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.