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Just How Important Is Calcium?

Monday, February 24th, 2014

Through every stage of life, calcium is an important component of a woman’s diet. Calcium is involved in many aspects of overall health. It is believed to be important for bone health, prevention of cardiovascular disease, blood pressure regulation, weight management, and prevention of some types of cancer.

How Much Calcium Do You Need?

The recommended daily allowance of calcium for women between 19 and 50 years of age is 1,000 mg. That recommendation does not change when you are pregnant, but meeting it does become even more important, because you are providing nutrition for your baby as well, and his or her bones and teeth need calcium for proper development. In addition, when you don’t get enough calcium for a long period of time, you are at risk for developing osteopenia, which can lead to osteoporosis.  What’s the difference? Osteoporosis is a disease that breaks down the tissue in our bones, making them fragile and more likely to break. Osteopenia is not a disease, but a term that describes low bone density. Both can lead to painful fractures.  While osteopenia is not considered a disease, being diagnosed with osteopenia requires further monitoring. Preventive measures should be taken since osteoporosis may develop if bone density loss increases.

Actually, the real protection against osteoporosis begins when one is a teenager, because porousness of the bones is the end stage of a long process. Continuing to drink milk after childhood through the teenage years is like putting calcium in the bank to be drawn on later. Unfortunately, teenagers favor sodas over milk and not many drink the two glasses of milk a day that would allow them to meet more than half their daily calcium needs.

Which food has more calcium?  A cup of collard greens or a cup of whole milk?  The answer is collard greens!  Eight ounces of skim milk contains almost 300 mg – even more than whole milk, and in a healthier, fat-free package. Yogurt and cheese are good sources of calcium too, but remember that dairy products are just one of many ways to get the calcium you need. Salmon, kale, broccoli, and calcium-fortified orange juice are just a few of the other many places to find calcium.  I don’t believe that my orange juice should be calcium-fortified, but the manufacturers are offering the option.  Just drink milk!

What about calcium supplements? Their safety is often called into question, although for now they appear to be harmless. The real issue is that supplements are not a stand-in for natural foods that contain calcium, because they lack the protein, vitamins, and minerals that you, and your growing baby if you are pregnant, both need. With just a little effort you can get all the calcium you need easily through a healthy diet.

Calcium need during menopause is 1200 milligrams per day. After menopause, it increases to 1500 milligrams per day.  We once thought that calcium and Vitamin D supplementation should be taken to prevent bone fractures in postmenopausal women.  However, the United States Preventive Services Task Force, an independent panel of experts in prevention and primary care, recently issued a draft statement in June, 2012, recommending that healthy postmenopausal women should NOT take low doses of calcium or Vitamin D supplements to prevent fractures.  Why?  Because the supplements were found NOT to prevent fractures and only increased the risk of other problems, such as kidney stones.  So the risks outweighed the benefits and taking these supplements may actually be harming you.


Lactose Intolerance

Lactose intolerance is a common condition in which unpleasant symptoms such as bloating or diarrhea occur after consuming lactose, milk’s natural sugar. This happens when an individual does not produce enough of the enzyme lactase to properly break down the lactose. Lactose intolerance can unsurprisingly make it more of a challenge to consume enough calcium. However, some individuals can consume a small amount of milk without issue. Yogurt is often a good alternative.  However, there are many products today designed for lactose-intolerant individuals. In addition, there are many non-dairy sources of calcium available such as kale, broccoli, collards, and foods fortified with calcium.

Can You Get Too Much Calcium?

Like anything other good thing, too much calcium can present potential problems. Hypercalcemia can cause renal and vascular problems, as well as kidney stones. It can also cause constipation. However, it’s important to realize that you would have to consume more than three times the recommended daily allowance of calcium for problems to begin to occur. Given the average American diet, this is just not a real concern. So drink plenty of skim milk and enjoy lots of other calcium-rich foods as part of your balanced nutritious diet, especially while you are pregnant, lactating or postmenopausal.

For more information about the risk factors associated with postmenopausal osteoporosis, I refer you to my health book, Inside Information for Women.

– Yvonne S. Thornton, M. D., M. P. H.

Osteoporosis Cannot Be Prevented By Calcium Alone

Thursday, February 14th, 2013

Everyone knows how important calcium is in the long-term prevention of osteoporosis. By drinking dairy in your youth, you are building strong bones that will hold up longer against the disease in adulthood. However, few people understand how calcium is absorbed into the body. When you drink a glass of milk, the calcium doesn’t simply soak into your bones on the way down. It must interact with other molecules in your system and bond to them in a way that makes them part of your digestion. Without this bonding, the calcium will simply be flushed out. Unfortunately, many people who try to get enough calcium in their diet don’t get as much as they think they do because it is not properly absorbed. To absorb calcium, your body also needs vitamin D.

Think of vitamin D like the doorman. You can make sure calcium pays a visit to your body by eating an adequate amount, but it will be turned away if no one is there to let it in. To make sure your body actually absorbs calcium and transfers it into your bones, you need to also get enough vitamin D. Studies show that vitamin D and calcium on their own do not effectively prevent fractures in people with osteoporosis.

To learn how much vitamin D you should be getting at your age, make sure you talk to your doctor. He or she will perform tests to first find out whether or not you are deficient in the first place. You can get vitamin D from sun exposure, but you should be careful to avoid too many UV rays at a time. You can also get it from dietary supplements and certain foods such as egg yolks, liver, and fortified milk.

Calcium is certainly important in the prevention of osteoporosis, but vitamin D is equally so. Don’t assume that just because you are getting a lot of calcium, you are safe from weakened bone strength in old age. To prevent the pain and inconvenience of fractures later in your life, start increasing the amount of vitamin D you get today.

– Yvonne S. Thornton, M. D., M. P. H.

