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Calcium and Strong Bones

Protecting Your Bones

 

The bone-thinning condition called osteoporosis can lead to small

and not-so-small fractures. Although many people think of calcium in

the diet as good protection for their bones, this is not at all the

whole story. In fact, in a 12-year Harvard study of 78,000 women,

those who drank milk three times a day actually broke more bones

than women who rarely drank milk.

 

http://www.pcrm.org/health/prevmed/strong_bones.html

 

Similarly, a 1994 study of elderly men and women in Sydney,

Australia, showed that higher dairy product consumption was

associated with increased fracture risk. Those with the highest

dairy product consumption had approximately double the risk of hip

fracture compared to those with the lowest consumption.2

 

To protect your bones you do need calcium in your diet, but you also

need to keep calcium in your bones.

 

How to Get Calcium into Your Bones

1. Get calcium from greens, beans, or fortified foods.

 

The most healthful calcium sources are green leafy vegetables and

legumes, or " greens and beans " for short. Broccoli, Brussels

sprouts, collards, kale, mustard greens, Swiss chard, and other

greens are loaded with highly absorbable calcium and a host of other

healthful nutrients. The exception is spinach, which contains a

large amount of calcium but tends to hold onto it very tenaciously,

so that you will absorb less of it.

 

Beans are humble foods, and you might not know that they are loaded

with calcium. There is more than 100 milligrams of calcium in a

plate of baked beans. If you prefer chickpeas, tofu, or other bean

or bean products, you will find plenty of calcium there, as well.

These foods also contain magnesium, which your body uses along with

calcium to build bones.

 

If you are looking for a very concentrated calcium source, calcium-

fortified orange or apple juices contain 300 milligrams or more of

calcium per cup in a highly absorbable form. Many people prefer

calcium supplements, which are now widely available.

 

Dairy products do contain calcium, but it is accompanied by animal

proteins, lactose sugar, animal growth factors, occasional drugs and

contaminants, and a substantial amount of fat and cholesterol in all

but the defatted versions.

 

2. Exercise, so calcium has somewhere to go.

Exercise is important for many reasons, including keeping bones

strong. Active people tend to keep calcium in their bones, while

sedentary people lose calcium.

 

3. Get vitamin D from the sun, or supplements if you need them.

 

Vitamin D controls your body's use of calcium. About 15 minutes of

sunlight on your skin each day normally produces all the vitamin D

you need. If you get little or no sun exposure, you can get vitamin

D from any multiple vitamin. The Recommended Dietary Allowance is

200 IU (5 micrograms) per day. Vitamin D is often added to milk, but

the amount added is not always well controlled.

 

How to Keep It There

It's not enough to get calcium into your bones. What is really

critical is keeping it there. Here's how:

 

1. Reduce calcium losses by avoiding excess salt.

Calcium in bones tends to dissolve into the bloodstream, then pass

through the kidneys into the urine. Sodium (salt) in the foods you

eat can greatly increase calcium loss through the kidneys.3 If you

reduce your sodium intake to one to two grams per day, you will hold

onto calcium better. To do that, avoid salty snack foods and canned

goods with added sodium, and keep salt use low on the stove and at

the table.

 

2. Get your protein from plants, not animal products.

 

Animal protein—in fish, poultry, red meat, eggs, and dairy products—

tends to leach calcium from the bones and encourages its passage

into the urine. Plant protein—in beans, grains, and vegetables—does

not appear to have this effect.4

 

3. Don't smoke.

 

Smokers lose calcium, too. A study of identical twins showed that,

if one twin had been a long-term smoker and the other had not, the

smoker had more than a 40 percent higher risk of a fracture.5

 

American recommendations for calcium intake are high, partly because

the meat, salt, tobacco, and physical inactivity of American life

leads to overly rapid and unnatural loss of calcium through the

kidneys. By controlling these basic factors, you can have an

enormous influence on whether calcium stays in your bones or drains

out of your body.

 

Hormone Supplements Have Serious Risks

Some doctors recommend estrogen supplements for women after

menopause as a way to slow osteoporosis, although the effect is not

very great over the long run, and they are rarely able to stop or

reverse bone loss.

 

Many women find these hormones distasteful because the most commonly

prescribed brand, Premarin, is made from pregnant mares' urine, as

its name suggests. What has many physicians worried is the fact that

estrogens increase the risk of breast cancer. The Harvard Nurses'

Health Study found that women taking estrogens have 30 to 80 percent

more breast cancer, compared to other women.6

 

Moreover, Premarin may aggravate heart problems. In a study of 2,763

postmenopausal women with coronary disease followed for an average

of four years, there were as many heart attacks and related deaths

in women treated with the combined regimen of estrogens and a

progesterone derivative, as with placebo, but the coronary problems

occurred sooner in women taking hormones. Hormone-treated women were

also more likely to develop dangerous blood clots and gallbladder

disease.7 Controlling calcium losses is a much safer strategy.

