All You Need to Know About Osteoporosis: Calcium

Many factors can increase your risk of poor bone health, but what you’re eating today can play a major role in keeping your skeleton strong for the future.

Why is calcium so important?

Calcium is essential for building and maintaining our bones. 99% of the body’s calcium can be found in the bones, and it is also essential for maintaining healthy functioning of the heart, muscles, blood and nerves.

Our bodies cannot make calcium, and therefore it must come from what we eat. However, when we don’t eat sufficient calcium-rich foods, some of the calcium in our bone dissolves to increase the amount circulating in the bloodstream.

Peak bone mass is generally reached by age 30, however during puberty the greatest rate of growth will occur, and this is why calcium is essential for children and teenagers. Individuals with a higher peak bone mass are more likely to maintain better bone health during times of rapid bone loss, such as during the menopause.

Calcium requirements

In the UK the Department of Health’s RNI for calcium is:

If you wish to compare, the recommendation for calcium in Australia is:

• Children 5 to 9 years total intake of 800 -1000 mg/day.
• Children and adolescents aged 9 to 18 years total intake of 1000 – 1300mg/day.
• Adults up to the age of 51 years total intake of 1000 mg/day.
• Postmenopausal women total daily intake of 1000 -1300 mg/day.

However, our intake of calcium-rich foods isn’t the only thing we need to be aware of. There are also a number of factors that may lead to calcium absorption being reduced.

Some of these include:

#1 Excessive caffeine – a high consumption of caffeine could affect the balance of calcium in the body.

#2 Excessive alcohol – drinking too much alcohol can be damaging to your skeleton, and also increases your risk of fracture from falls. The current recommendation for alcohol is 2 – 3 units for women, and 3 – 4 units for men.

#3 Soft drinks containing phosphates – phosphate (or phosphoric acid) is used to improve the flavour in some fizzy drinks, however too much can cause calcium to be removed from the bones.

#4 High intake of protein – excessive amounts of protein may upset the acid balance within the body, which can lead to calcium being removed from the bones.

#5 Diets high in salt – high levels of sodium can increase the amount of calcium the body eliminates through urine.

#6 Low body weight – being underweight increases the risk of brittle bones, or broken bones. Check effects of low calcium absorption.

Sources of calcium

Government recommendations suggest three calcium servings per day for adults. This may include for example:

• An average glass (200ml) of semi-skimmed or skimmed milk
• A small pot (150g) of diet yogurt
• A match-box sized (30g) piece of cheese

Practical tips for getting more calcium into your diet

• Start your day with a breakfast cereal topped with milk, calcium-enriched soymilk, or yoghurt.
• Choose canned fish with bones, particularly canned salmon and sardines. For maximum benefit, mash the bones into the fish.
• Snack on nuts or dried fruit, such as apricots and figs (excellent source of calcium), rather than choosing unhealthy crisps or confectionery.
• Try soybean nuts as an alternative to salted peanuts.
• Add milk or skim milk powder to soups or casseroles.
• Use natural yoghurt in soups, desserts and salads.
• Look out for calcium enriched water or orange juice, as a healthier alternative to fizzy drinks.
• Try cooking with tofu – it’s high in calcium, and low in fat.
• Go for a calcium-enriched soymilk instead of cows milk.
• Choose green leafy vegetables, such as broccoli, bok choy, watercress, spinach, or kale.
• Don’t overdo it with caffeine-containing drinks. Try to limit your caffeine intake to the equivalent of three cups of coffee a day.

Why do people get osteoporosis?

If calcium cannot be replaced fast enough, bones become thinner and weaker, resulting in osteoporosis. As we get older calcium is absorbed less effectively from the intestine, this is why we need to ensure adequate intake.

It has been said that Osteoporosis is better prevented than treated. So, what steps can you take prevent this debilitating disease?

#1 Ensure you are getting adequate calcium from your diet – particularly important in childhood and young adulthood.

#2 Reduce smoking. Check out Giving Up Smoking and Weight Gain.

#3 Stop heavy alcohol use.

#4 Take more physical exercise – 17 Ways to Make Yourself LOVE Exercise.

#5 Avoid diets high in protein, salt, and caffeine.

I’m often asked why countries with relatively low intakes of calcium also have a lower incidence of osteoporosis. This is a difficult question to answer, however it’s clear that not only dietary factors, but also lifestyle factors have a massive impact.

Generally speaking, such cultures are more physically activity, consume a vastly different diet to westernised populations (lower in protein etc), drink less alcohol, and rarely smoke. Therefore, it seems plausible that all of these factors combined may be offering protection against diseases, such as osteoporosis.

Osteoporosis series

This is the first in a series of posts relating to calcium and osteoporosis – stay tuned for information on calcium supplements, vitamin D, and exercise for preventing osteoporosis.

Please drop me an email if you have any specific questions.