligrams per day. Make sure the soymilk and orange juice are also fortified with vitamin D.

Vitamin D helps your body absorb calcium and deposit calcium in your bones. The best food sources of vitamin D are fortified milk products, fatty ocean fish (halibut, herring, channel catfish, mackerel, salmon, sardines, tuna and cod), liver and mushrooms (chanterelle, morel and shiitake). You can also absorb vitamin D through your skin that is exposed to sunlight for about 20 minutes per day. However, with sun exposure, you have a greater risk of skin cancer and in the northern half of the United States, you can't depend on sunlight for all your vitamin D needs in the winter.

I would suggest a calcium and vitamin D supplement only if you are unable to consume enough calcium rich foods to get the calcium you need. Depending on your bone density status, you may not see a reduction in bone loss for two years or more after starting calcium supplements. So don't stop taking the calcium supplements when you don't see a quick improvement in your bone density scan. Your calcium intake can be part food and part supplement, but remember that supplements are best taken at meals.

There are many calcium supplements available in your pharmacy. However, some supplements contain vitamin D and some do not. Pick a calcium supplement with vitamin D. The average recommended daily dose of 1,200 milligrams calcium is the same for women taking or not taking estrogen (hormone replacement therapy). These recommended amounts include both the food you eat and any supplements with calcium you take. I would also suggest you discuss this with your doctor for him / her to consider your other health concerns. (Do not take calcium supplements or overeat milk products if you have a history of kidney or bladder stones.)

Women on anti-resorptive therapy (drugs like Fosamax that prevent loss of calcium from bones) may benefit from higher intakes of calcium. In the first 10 years after menopause, bone loss can average 13%. Twenty-six percent of women over age 65 and 50% of women over age 85 have osteoporosis. Osteoporosis starts in men around age 55. Twenty percent to 50% of women with a history of anorexia are at risk for osteoporosis.

Ninety nine percent of the calcium in your body is in your bones. Your bones are your calcium savings account and your blood calcium is your calcium checking account. You don't want to take calcium out of your bone savings because it will make your bones more susceptible to breaking (fractures). When the amount of calcium in your blood decreases, unless there is enough calcium coming in from the food you eat and supplements you take, your body draws calcium out of your bone calcium (savings account). As a result, your bones become more porous and fragile. This is a major factor in broken hips so common in seniors, especially women.

How much calcium is in your bones, however, is not a simple issue of getting enough calcium and vitamin D during your growth years. Estrogen and exercise both play a role. Research has shown that women who have a hysterectomy (removal of the uterus) are at greater risk of osteoporosis even if they retain their ovaries and should discuss hormone replacement therapy (estrogen) with their doctor. Since you have already gone through menopause, you are not making much estrogen though large body fat stores can produce estrogen. Estrogen helps keep calcium in your bones. Exercise also helps keep bones hard. Any weight bearing exercise, except swimming and bicycling, stresses your bones and keeps them hard. Talk to your doctor about an exercise program for you. Studies in Wisconsin have shown that women in their 80's and 90's can increase bone density (hardness) with sufficient calcium, vitamin D and exercise. It's not too late.

If you haven't had a bone density test, ask your doctor to schedule one. You'll only have to take off your shoes and lie down on a DEXA (dual energy x-ray absorptiometry) low dose x-ray machine with 1/10 the radiation of a chest x-ray for a few quick minutes to determine if you are at risk for osteoporosis due to poor bone density.

Also, if you smoke, stop and if you drink excessively alcohol, cut down the number of drinks per day to one for women.

What type of calcium pills should a woman be taking? You know how a lot of women are taking calcium pills?

The best-absorbed form of calcium from a pill is a calcium salt like carbonate or citrate. Calcium gluconate and calcium lactate are absorbed well by pregnant women. Seniors absorb calcium lactate, gluconate and citrate well. Calcium citrate can be taken between meals otherwise take other calcium supplements with each meal instead of all at once.