 

Reversing Osteoporosis

If you already have osteoporosis, you will want to speak with your

doctor about exercises and perhaps even medications that can reverse

it.

 

Osteoporosis in Men

Osteoporosis is less common in men than in women, and its causes are

somewhat different. In about half the cases, a specific cause can be

identified and addressed:8

 

Steroid medications, such as prednisone, are a common cause of bone

loss and fractures. If you are receiving steroids, you will want to

work with your doctor to minimize the dose and to explore other

treatments.

Alcohol can weaken your bones, apparently by reducing the body's

ability to make new bone to replace normal losses. The effect is

probably only significant if you have more than two drinks per day

of spirits, beer, or wine.

A lower than normal amount of testosterone can encourage

osteoporosis. About 40 percent of men over 70 years of age have

decreased levels of testosterone.

In many of the remaining cases, the causes are excessive calcium

losses and inadequate vitamin D. The first part of the solution is

to avoid animal protein, excess salt and caffeine, and tobacco, and

to stay physically active in order to reduce calcium losses. Second,

take vitamin D supplements as prescribed by your physician. The

usual amount is 200 IU (5 micrograms) per day, but it may be doubled

if you get no sun exposure at all. If you have trouble absorbing

calcium due to reduced stomach acid, your doctor can recommend

hydrochloric acid supplements.

 

Calcium and Magnesium in Foods (milligrams)

Food Source Calcium Magnesium

Collards (1 cup, boiled)

358

52

 

Orange juice, calcium-fortified (1 cup) 350*

--

 

Oatmeal, instant (2 packets)

326

70

 

Figs, dried (10 medium)

269

111

 

Tofu, calcium-set (1/2 cup)

258

118

 

Spinach (1 cup, boiled)

244

158

 

Soybeans (1 cup, boiled) 175

148

 

White beans (1 cup, boiled) 161

113

 

Mustard greens (1 cup, boiled) 150

20

 

Navy beans (1 cup, boiled)

128

107

 

Vegetarian baked beans (1 cup)

128

82

 

Great northern beans (1 cup, boiled) 121

88

 

Black turtle beans (1 cup, boiled) 103

91

 

Swiss chard (1 cup, boiled)

102

152

 

Broccoli (1 cup, boiled)

94

38

 

Kale (1 cup boiled)

94

24

 

English muffin

92

11

 

Butternut squash (1 cup, boiled)

84

60

 

Pinto beans (1 cup, boiled)

82

95

 

Chick peas (1 cup, canned) 80

78

 

Sweet potato (1 cup, boiled)

70

32

 

Green beans (1 cup, boiled) 58

32

 

Barley (1 cup)

57

158

 

Brussels sprouts (8 sprouts) 56

32

 

Navel orange (1 medium)

56

15

 

Raisins (2/3 cup)

53

35

 

Source: J.A.T. Pennington, Bowes and Church's Food Values of

Portions Commonly Used. (Philadelphia: J.B. Lippincott, 1994.)

*Information from manufacturer

 

 

References

1. Feskanich D, Willett WC, Stampfer MJ, Colditz GA. Milk, dietary

calcium, and bone fractures in women: a 12-year prospective study.

Am J Publ Health 1997;87:992-7.

2. Cumming RG, Klineberg RJ. Case-control study of risk factors for

hip fractures in the elderly. Am J Epidemiol 1994;139:493-503.

3. Nordin BEC, Need AG, Morris HA, Horowitz M. The nature and

significance of the relationship between urinary sodium and urinary

calcium in women. J Nutr 1993;123:1615-22.

4. Remer T, Manz F. Estimation of the renal net acid excretion by

adults consuming diets containing variable amounts of protein. Am J

Clin Nutr 1994;59:1356-61.

5. Hopper JL, Seeman E. The bone density of female twins discordant

for tobacco use. N Engl J Med 1994;330:387-92.

6. Colditz GA, Stampfer MJ, Willett WC, et al. Type of

postmenopausal hormone use and risk of breast cancer: 12-year follow-

up from the Nurses' Health Study. Cancer Causes and Control

1992;3:433-9.

7. Hulley S, Grady D, Bush T, et al. Randomized trial of estrogen

plus progestin for secondary prevention of coronary heart disease in

postmenopausal women. JAMA 1998;280:605-13.

8. Peris P, Guanabens N, Monegal A, et al. Aetiology and presenting

symptoms in male osteoporosis. Br J Rheumatol 1995;34:936-41.

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