Osteoporosis in Women: Are you getting enough Calcium?

Osteoporosis is the most common type of bone disease and occurs when the body fails to form enough new bone, when too much old bone is reabsorbed by the body, or both.

Researchers estimate that about 1 out of 5 American women over the age of 50 have osteoporosis. About half of all women over the age of 50 will have a fracture of the hip, wrist, or vertebra (bones of the spine).

Calcium and phosphate are two minerals that are essential for normal bone formation. But, each day you lose calcium through your skin, nails, hair, sweat, urine and feces. Our bodies cannot produce calcium. That’s why it’s important to try to get enough calcium through the foods we eat. When we don’t get enough calcium for our body’s needs, calcium is taken from our bones. As you age, calcium and phosphate may be reabsorbed back into the body from the bones, which makes the bone tissue weaker. This can result in brittle, fragile bones that are more prone to fractures, even without injury.

Usually, the loss occurs gradually over years. Many times, a person will have a fracture before becoming aware that the disease is present. By the time a fracture occurs, the disease is in its advanced stages and damage is severe.

What can you do about it now?

1. Eat High-Calcium foods:
- Cheese
- Ice cream
- Leafy green vegetables, such as spinach and collard greens
- Low-fat milk
- Salmon
- Sardines (with the bones)
- Tofu
- Yogurt

2. Add some non-fat milk powder to typical foods you already eat: muffins, pudding, oatmeal, etc.

3. Get plenty of Vitamin D, which helps absorb calcium. This includes sun and food from these sources:

Cod liver oil, 1 tablespoon	1,360	340
Salmon (sockeye), cooked, 3 ounces	447	112
Mackerel, cooked, 3 ounces	388	97
Tuna fish, canned in water, drained, 3 ounces	154	39
Milk, nonfat, reduced fat, and whole, vitamin D-fortified, 1 cup	115-124	29-31
Orange juice fortified with vitamin D, 1 cup (check product labels, as amount of added vitamin D varies)	100	25
Yogurt, fortified with 20% of the DV for vitamin D, 6 ounces (more heavily fortified yogurts provide more of the DV)	80	20
Margarine, fortified, 1 tablespoon	60	15
Liver, beef, cooked, 3.5 ounces	49	12
Sardines, canned in oil, drained, 2 sardines	46	12
Egg, 1 large (vitamin D is found in yolk)	41	10
Ready-to-eat cereal, fortified with 10% of the DV for vitamin D, 0.75-1 cup (more heavily fortified cereals might provide more of the DV)	40	10
Cheese, Swiss, 1 ounce

4. If you can't get enough in your regular diet, take a supplement; but be careful because your body might not have complete access to the amount of calcium the supplement says you're getting. It's always best to get nutrients from their natural source. *note: Calcium supplements made from unrefined oyster shell, bone meal or dolomite may contain lead or other toxic metals. Choose supplements that are made by known brand names with proven reliability for these types of supplements

 

What Should I Look for in Supplements for Bone Health?

Here's a list/article from webMD:
Given the vast selection, choosing a supplement for bone health can be confusing. Again, the best advice is to start with your doctor. He or she may recommend a specific type of calcium for bone health. Here are a few other things to consider when choosing and using a supplement.

• Is it a brand name you recognize? Most brand name supplements should be fine, osteoporosis experts say. You can also look for the United States Pharmacopeia (USP) label, which indicates that the product has met the USP's purity requirements.
  
• What type of calcium is it? If you look on the ingredients of calcium supplements you might see different types, like calcium carbonate and calcium citrate. Does the variety you get make a big difference? Probably not much, although vitamin experts aren't sure.
  
  There is some evidence that calcium citrate might be more helpful for people who have low levels of stomach acid (because they take medicines for gastric reflux or other conditions.) Theoretically, calcium citrate might reduce the risk of kidney stones, Schousboe says, but he stresses that there's no real evidence to prove this so far.

• Is the calcium supplement easily absorbed? Any good calcium supplements for bone health should be easy for your body to absorb. But supplements that are liquid or chewable are often the easiest to take in, since they're broken down before you swallow them.
  
• Should you take your calcium supplement with food? Generally, calcium carbonate should be taken with food, while calcium citrate can be taken with or without food. Taking some calcium supplements on an empty stomach may increase the risk of kidney stones, Schousboe says.
  
• Does your calcium supplement cause side effects? Some people find that calcium supplements can cause side effects like gas or constipation. You may be able to control these problems by taking your supplement with more water, or upping the fiber in your diet. If this doesn't help, try a different supplement.
  
• Does your calcium supplement contain other ingredients? Many calcium supplements for bone health also include other vitamins and minerals, like vitamin D. Is it better to get your vitamin D in the same pill as your calcium? It doesn't make any difference. Just keep track of what you're getting. If you're taking multiple supplements and aren't careful enough, you could get excessive doses of vitamin D.
  
• Will you need more than one supplement a day? In general, vitamin experts recommend taking no more than 500 milligrams of calcium at once. Why? Your body can only absorb so much calcium at one time. Going over 500 milligrams at once won't give you the full benefits of the calcium.
  
  So for instance, if you need to take 1,000 milligrams, your doctor might recommend splitting up the dose into 500 milligrams twice a day.

As for other distinctions among calcium supplements, they don't really matter. Although some manufacturers claim that coral calcium -- made from exotic fossilized coral reefs -- has benefits over other formulas, the experts are unconvinced.
"Many of us just think it's a clever marketing ploy and nothing more," says Schousboe. "But if people feel better taking coral calcium, that's fine. What's important is that they get enough calcium. If they waste a little money doing it, that's OK."

"I usually just recommend that people stick to getting adequate calcium and vitamin D and eating a good, healthy diet," Amin tells WebMD.