The recommended daily dose of calcium per day is 1,000 milligrams for persons 19 to 50 and 1,200 milligrams for persons 51+ years. Read the bottle label for the amount of calcium. Some will list the amount of calcium carbonate compound rather than the amount of elemental calcium. Milk and milk products are still the best source of calcium since they also contain vitamin D, riboflavin (B2), phosphorus, potassium, vitamin A and protein.

Do not take bone meal or dolomite calcium as a supplement. Bone meal calcium comes from slaughterhouse animals' bones. Both may be contaminated with toxic metals such as arsenic, mercury, lead, cadmium and others. Animals as well as people store heavy metal toxins in their bones. Any heavy metals you have ever been exposed to are stored in your bones. Grinding them up doesn't rid the bones of heavy metals. Leaded paint and leaded gas have added greatly to our lead exposure.

You should eat one antacid a day and you will have your daily required calcium, according to my friend's doctor. Is this true or false?

True and False. Check the Nutrition Facts label on the antacid. Some antacids (chewable tablets) do contain calcium carbonate which is 40% calcium, but the amounts vary between brand names. Of those containing calcium (depending on the brand of antacid), they contain between 200 milligrams to 320 milligrams of calcium per tablet. You will need four to six antacid tablets containing calcium carbonate per day to fulfill your calcium requirement depending on your age (1,000 milligrams for persons 19 to 50 years of age and 1,200 milligrams for persons 51+ years). A roll of antacids is more expensive than the same amount of calcium carbonate supplements so compare the cost.

The absorption of some other vitamins and minerals is decreased in the presence of antacids. The absorption of riboflavin, vitamin C and iron is decreased by antacids.

Dr. Heaney at Creighton University has done considerable work on calcium absorption and antacids. Dr. Heaney concludes that the differences among most calcium supplements are irrelevant if antacids are taken with a meal. Many antacids are absorbed as well as food sources (like milk) if taken with a meal.

Calcium supplements should be taken three times per day, much in the same way we advise milk drinking. Therefore, if you took two antacids per meal, it might not affect absorption, but you wouldn't get vitamin D from the antacids. Vitamin D is necessary for absorption of calcium and the storage of calcium in bone. Antacids do not contain vitamin D.

If you have heart, kidney or liver disease, high blood pressure, are on a low salt nutrition therapy or suffer from water retention, consult your physician BEFORE taking any antacids. Antacids containing magnesium (liquid antacids) may cause diarrhea and aluminum containing antacids (liquid antacids) may cause constipation.

I am concerned about women getting brittle bones from not enough calcium. I don't like to drink milk except with cereal. How do you get your daily requirement of calcium?

You can meet the Recommended Dietary Allowance of 1,000 milligrams (women or men 19 to 50 years of age) to 1,200 milligrams (women or men 51+ years) of calcium from good food sources like:
  • real cheese (cheddar has 204 milligrams in 1 ounce)
  • cream soups (1 cup cream of chicken made with milk 181 milligrams)
  • custard (1 cup has 151 milligrams)
  • pudding made with milk (1 cup has 110 milligrams)
  • ice cream (1 cup has 230 milligrams).
Milk and milk products are by far the best sources of calcium. Other good food sources of calcium are:
  • fortified dry cereal (3/4 to 1 1/3 cup Total has 1,000 to 1,104 milligrams, 3/4 cup Golden Grahams has 350 milligrams)
  • collard greens frozen cooked (1 cup has 357 milligrams)
  • rhubarb cooked (1 cup has 348 milligrams)
  • sardines (3 ounces has 325 milligrams)
  • potatoes au gratin (1 cup has 292 milligrams)
  • spinach leaf or chopped frozen cooked (1 cup has 291 milligrams)
  • spinach canned (1 cup has 272 milligrams)
  • soybeans green cooked (1 cup has 261 milligrams)
  • turnip greens frozen cooked (1 cup has 249 milligrams)
Try mashing your potatoes with milk, adding skim milk powder (fat free) to your coffee instead of powdered creamer and using milk in cooking.

