Are you getting the enough
calcium from your food sources .... Check..........
Recent evidence indicates
that taking high-dose calcium supplements doesn’t prevent fractures and may
even be risky.
Like many women, you may have memorized the minimum daily
calcium requirement—1,000 milligrams (mg) a day for women ages 50 and younger
and 1,200 mg for women over 50—and followed it faithfully in an effort to
preserve your bones. You’ll probably be surprised to learn that many health
authorities don’t agree with that recommendation. Dr. Walter Willett, chair of
the Department of Nutrition at Harvard T.H. Chan School of Public
Health, thinks you’re likely to do just as well on half as much calcium.
“Essentially, I think that adults do not need 1,200 mg of
calcium a day. The World Health Organization’s recommendation of 500 mg is
probably about right. The United Kingdom sets the goal at 700 mg, which is
fine, too. It allows for a little leeway,” he says.
Why the
1,200-mg recommendation?
Adequate calcium is necessary for good health, and not just
because it’s a major component of our bones. It also plays a vital role in
keeping our organs and skeletal muscles working properly. The body gets the
calcium it needs for basic functions by releasing the calcium stored in our
bones into the blood through bone remodeling—the process by which bone is
constantly broken down and rebuilt.
Because bone density drops when bone breakdown outpaces bone
formation, scientists reasoned that maintaining an adequate level of calcium in
the blood could keep the body from drawing it out of the bones. In the late
1970s, a couple of brief studies indicated that consuming 1,200 mg of calcium a
day could preserve a postmenopausal woman’s calcium balance.
Based on those studies, in 1997 an Institute of Medicine panel
raised the recommendation for calcium intake from 800 mg to 1,200 mg a day for
women over 50. That wasn’t a sound decision, Dr. Willett says: “The
recommendation was based on calcium balance studies that lasted just a few
weeks. In fact, calcium balance is determined over the course of years.”
Moreover, there wasn’t any evidence that consuming that much calcium actually
prevented fractures. Nonetheless, the recommendation has been carried forward
since then.
What recent research
has found
In the past two decades, several clinical trials involving
thousands of postmenopausal women have sought to determine how calcium intake
affects the risk of hip fractures. In each study, women were randomly assigned
to one of two groups—one to receive calcium and supplements of vitamin D (to
aid calcium absorption) and the other to get placebo pills. After several
years, the researchers looked at the number of hip fractures in each group.
Here’s what they found:
Calcium and vitamin D supplements don’t prevent fractures. That
finding came from two British studies reported in 2005. It was substantiated by
a 2006 report from the Women’s Health Initiative, which showed that 18,000
postmenopausal women who took a supplement containing 1,000 mg of calcium and
400 international units (IU) of vitamin D were no less likely to break their
hips than an equal number who took a placebo pill, although the density of
their hip bones increased slightly. Even that small change might have been due
to the vitamin D rather than the calcium.
High calcium intake—from either food or pills—doesn’t reduce hip
fracture risk. This was the conclusion of a 2007 report by Swiss and American
scientists who conducted an analysis of more than a dozen studies of calcium.
