Calcium

We can't talk about calcium without first talking about osteoporosis. In fact, 1 in 4 Canadian women and 1 in 8 Canadian men have osteoporosis. Osteoporosis is a disease in which the bones become weak and brittle, making them more likely to fracture. The greatest risk factor for osteoporosis is family history. Other risk factors for osteoporosis include:

• inactivity
• underweight
• smoking
• life stage (post-menopause)
• low calcium and vitamin D intake
• excessive intakes of caffeine (<4 cups per day)
• excessive intake of alcohol (>2 drinks per day)

Bone Density

Bone density speaks to the strength of bone. By the time we reach our late 20's, maximum bone density is already reached. This means that after this age we can no longer make our bones any stronger, however, regardless of age we can work to maintain bone strength, or at least to slow bone loss associated with aging.

What can you do?

1. Bone up on your bone health knowledge - read on!
2. Speak to your doctor if you have questions or concerns and take action against osteoporosis in the way that is right for you. For more information visit the Osteoporosis Society of Canada website at www.osteoporosis.ca

The Bone Health Triad - Calcium, Vitamin D and Weight-Bearing Activity

Calcium

Calcium is an essential mineral and is best known for its role in strong bones and teeth. What is less well known is that calcium plays an important role in nerve transmission and muscle function as well.

Calcium is found in varying amounts in a variety of foods. The most commonly consumed and readily absorbed source of calcium is found in dairy products including milk, cheese, and yogurt. Calcium is also found in non-dairy foods such as dark green leafy vegetables, nuts and seeds, and canned fish with bones. Some foods and beverages that are fortified with calcium include tofu, some brands of orange juice, and fortified soy and rice beverages.

Although dairy foods have the highest amounts of calcium and are better absorbed than their non-dairy counterparts, non-dairy sources play an important role in ensuring we get enough calcium. For a list of Non-Dairy Sources of Calcium visit the health services website at www.healthservices.gov.bc.ca and look at Health File Number 70.

How much is enough?

For adults 19-50 years of age the Dietary Reference Intake (DRI) as outlined by the National Academy of Sciences, sets the Adequate Intake (AI) for calcium at 1000 milligram (mg) per day. For those over the age of 51 the AI is 1200mg/day. Adolescents, due to rapid growth and development need the greatest amount of calcium at 1300mg/day.

Careful planning can ensure that we get enough calcium each day:

Typical Breakfast			Calcium Rich Breakfast
2 slices whole wheat toast	50mg		2 slices whole wheat toast	50mg
2 tsp jam	0mg		2 Tbsp almond butter	85mg
Coffee with 2 Tbsp milk	40mg		1 medium orange	55 mg
			Soy Latte (on the way to work)	300mg
Calcium Count:	90mg		Calcium Count:	490mg
Typical Lunch			Calcium Rich Lunch
Ham sandwich	50mg		Canned salmon sandwich	250mg
Soup made with water	0mg		Soup made with milk	300mg
Cola	0mg		Water	0mg
Calcium Count:	50mg		Calcium Count:	550mg
Typical Dinner			Calcium Rich Dinner
4 ounces roast chicken	0mg		1 ounce roast chicken	0mg
1 medium baked potato	0mg		1 medium baked potato	0mg
3/4 cup broccoli	50mg		3/4 cup broccoli	50mg
3/4 cup carrots	0mg		3/4 cup carrots	0mg
1/2 cup ice cream	75mg		1/2 cup frozen yogurt	150mg
Calcium Count:	125mg		Calcium Count:	200mg
Typical Snack			Calcium Rich Snack
Granola bar	0mg		3/4 cup yogurt	300mg
Apple	0mg		1/4 cup almonds (12)	75mg
Calcium Count:	0mg		Calcium Count:	375mg

What about supplements?

Always try to get the nutrients you need from foods first. No supplement can make up for a poor diet. However, if you avoid dairy foods for any reason or are inconsistent in your intake of calcium, talk to a registered dietitian, pharmacist or physician for the supplement that is right for you.

Vitamin D

Vitamin D helps our body to absorb the calcium from our diet. Our body is capable of producing vitamin D when our bodies are exposed to the sun. Ten to 15 minutes of sun exposure to bare hands and face 2 to 3 times per week allows our bodies to produce enough vitamin D. However, our bodies cannot produce vitamin D when skin is covered with clothing, if we use sunscreen, or if we are sitting in the shade or behind a window. Also, as we age our bodies lose the ability to produce vitamin D. In southern BC, our latitude and wet weather also complicates matters because we can't produce enough from November to April due to a like of sun exposure. As a result, it is important to ensure that dietary sources of vitamin D are included in the diet.

Vitamin D is found in only a few foods naturally. These include egg yolks, fish and liver. Some foods and beverages are fortified with vitamin D, like margarine, milk, fortified soy and rice beverages and, just recently, some brands of fortified orange juice.

Weight bearing exercise

Weight bearing exercise is the third element in the bone health triad. Weight bearing exercise such as walking, jogging, dancing, and yoga helps to "lay down" or "set" bone. In terms of activity pretty much anything except swimming counts. Weight bearing activity does this by stimulating bone tissue, which in turn causes it to strengthen.

Tips to optimize bone health

1. Shop for foods that will help you to follow Canada's Food Guide to Healthy Eating.
2. Include calcium containing beverages and foods as part of your diet.
3. Consume foods and fortified beverages containing vitamin D such as fish, non-hydrogenated margarine, eggs and fortified milk and soy beverages.
4. Ensure you receive enough vitamin D and calcium in your diet each day. Talk to a health professional before taking a supplement if you are not meeting your nutrient requirements from food alone.
5. Enjoy doing something active everyday!

Have questions?

Dietitians are a trusted source for nutrition information. For answers to nutrition questions contact Dial-A-Dietitian at 1-800-667-3438. See your doctor if you have concerns about your bone health.

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