Otherwise, I would advise you to consider a calcium supplement. You will need 1,200 milligrams of calcium per day for postmenopausal women 51+ years and 1,000 milligrams per day for women 19 to 50 years.

Your bones have the breaking strength of cast iron, but are flexible. The human skeleton is the slowest system to mature. Men's bones peak by age 20 and tend to lose bone minerals at 4% every 10 years. Women's bones maintain peak calcium content until menopause (assuming calcium intake meets the RDA) then lose 13% over the next 10 years. Delayed puberty and under nutrition like in anorexia or use of steroids can increase your risk of osteoporosis when bone is not build up in childhood and adolescence. You should choose high calcium foods and participate in a daily exercise program to keep your bones hard.

I'm concerned about getting enough calcium and am only 34 years old. The other day, I was watching a popular television program and they were discussing osteoporosis in women after menopause.

Osteoporosis is characterized by a loss of calcium from bone, especially the spine and deterioration of bone tissue to the point it looks like Swiss cheese. A simple test for osteoporosis in adults is measure your arm span and compare that measurement to your height. Stretch your arms straight out from your shoulder and have someone else measure your arm span in inches from your right middle finger tip to your left middle finger tip, going across your back. This measurement should equal your height in bare feet. Any difference between these two measurements may reflect the amount of height loss due to osteoporosis as long as the person doesn't have other diseases of the spine which reduce height.

A more accurate test for osteoporosis can be done by a DEXA scan which is a low dose x-ray. By the time osteoporosis shows up on an x-ray, 40% of bone may have been lost. Regular X-ray machines are not used as a screening tool since your radiation exposure accumulates over your lifetime and the smaller your radiation exposure, the better.

Previously, osteoporosis has not appeared in women until later life (after 55). We used to think that it was from a life long habit of not drinking milk. Researchers now believe osteoporosis involves multiple factors including calcium, vitamin D, estrogen and exercise. We may be seeing more osteoporosis at a younger age because of the starvation imposed by anorexia.

To ensure an adequate intake of calcium (RDA is 1,000 milligrams for females (19 to 50 years), you should drink three cups of milk per day and eat other calcium rich foods. Other foods that are equal to one cup of milk are:

  • 1 oz grated or shredded Parmesan or Romano cheese
  • 1 1/2 ounces of hard cheese (brick, cheddar, Colby, edam, gouda, gruyere, Monterey Jack, mozzarella, muenster, provolone, Roquefort, Swiss, Tilsit, American)
  • 3 1/2 ounces of shrimp
  • 3/4 cup macaroni and cheese or Total cereal
  • 1 cup of yogurt, baked custard, pudding or kefir
  • 1 1/8 cup of tofu
  • 1 1/2 cup of oysters or soybeans
  • 1 3/4 cup of cream soup or ice cream
  • 2 cups of cottage cheese or baked beans.
Foods such as canned salmon or sardines which have bones, dark green leafy vegetables (spinach, Swiss chard, collards, bok choy, kale, beet, dandelion, mustard, turnip greens) and broccoli are good sources of calcium also. Any food that would have a milk product like cheese as an ingredient like pizza or tacos would also be a good source.

The other alternative is a calcium supplement. You will need 1,000 to 1,200 milligrams of calcium per day to substitute for milk.

Does baking a custard affect the calcium in milk?

Cooking does not alter the calcium in milk. Calcium from milk in baked custard stays in the same form as calcium in fluid milk. Minerals are usually pretty stable to most cooking methods.

The absorption of calcium can be decreased by oxylates in green leafy vegetables or by phytates in bran. A high protein eating plan or large intake of carbonated beverages, both high in phosphorus, increase calcium excretion because you do not have any hormones in your body to regulate phosphorus. Your kidneys regulate how much phosphorus is in your blood. When phosphorus gets too high, your kidneys excrete the extra. Unfortunately, phosphorus and calcium are closely associated and calcium gets excreted along with the phosphorus.

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