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25 sources of
dietary calcium
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|
Produce
|
Serving size
|
Estimated calcium
in milligrams
|
|
Collard greens, frozen
|
8 oz
|
360
|
|
Broccoli rabe
|
8 oz
|
200
|
|
Kale, frozen
|
8 oz
|
180
|
|
Soy Beans, green, boiled
|
8 oz
|
175
|
|
Bok Choy, cooked, boiled
|
8 oz
|
160
|
|
Figs, dried
|
2 figs
|
65
|
|
Broccoli, fresh, cooked
|
8 oz
|
60
|
|
Oranges
|
1 whole
|
55
|
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Seafood
|
Serving size
|
Estimated calcium
|
|
Sardines, canned with bones
|
3 oz
|
325
|
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Salmon, canned with bones
|
3 oz
|
180
|
|
Shrimp, canned
|
3 oz
|
125
|
|
Dairy
|
Serving size
|
Estimated calcium
|
|
Ricotta, part-skim
|
4 oz
|
335
|
|
Yogurt, plain, low-fat
|
6 oz
|
310
|
|
Milk, skim, low-fat, whole
|
8 oz
|
300
|
|
Yogurt with fruit, low-fat
|
6 oz
|
260
|
|
Mozzarella, part-skim
|
1 oz
|
210
|
|
Cheddar
|
1 oz
|
205
|
|
Greek yogurt
|
6 oz
|
200
|
|
American cheese
|
1 oz
|
195
|
|
Feta cheese
|
4 oz
|
140
|
|
Cottage cheese
|
4 oz
|
125
|
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Fortified food
|
Serving Size
|
Estimated calcium
|
|
Almond milk, rice milk or soy milk, fortified
|
8 oz
|
300
|
|
Tofu, prepared with calcium
|
4 oz
|
205
|
|
Orange juice fortified with calcium
|
4 oz
|
150
|
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Cereal, fortified
|
8 oz
|
100-1,000
|
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Source: International Osteoporosis Foundation
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The downside of
calcium supplements
The studies also revealed a couple of downsides to high levels
of calcium supplementation, but not to calcium obtained through a
regular diet:
An increased risk of kidney stones. In the Woman’s Health
Initiative, women taking the calcium–vitamin D combination had a higher risk of
developing kidney stones than those who got the placebo. Although high levels
of dietary calcium are thought to offer some protection against kidney stones,
high doses of calcium from supplements may promote stone formation by
increasing the amount of calcium that is eliminated in the urine.
An increased risk of heart attack. In a randomized study of
1,471 postmenopausal women conducted in New Zealand, 21 of 732 women who took
1,000 mg of calcium a day had heart attacks, compared with 10 of 736 who
received a placebo. A 2010 analysis of 15 randomized controlled trials also
linked calcium supplementation with an increased risk of heart attack. Some
researchers have speculated that calcium supplements may contribute to heart
disease by increasing blood levels of calcium, which can cause arteries to
stiffen and blood pressure to rise.
Vitamin D is
important, too
Vitamin D is also essential for healthy bones. In fact, the
daily vitamin D requirement was first introduced to help prevent rickets—a
condition in which developing bones are soft and can become
bowed—in children.
Vitamin D is made in the skin through exposure to ultraviolet
radiation in sunlight. However, the amount produced varies widely from person
to person. People with darker skin produce less vitamin D than lighter-skinned
people, and in all populations, the skin’s ability to convert sunlight to
vitamin D declines with age. Plus, if you follow the advice to reduce your risk
of skin cancer by keeping covered and wearing sunscreen, you’re also cutting
your vitamin D production. Such variability has made it difficult for
researchers to tell how much vitamin D people make in addition to the amount
they consume in supplements. Evidence from studies that have measured blood
levels of vitamin D indicates that levels in the high-normal range are optimal
for building bone. To reach those levels may require taking 800 to
1,000 IU of vitamin D a day.
What’s the
bottom line?
One thing the studies have taught us is that both calcium and
vitamin D are essential in building bone. The question is how much of each. Dr.
Willett recommends going lower on calcium and higher on vitamin D than the
guidelines suggest—500 to 700 mg a day of calcium and 800 to
1,000 IU of vitamin D. At that rate, you can probably get all or most
of your calcium from food, especially if you have a serving or two of dairy
products daily. If you can’t tolerate dairy, you should still be able to get
300 mg a day in your diet and can take a low-dose calcium supplement to make up
the rest. By keeping your supplement consumption to 500 mg or less a day, you
should avoid the possible risk of heart disease and kidney stones suggested by
the studies.
