 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.1
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:
- 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.
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