Calcium Will Ease the Pains of PMS

Thursday, December 27th, 2012

It’s almost that time of the month. Your skinny jeans don’t fit, you’re crying about the dishes in the sink, and chocolate is all you want for dinner. Premenstrual syndrome (PMS) affects at least 85% of all women in some way. Some don’t have the same symptoms as others, but many women will have at least one as part of their cycle. You might get acne, tender breasts, fatigue, bloating, cravings, muscle pain, trouble with memory, irritability, mood swings, and anxiety all at once. In many ways, these symptoms interfere with everyday life by making even the most simple and mundane tasks more difficult. The fatigue can feel paralyzing, and the mood swings can make you feel like a monster. Even the most casual conversations can turn into fights or tear-jerkers.

For women who are predisposed to it, PMS is impossible to avoid. Sometimes, contraceptives can ease the symptoms, but other times they actually become much worse. There are also a few easy remedies you can try to ease symptoms, such as exercise and diet adjustment. By exercising, you release much of the tension and stress built up in your body, which will make each problem seem a lot less intense. Avoiding junk food and alcohol can also make symptoms fade away faster, but this only works for some women. However, there is one easy treatment for PMS that has been repeatedly proven to work in a clinical setting. An increased intake of calcium will help ease the symptoms of PMS. In the study, women who increased their intake by 1200-1600 mg every day had significantly less symptoms than before they began the supplementation.

Always consult with your doctor before making any changes to your diet, but increasing the amount of calcium you eat while you are experiencing PMS is easy. You don’t even need to pay for the supplements if you try adding more calcium-rich foods to your diet. Milk, yogurt, beans, tofu, kale, spinach, and orange juice are all excellent sources of calcium. When that time of the month rolls around and you feel too bloated to function and too emotional to face your friends, stock up on calcium rich foods to get over your PMS before it gets the best of you.

 – Yvonne S. Thornton, M. D., M. P. H.

Are You Getting Too Much Calcium?

Monday, June 18th, 2012

Growing up, I’m sure your mother, like mine, urged you to drink milk to help keep your bones strong.  While it’s true your bones do need calcium and Vitamin D, it is also possible to get too much.  Nobody is at risk of overdosing on Calcium because of the milk they drink, but women who take calcium supplements to slow osteoporosis, could very well be at risk.

According to the Heidelberg study, a long-term cancer and nutrition study of 24,000 women in Germany, those who took a combination of vitamins, minerals, and calcium tablets were 86 percent more likely to have a heart attack than those who did not take supplements.  This data is puzzling researchers, since previous studies suggested that supplements could reduce the risk of heart problems, obesity, and diabetes.  This new study had more participants and was done over a much longer period of time though, causing some to change their minds about the benefits of supplements.  In fact, the German study showed only a 10% benefit when it came to women with osteoporosis who took the calcium supplements.  They also found that diets high in calcium rich foods did not seem to increase the risk of heart problems, but the calcium tablets did.  They believe this may be due to the way the different forms are absorbed.  When you take supplements, you get a lot of the vitamin or mineral at once, while working it into your diet allows your body to absorb smaller amounts throughout the day.

In other words, mom scores again; you should be eating and drinking your calcium.  And don’t forget about Vitamin D. Vitamin D helps the absorption of calcium from the intestines. Vitamin D comes from the diet and the skin. Vitamin D production by the skin is dependent on exposure to sunlight. So, take a brisk walk in the sun and perhaps, one would not need to overdose on calcium tablets alone.  If you are suffering from osteoporosis and your physician has recommended calcium tablets though, you may want to speak with them about taking several smaller doses throughout the day or lessening your dose while upping your dietary intake.  As usual, maintaining our health the good old fashioned way turns out to be the best strategy.

Early Menopause is Bad News for Women and Their Bones

Monday, May 7th, 2012

Let’s face it.  None of us looks forward to getting old, but we try to do it with as much grace as possible.  For some women though, menopause, a hormonal change that should come later in life, comes sooner than expected.  Instead of dealing with hot flashes, night sweats, mood swings and all the other symptoms of menopause in their 50s, they’re facing it in their 40s or even younger.  And as if early menopause isn’t bad enough, studies now show that it increases their risk for osteoporosis and even shortens their life expectancy.

Swedish researchers from Skane University Hospital in Malmo conducted a study of almost 400 women over the course of just under 30 years.  They found that of the women who started menopause before the age of 47, 56 percent developed osteoporosis compared to just 30 percent in the women who started menopause later in life.  Women suffering from osteoporosis are at greater risk for bone fractures, bone pain, and loss of height due to bone loss.  Their findings also showed that women who had undergone early menopause had a greater risk of fragility fracture and death with a rate 17 percent higher than the women with later menopause.  The rate of fractures in women with early menopause was 44% compared to 31% in those women who entered menopause later.

The cause of early menopause is not yet clear, though there seems to be a link between it and premature ovarian failure, hysterectomies, chemotherapy, and possibly even stress.  Premature ovarian failure has been associated with Fragile X syndrome, so there may be a genetic link. Unfortunately, preventing and reversing early menopause is not yet possible, but there are ways to decrease your risk of osteoporosis.  The bone masses of most women peaks in their 20s.  You can increase yours by getting plenty of calcium, vitamin D and exercise.  A balanced diet and thirty minutes of weight training or other moderate exercise every day can make big difference when it comes to your bone health.

The association found between early menopause, osteoporosis, and death is causing some to call for more studies to determine a more definite correlation. The higher mortality rate in women with early menopause does need further study in order to address the confounding variables, such lifestyle, medications and smoking.  In the meantime, we should take the results as a warning to take care of our bodies, particularly our bones, as early as possible.

— Yvonne S. Thornton, M. D., M. P. H.