Medical Update*

Make sure you get enough calcium in your diet

Posted by the Asbury Park Press on 01/22/06

Samantha McCallum makes sure to drink a glass of milk every day.

The Belmar resident also makes yogurt a part of her daily diet.

"I want to make sure I'm getting enough calcium," the 32-year-old explains. "Calcium fortifies your body's frame. Without it, you're really in trouble."

McCallum's right.

The most abundant mineral in the body, calcium has several functions including, most importantly, building bone mass. Additionally, calcium is needed for muscle contraction, blood vessel contraction and expansion, and sending messages through the nervous system.

Adequate calcium consumption throughout life can help prevent osteoporosis. Studies have shown that a calcium-rich diet can help lower high blood pressure.

"Calcium is important at all stages and ages of life," points out Effie Akerlund, a registered dietitian and assistant director of food and nutrition at Community Medical Center, Toms River. "From the earliest years, it's important to get the recommended daily intake."

Most diets inadequate

Unfortunately, according to health experts, calcium is one of the nutrients most likely to be lacking in the American diet. According to the UDSA's Continuing Survey of Food Intakes, 75 percent of Americans are not meeting meeting calcium intake recommendations.

And it gets worse.

Ninety percent all all women ages 20 and older are not getting the recommended allowance, as well 88 percent of teenage girls ages 12 to 19, 73 percent of men 20 and older, 70 percent of girls ages 6 to 11, 68 percent of teenage boys 12 to 19 and 60 percent of boys ages 6 to 11.

"The fact is, we're not getting enough calcium each and every day," Akerlund points out, "and that can only lead to bone loss later in life."

In 1997, the National Academy of Sciences released guidelines for Dairy Reference Intakes of calcium, which recommended 1,200 milligrams a day for people 51 and older. In recent years, the National Institutes of Health has recommended increasing the daily intake to 1,500 milligrams.

"There's no disputing how important a role calcium plays in a body's health," Akerlund says. "The challenge comes with making sure we meet the daily requirements. We weren't reaching those requirements when the daily intake was 800 mgs (prior to the NAS update in 1997), and now it's even more than a challenge."

It doesn't have to be, though.

Drink your milk

Milk, yogurt and cheese are the major contributors of calcium in any diet. Including servings of such calcium-rich foods will increase calcium intake. So will soft-serve ice cream, broccoli, calcium-fortified orange juice, salmon, tofu, cheese pizza, macaroni, cheese and spinach.

"There are many different sources of calcium," Akerlund says. "It's just a matter of finding one that works for you."

For example, a child who turns his or her nose up at 2 percent milk may think twice when it's flavored with chocolate or strawberry, Akerlund says. Other good choices for youngsters: string cheese and drinkable yogurt.

"Kids think it's cool," Akerlund says. "They're not thinking about building strong bones."

While it's easy to control what youngsters eat when they're younger, Akerlund acknowledges that when kids reach their teen and young adult years, it's not as easy.

Staci Williams, 22, of Howell can't remember the last time she drank a glass of milk.

"Probably not in a good 10 years," she says with a laugh. "I'd rather drink water."

And while water is a healthy alternative to soft drinks, it's not adding to the calcium intake.

For people who are not fans of milk, Akerlund says there are alternatives.

"There are people who do not like milk or who are lactose intolerant," she points out, "but there are ways to still get calcium."

Fortified foods help

A trip to the grocery store can find things such as calcium-fortified apple juice, as well as fortified pancakes, waffles and cereal. And there's naturally calcium-rich broccoli and oranges.

And, Akerlund points out, there are other less obvious ways to introduce that much-needed calcium at mealtime.

Milk can be substituted for water when making soups. Dry milk can be added to casseroles, gravies and sauces. Powdered milk can also be added to mashed potatoes and hot cereal. Cheese can be sprinkled on top of salads, soups, chili, broccoli and baked potatoes for a boost. Shredded cheese can also be added to scrambled eggs. Mix whole grain cereal with fruit-flavored yogurt for breakfast. Hot cereal can be a calcium booster when prepared with milk instead of water. Instead of coffee, think latte — coffee with steamed milk.

"The first step to getting enough calcium in your diet is making sure you fit it in to meals every day," Akerlund says. "The next step is making an effort to include those foods every day. Meeting those calcium requirements is a daily effort."

Supplements may be needed

There are times though — many times — health experts say, when adults do not meet those daily intake requirements. For those cases, calcium supplements may be the answer.

Calcium carbonate and calcium citrate are two of the most popular types of calcium supplements. Which type of supplement to choose depends on the person.

Calcium carbonate is alkaline-based and is best taken after meals or with orange juice. Calcium citrate is acidic and may be taken at any time, even on an empty stomach. Calcium carbonate also provides more elemental calcium than calcium citrate, but the pills are larger and may be more difficult to swallow.

Whether choosing carbonate or citrate, the National Osteoporosis Foundation points out that it is important to understand how much elemental or actual calcium is in the supplement.

An easy way to figure out how much calcium each preparation contains, the nonprofit organization says, is to look at the label and find the heading titled "percent of daily value." If the percent of daily value is 20, add a "0" to the 20. Taking the recommended number of tablets will provide 200 mg of elemental calcium.

At the same time, experts say it is important not to exceed 2,500 mg of calcium a day, which is considered the highest level of daily intake that is likely to pose no health risks. Adverse conditions associated with high calcium intake include impaired kidney function, decreased absorption of other minerals and hypercalcemia (elevated levels of calcium in the blood).

"Calcium doesn't get a lot of publicity, but it is something everyone should be concerned about," Akerlund points out. "Getting enough calcium is a lifelong commitment, but one that has many benefits, short-term and long-range."

Log onto our Web site, www.app.com and click on Web Extras for more information about calcium supplements.