Bone Health

How can I keep my bones healthy and strong?
Be sure to get the recommended amount of calcium and Vitamin D. College students should have an intake of 1200 mg of calcium daily. Vitamin D helps the gastrointestinal tract absorb calcium. The recommended vitamin D intake is 400 to 800 IU per day. Although some of our vitamin D is manufactured in our skin after exposure to sunlight, we cannot rely on the sun to produce all the vitamin D we need, especially in northern areas like New England. Taking separate supplements of vitamin D is not recommended, as the side effects of getting too much can be harmful.

What are the best sources of calcium in food?
Nutritionists believe that it is preferable to choose food over calcium supplements if possible since calcium rich foods contain many other nutrients that work with calcium to keep your bones healthy. Also, calcium from supplements is not as well absorbed by the body as calcium from dairy products.

Milk Group
The milk group is the best source and you should try to get "4 a day." About four servings of dairy (each about 300 mg) approach the daily goal of 1200mg calcium. Three servings plus a 500mg calcium supplement would also give you the needed amounts. Dairy products are a particularly good source of calcium because they are also fortified with vitamin D.

Milk
All types of milk 1 cup 300 mg
Calcium-fortified soy milk 1 cup 300 mg
Low-lactose milk 1 cup 300 mg

Yogurt
All yogurts 1 cup 350-400 mg
(top off your baked potato or add fruit to make a smoothie)

Cheese and Ice Cream
Swiss cheese 1.5 oz 408 mg
American cheese 2 oz 348 mg
Cheddar cheese 1.5 oz 306 mg
Mozzarella cheese (skim) 1.5 oz 311 mg
(top off your salad)
Parmesan cheese, grated 1 oz 390 mg
(top off your pasta)
Low-fat cottage cheese 1/2 cup 78 mg
Typical ice cream 1/2 cup 88 mg

Meat/Protein Group
Sardines with bones 3 oz. 371 mg
Canned Salmon with bones 3 oz 167 mg
(good substitute for tuna)
Almonds 1/3 cup 120 mg
Tofu (calcium-fortified) 1/2 cup 258 mg

Vegetable Group
Kale 1/2 cup 90 mg
Okra 1/2 cup 88 mg
Beet greens 1/2 cup 82 mg
Broccoli 1/2 cup 47 mg
(Dark green vegetables are rich in calcium, but little is absorbed. However, they are a good source of vitamin K, which is also important for bone health.)

Fruit Group
Orange 1 52 mg
Calcium-fortified orange juice 8 oz 350 mg
(a very well absorbed source of calcium)
Figs, dried 10 289 mg

Grain Group
Enriched English muffin 1 96 mg
4-inch Pancakes made with milk 2 72 mg
Hamburger bun 1 54 mg
6-inch corn tortilla 1 42 mg
Calcium fortified cereal 1 cup 300 mg
(Start your day with cereal and milk.)

Combination Foods
Cheese pizza 1 slice 220 mg
Taco Salad 1 280 mg
Taco 1 109 mg
Caffe Latte 12 oz 412 mg
Caffe Mocha 12 oz 337 mg
Cappuccino 12 oz 262 mg

Should I take a calcium supplement?
If your typical diet does not allow you to consume enough calcium, calcium supplements should be taken.

Multivitamins with minerals do not have the amount of calcium needed as a supplement.

Calcium supplements exist in different compounds, all available over the counter. Although all of these provide calcium they have different calcium concentrations, and absorption may differ.

The best choices for calcium supplements include:

• Calcium carbonate pills, especially those that include vitamin D
  
• Calcium citrate or maleate pills, especially those with vitamin D. These are more expensive but are absorbed somewhat better.
  
• Chewable forms of calcium, such as "Viactiv," or similar generic brands

If you take a multivitamin with vitamin D, you do not need vitamin D in your calcium supplement, too.

You can adjust your daily intake of a supplement, depending on your dietary intake of calcium foods for the day, to approach your goal of 1200 mg per day.

Women diagnosed with osteopenia (below normal bone density) or osteoporosis (more advanced bone loss), need 1500 mg calcium per day through diet and supplements.

What else can I do to keep my bones healthy?
Get regular physical activity.
Physical activity, particularly weight-bearing exercise, applies tension to muscle and bone which encourages the body to compensate for the added stress by increasing bone density. Activities that involve the repeated action of your feet hitting the ground such as brisk walking, jogging, racket sports or aerobic dancing are the best options. Weight training on resistance machines or with free weights also strengthens bones. Swimming and bicycling promote fitness but they aren't bone builders.

Maintain a healthy weight.
If you cut back on food to cut calories, you may come up short on calcium, too. A Word of Caution: being too thin or exercising too much may change a woman's menstrual cycle (irregular periods or none at all) by affecting hormone levels. Because estrogen helps deposit calcium in the bones, you lose the natural protections that hormones provide against bone loss and increase your risk for osteoporosis. A return to normal eating and exercise patterns may lead to return of normal menstrual periods and prevent further bone loss. However, affected women may live the rest of their lives with weakened bones, leading to impaired mobility, chronic pain and deformity.

Avoid smoking.
Smoking is bad for your bones as well as your heart and lungs.

Go easy on alcoholic drinks.
Excessive drinking interferes with calcium absorption.

Reduce caffeine intake.
Two to three cups of caffeinated coffee daily has been shown to contribute to bone loss, particularly if calcium intake is low.

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last modified: March 19, 2009