Although we are doing our best to raise healthy children, we are really neglecting an important problem. Our girls are growing up with very inadequate calcium intake. The results of this won’t show until they are in their 40’s and 50’s when they will be battling osteoporosis. Many mothers and grandmothers who are now at that age are just finding out that they have the problem and are at high risk for fractures as they get older.
The reason for real concern is that as we age, if we have not built up a good amount of bone mass, our bones weaken and the risk of fracture increases dramatically. This can have a devastating effect on overall health. A painful hip fracture from a simple fall can cause multiple problems including blood clots, pneumonia, depression and other serious health problems. Spinal bone fractures cause severe back pain, nerve compression, loss of bodily functions and many other problems. These disabling fractures occur spontaneously, even if there was no injury from a fall. The loss of mobility and chronic pain is often the beginning of a downhill spiral in the older person’s health and vitality. Weak bones can rob any person of the enjoyment of daily life and the joys of long prosperous life.
Why Calcium is needed (dual functions)
Calcium is a mineral that is essential in our health. It is the substance that gives our bones hardness and strength. It also must be circulated in the blood to maintain heart rhythm, nerve and muscle function and a number of delicate metabolic functions. It is so essential to life function that the body removes calcium from the bones and puts it into the blood if there is inadequate intake from the diet. There must always be a steady level of it in the blood.
To maintain bone strength and all the functions of calcium, all of our living bones go through the constant processes of bone breakdown and new bone formation. Hormones govern both of these processes. The balance of breakdown and build up is different at different ages. One thing is certain: Throughout life, a constant intake of calcium is necessary.
Variation in calcium requirements with age
During a little girl’s childhood, when growth occurs, growth hormone predominates and most of the bone activity is concentrated in building up bones in length and strength. The calcium requirements are high, 1200-1500 milligrams per day. Once maturity is reached, growth stops. The strength of her bones is at its lifetime peak.
At this point, during the young adult phase of her life, bone density stabilizes, as the amount of breakdown equals the amount of new bone formation. This is maintained by high levels of the hormone estrogen which protects her from excessive bone loss. The calcium requirements decrease slightly to 1000 milligrams per day at this time.
During pregnancy there is a very high level of estrogen but the need for calcium is increased to provide material for bone growth for the unborn baby. The requirement is 1200-1500 milligrams per day.
As the woman reaches age 45-55, there is a natural decrease in estrogen. This allows more bone to be broken down than is built up. Calcium requirements increase to 1200-1500 milligrams per day. At that point in a woman’s life, if she doesn’t have a really good peak bone mass, the bone breakdown will silently lead to dangerously low bone mineral density- Osteoporosis. If this happens, fracture risk rises dramatically.
Calcium in the diet
Calcium is found in dairy products and legumes such as soy and beans. Bones have calcium so fish like canned salmon and sardines with the bones left in are a source of calcium. Most of us started out drinking three glasses of milk a day when we were children. This provided us about 1200 milligrams of calcium each day. Over the last twenty years the average amount of milk and milk products consumed by children and adults has decreased dramatically. The result of this change in diet is a serious decrease in bone mineral density, especially in young women who are missing the chance to build up their bone strength during the most critical time in their lives.
In summary, children, teenagers, pregnant women and the elderly need 1200-1500 milligrams of calcium, while young adults need about 1000 milligrams daily. (Men and boys need calcium too, but the problem with osteoporosis starts at a later age, and is less severe than in women.)
The most important time when bones are built up to the peak adult bone mass is during puberty. During the final growth spurt, the young teenage girl not only grows taller but she broadens and strengthens her bones dramatically. It is during this critical time when a poor calcium intake can be a major mistake that will affect her bone health for the rest of her life.
Dr. Henry Anhalt, a pediatric endocrinologist tested the bone mineral density of teenage girls in a high school recently and discovered that a large percentage of the teenage girls have very low bone mineral density at this critical age when they should have peak bone mass. This means that if they do not start concentrating on their calcium intake from now on they are very likely to suffer from osteoporosis in the future.
Besides calcium intake, there are several other contributing factors that put women at risk for the problem of osteoporosis.
- Family history: If a woman’s mother, grandmother, sisters or aunts have osteoporosis, her own risk of developing it is higher.
- Small size: If a woman weighs less than 120 pounds she is more likely to have a small, delicate bone structure which increases her risk.
- Drugs such as chemotherapy and cortisone increase risk for osteoporosis
- Sedentary women who rarely walk and exercise are at increased risk.
- Surgery such is removal of ovaries can increase risk.
The solution—START NOW!
We can start immediately to help our daughters, mothers and ourselves avoid the complications of osteoporosis. Our first job is to get our children and all of us on enough calcium. All milks, including low fat and skim milks have about 400 milligrams per 8 ounce portion. Cottage cheese and yogurts have about 400 milligrams in 6 ounces. Cheeses are a good source of calcium but sliced processed American cheese has the least. Muenster, mozzarella, gouda, edam and Swiss cheese have much more calcium. The problem with milk products is that they often have very high saturated fat and cholesterol content. Since this is not desirable in older children and adults the best milk products are those made from fat free milk or low fat milk. There are other problems that some people have with milk such as digestive intolerance and allergy.
We now have fortified juices and drinks, which contain calcium. These are good sources of calcium but many are also very high in sugar calories. For this reason it is better to only drink Rice Dream or Calcium fortified orange juice once a day. There are many calcium supplements, which are easy to take. Calcium Carbonate chewables like Tums Ultra contain 400 milligrams in each tablet. Viactive contains 500 milligrams of calcium plus 400 of vitamin D. There are many other supplements, although some are made from non-kosher ingredients and some cause constipation. Most daily multivitamin supplements contain only 200 milligrams of calcium.
It is important to know that we can only absorb about 500 milligrams of calcium at a time. This means that even if we take 1000 milligrams we will receive only 500 milligrams. The extra is wasted. Calcium foods or supplements must be eaten at three different times in the day to be absorbed properly.
Another factor in protecting ourselves is exercise. Weight bearing exercise such as walking helps maintain bone strength throughout life. We must all try to keep active throughout our lives. In many ways exercise is the “Fountain of Youth”.
Fortunately, for those women who already have low bone density, there are new medications such as Fosamax, Actonel and Evista, which can prevent further bone breakdown. A new injectable drug was recently approved by the FDA, Forteo, which is the only drug that actually increases bone mass. A doctor must prescribe these medications if they are needed.
Now that we understand the nature of bones and the need for calcium we must do our part and take care of ourselves. When it comes to osteoporosis, “prevention is the cure.” Talk to your children and your mother and your sisters about maintaining good calcium intake. By being conscientious and eating properly we can look forward to a safer, healthier and much more comfortable old age.
A word about vitamin D
To maintain good bone health, children and adults need both calcium and vitamin D. During growth, a severe curvature of the legs, known as rickets, can be caused by lack of vitamin D. This problem is extremely rare now in the United States since so many foods are fortified with vitamin D. Vitamin D is also manufactured in our own bodies when our skin is exposed to small amounts of sunlight. It is estimated that everyone needs 400 to 800 units of vitamin D a day.