Although vitamin D is added to milk and some other foods, you’ll
probably need a supplement to be sure you’re getting enough. A capsule
containing 800 to 1,000 IU should do the trick
|
Food
|
Serving Size
|
Amount of Calcium
|
|
Milk, whole, 2%, 1%,
skim
|
250 mL (1 c)
|
291 to 316 mg
|
|
Milk, evaporated
|
125 mL (1/2 c)
|
367 mg
|
|
Buttermilk
|
250 mL (1 c)
|
300 to 370 mg
|
|
Kefir
|
250 mL (1 c)
|
267mg
|
|
Cheese, hard
|
50 g
|
370mg*
|
|
Processed cheese spread
|
60 mL (4 tbsp)
|
348 mg
|
|
Cheese, processed
slices
|
50 g
|
276 mg
|
|
Cottage cheese, 1
or 2%
|
250 mL (1 c)
|
146 mg
|
|
Pudding or custard made
with milk
|
125 mL (1/2 c)
|
150 mg
|
|
Yogurt, plain
|
175 g (3/4 c)
|
320mg*
|
|
Yogurt, fruit bottom
|
175 g (3/4 c)
|
214mg*
|
|
Frozen yogurt,
soft serve
|
125 mL (1/2 c)
|
109 mg
|
|
Ice cream
|
125 mL (1/2 c)
|
89 mg
|
|
Tofu, made with calcium
sulphate
|
150 g
|
347 mg
|
|
White beans, cooked
|
175 mL (3/4 c)
|
119 mg
|
|
Navy beans, cooked
|
175 mL (3/4 c)
|
93 mg
|
|
Black beans, cooked
|
175 mL (3/4 c)
|
34 mg
|
|
Pinto beans, cooked
|
175 mL (3/4 c)
|
58 mg
|
|
Chickpeas, cooked
|
175 mL (3/4 c)
|
58 mg
|
|
Tahini (sesame seed
butter)
|
30 mL (2 tbsp)
|
130 mg
|
|
Almonds, dry roast
|
60 mL (1/4 c)
|
93 mg
|
|
Almond butter
|
30 mL (2 tbsp)
|
88 mg
|
|
Sesame seeds kernels,
dried
|
60 mL (1/4 c)
|
23 mg
|
|
Sardines, Atlantic
canned with bones
|
75 g
|
286 mg
|
|
Sardines, Pacific
canned with bones
|
75 g
|
180 mg
|
|
Salmon canned with
bones
|
75 g
|
208 mg
|
|
Fortified rice or soy
beverage
|
250 mL (1 c)
|
320 mg
|
|
Orange
juice fortified with calcium and vitamin D
|
250 mL (1 c)
|
320 mg
|
|
Regular soy beverage
|
250 mL (1 c)
|
65 mg
|
|
Turnip greens
|
125 mL (1/2 c)
|
104 mg
|
|
Chinese cabbage/bok
choy
|
125 mL (1/2 c)
|
84 mg
|
|
Okra
|
125 mL (1/2 c)
|
65 mg
|
|
Mustard greens
|
125 mL (1/2 c)
|
55 mg
|
|
Kale
|
125 mL (1/2 c)
|
49 mg
|
|
Chinese broccoli/gai
lan
|
125 mL (1/2 c)
|
46 mg
|
|
Broccoli
|
125 mL (1/2 c)
|
33 mg
|
|
Orange
|
1 med
|
52 mg
|
|
Blackstrap molasses
|
15 mL (1 tbsp)
|
179 mg
|
|
Dried fish, smelt
|
35 g
|
560 mg
|
|
Daylily flower
|
100 g
|
301 mg
|
|
Tempeh, cooked
|
150g
|
144 mg
|
|
Fat choy (black moss),
dried
|
10g
|
88 to 122 mg
|
|
Soy bean curd slab,
semisoft
|
100 g
|
308 mg
|
|
Soy
bean milk film, stick shape
|
100 g
|
77 mg
|
|
Seaweed, Wakame, raw
|
125 mL (1/2 c)
|
63 mg
|
|
Seaweed, dry (agar)
|
125 mL (1/2 c)
|
50 mg
|
|
mL = milliliter, g =
gram, c = cup, tbsp = tablespoon, mg = milligram
|
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|
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*calcium content may
vary, check the label
|
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Age
|
Daily Calcium
Requirement (this includes your diet and supplements)
|
|
19 to 50
|
1000 mg
|
|
50+
|
1200 mg
|
|
pregnant or lactating
women 18+
|
1000 mg
|
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|
