Get Your Calcium Q&A

How does a woman know whether she is getting enough calcium?

Dr. Chihal: I like to tell patients that the average American diet has about 350 milligrams of calcium in it. That’s what most people eat on a regular basis. Then each dairy serving has 250 milligrams. So if a woman only eats one dairy serving a day, she’s getting 350 from her regular diet plus 250 from the dairy serving for a total of 600 milligrams. You need 1,000 to 1,200 a day. So many of us are calcium-deficient.

Years ago, the recommended dietary allowance for calcium was less than it is today. Why is that?

Dr. Chihal: With our understanding of osteoporosis and its causes, the American Medical Association and other groups now know that we need more calcium than we originally thought. So they recommend that we increase our intake to help optimize our bone strength. This is particularly important in young women. You don’t get your optimum bone strength until you’re 35. Then after that, you have to protect it so that you don’t lose it as you get older.

What will calcium do to benefit a 40-year-old woman?

Dr. Chihal: If you are low in calcium, then it drains out of your skeleton and increases your risk for osteoporosis as you get older. It’s important to get the necessary amount of calcium at all ages — when you’re building bone from the time you are an adolescent until 35, and particularly menopause because that’s when we start to have acceleration of bone loss. However, it’s really important at all ages.

Up to a certain point, we are still enriching our bones. They are still being formed. Tell me a little bit about that.

Dr. Chihal: You’re building your skeleton the fastest when you’re an adolescent going through puberty. So the young lady who is between the ages of 10 and 18 has a great need for calcium. Yet, they’re almost all deficient. Very few of them get enough calcium. Usually they only get about 600 milligrams a day, and they need about 1,200. So they’re only getting half the amount of calcium they need as they’re building their skeleton. Most people don’t realize that you continue to build your skeleton until you’re 35. Then your skeleton is stable for about the next 10 years. Then as you start going through menopause, or really perimenopause, you start to lose bone. You can help prevent that by getting adequate calcium intake. So it’s important for all ages.

Why is it so important?

Dr. Chihal: Osteoporosis, which is what we’re trying to prevent, is really a devastating disease. It’s totally asymptomatic until your bones start to fracture. The two most common problems are spinal fractures, which can cause you to get stooped over as you get older, and hip fractures, which usually occur in women in their 70s, 80s and 90s. Hip fracture has the same mortality as breast cancer. Most people don’t know that. Of the women who survive, 20 to 30 percent will have to go into long-term nursing care because of their hip fracture. So we’re talking about preventing a disease that can be fatal but also can take away your independence as you get older.

What are some calcium-rich foods?

Dr. Chihal: The main source of calcium in our diet is dairy products. Skim milk and whole milk have the same amount of calcium in them. So with skim milk you can get your calcium and not get your fat. An ounce of cheese has a lot of calcium in it, although it has a lot of fat in it, too. Broccoli, fruits and vegetables are rich in calcium, but the main place you get your calcium is dairy. A lot of people have lactose intolerance. They can’t take dairy products. For those people, calcium supplementation is particularly important.

Are the vitamins and supplements as good as getting calcium from foods?

Dr. Chihal: I don’t think any supplement is ever as good as getting the calcium from your diet. Every expert in nutrition says eat the right food — get it in your diet. The fact is, however, that a lot of women are just not going to do that. So if you don’t have at least three dairy servings a day — a cup of yogurt, a glass of milk — then you should consider taking a calcium supplement.

What vegetables are rich in calcium?

Dr. Chihal: Broccoli, which I mentioned. Spinach is very high in calcium, although it’s hard to absorb from spinach. Kale, chard, all those green, leafy vegetables have a high calcium content. Beans, peas and dry beans that you cook are also very high in calcium. So you can get it from vegetables, but it’s just not as well absorbed as it is from dairy products.

Can you get too much calcium?

Dr. Chihal: Absolutely. I see women that want to get this great skeleton and are taking so much calcium they can get toxic from it. They can get kidney stones. So like most things in life, moderation is the key. Not too little, not too much. You want 1,000 to 1,500 milligrams, but never over 2,000 milligrams a day. It could cause problems.

What about calcium-enriched orange juice? Is that like having a supplement, or is that like having it in your diet?

Dr. Chihal: No, that’s like having a supplement. They put calcium carbonate into the orange juice. It’s a great way to get teenagers to get some extra calcium.

Which supplements are the best?

Dr. Chihal: The key is to take supplements regularly rather than the exact type of supplement. Calcium carbonate and calcium citrate are the two most common forms of calcium today. Calcium citrate is a little bit easier to absorb, especially in people who are older. If they’re taking medication for ulcers to lower their stomach acid, then calcium citrate is a little bit better as well. You can take it on an empty stomach. So I tell most women to take it when they wake up and brush their teeth. If you try to spread it out over the day, you’re much less likely to take it.

Do you think the low-fat diet craze has affected the amount of calcium that we consume?

Dr. Chihal: Fat and calcium go together if you look at whole milk, but you can certainly get dairy and eat low-fat also. Low-fat frozen yogurt has a lot of calcium in it, and that’s certainly not a bad thing to eat. You can do it. You just have to watch the fat and the calcium at the same time. It’s do-able. It just takes a little inventiveness and awareness of what you’re eating.

What do you think is the most important message for women to walk away with?

Dr. Chihal: I think the most important thing to do is analyze your diet. It’s easy — 350 milligrams for your regular diet. If you’re not getting three dairy servings a day, add that supplement in. Take it in the morning, and it will make a big difference in how your skeleton develops as you get older.

Anything else you want to add?

Dr. Chihal: Don’t forget your teenager daughters. I pop a supplement on my daughter’s plate every morning along with a glass of orange juice. Young women don’t get enough calcium, and that’s where it all starts. Optimize your skeleton while you’re young.

What about family history?

Dr. Chihal: Family history is critical. A recent study showed that 80 percent of the strength in your skeleton is inherited. So if you have a mother or grandmother or aunt with osteoporosis, then it is especially important for you to get all the calcium possible.

Source: Ivanhoe Broadcast News