Q: Which calcium supplement? Which one is best?
This issue strikes close to home with me because my mother fractured her wrist, then her hip and eventually died from complications from osteoporosis. Those of us who are over 50 years of age, female, post menopausal, have a family history of osteoporosis or a slight build are more likely to develop thinning bones that could lead to fractures along with permanent disability, like my mother suffered.
Many Americans are aware that calcium and vitamin D are critically important for building strong bones but may not realize how our muscles, nerves and blood vessels also depend on calcium in order to work properly. If your body doesn’t have enough calcium it will go looking for more, and the easiest place to get it is from your bones. Without adequate calcium in your diet or in supplements your body will use your skeleton as a calcium ATM until something gives – your hip breaks or your backbone collapses.
Most bone-building medicines work by reversing this process, strengthening your bones by putting calcium back into them. If you are taking a prescription medicine such as alendronate (Fosamax®), Actonel® (risendronate) or Boniva® it’s important to have enough calcium in your body so these medicines can do their job.
How much calcium is enough? The Institute of Medicine recommends 1000mg daily of calcium for men and women up to age 50, and 1200mg for adults older than 50 years of age. The National Institutes of Health used to recommend more for postmenopausal women but backed off when increased heart attacks started showing up in older women taking daily calcium supplements.
Do you even need a calcium supplement at all? Unlike taking calcium in a pill, eating calcium-rich foods does not increase your chances of having a heart attack. Most Americans get about 300mg of calcium daily from their diet, mostly from beans, nuts, and green vegetables. In addition, you’ll get an additional 300mg of calcium for every 8-ounce glass of milk, fortified orange juice, yogurt, or 1.5 ounces of cheese you consume.
Broccoli, cabbage, kale, turnip greens, and salmon are good sources of calcium. Eating spinach can interfere with calcium absorption, so it isn’t a good choice if you are trying to increase calcium in your diet.
If you are over 50, you’ll probably need a little help from a calcium supplement to protect your bones from becoming calcium ATM. Calcium citrate and calcium carbonate are the most common calcium supplements to choose from.
6 Tips To Improve Your Calcium Intake:
1. Eat more servings of vegetables. 8 ounces of broccoli has 60mg of elemental calcium and 8 ounces of kale has nearly 100mg. Spinach is not a good choice for calcium because it also contains oxalates that interfere with calcium absorption. Eating foods rich in calcium reduces your risk of heart attack, while taking supplements can increase it.
2. Take supplemental Vitamin D to help your body absorb calcium.
Vitamin D is recommended as 600 IU daily for folks up to 70 years of age and 800 IU daily for those over 70. You can also get Vitamin D from salmon (800 IU per 3 ounces), canned tuna (150 IU per 3 ounces), fortified milk (about 120 IU per 4 ounces), and fortified orange juice (80 IU per 4 ounces). Most calcium supplements also contain Vitamin D.
3. Choose calcium citrate if you take any medicines for stomach acidity, heartburn or stomach ulcer. Taking Prilosec® (omeprazole), Prevacid® (lansoprazole), Zantac® (ranitidine) and other medicines like these reduces the acid level in your stomach. Calcium carbonate needs plenty of stomach acid to be absorbed but calcium citrate doesn’t.
4. If you have trouble with constipation, avoid calcium carbonate.
5. Always take a calcium supplement with meals. Calcium is better absorbed when it is in your food (like broccoli) or if you take your supplement with food.
6. Maintain an adequate water or fluid intake to avoid kidney stones. Calcium is not very soluble in water, and taking calcium supplements can cause painful crystals or stones inside your kidney. Calcium citrate is less likely to do this than other calcium supplements. If you’ve had kidney stones in the past talk to your doctor before starting a calcium supplement.
May is National Osteoporosis Month. More information about calcium in your diet and how to keep your bones strong is available from the National Osteoporosis Foundation at www.nof.org.
