Calcium and Osteoporosis Supplement (English version)

GENERAL INFORMATION:

What is it? Osteoporosis (ah-stee-o-per-o-sis) is when your body breaks down bone faster than new bone is made and stored. Some loss of bone mass is natural as people age, especially for women after menopause. But, bone loss also can happen due to medicines or genetic factors (passed from parent to child). The bones become weak, brittle, and more porous than usual. Osteoporosis makes it easier for bones in your hip, pelvis, wrist, arm, and spine to break. You also are at risk for other health problems because of being inactive while bones are healing.

How can what I do, eat, and drink cause osteoporosis? The following things can cause your body to give up (get rid of) too much calcium from your bones.

• Not exercising regularly.

• Diet: Getting enough calcium in your diet is very important in preventing and treating osteoporosis. Avoid the following things that can prevent you from getting enough calcium in your diet. These things can also cause early loss of calcium from your bones.

- Drinking too much caffeine.

- Drinking too much alcohol.

- Eating too much fiber can cause you to absorb less calcium.

- Eating too much animal protein (more than 80-100 grams a day) can cause you to lose too much calcium. Plant or vegetarian protein does not seem to cause this problem.

Care: One important way to prevent or control osteoporosis is to get enough calcium in your diet every day. This CareNote explains how you can get enough calcium in your diet. It also tells how much calcium people of different ages and with different health problems need.

Calcium Sources

- Look up your age group in the table below to find out how much calcium you should be getting each day. Then use the food lists to figure out how much calcium you are getting now from your diet. Check with your caregiver or dietitian for calcium supplements to take if you can not get enough calcium from your diet. Never take more than 2,000 mg of calcium per day from supplements.

- Antacids with calcium and calcium chews are also available. Check labels on these items to find the total calcium or elemental calcium content of each dose. Check with your caregiver before trying chewable calcium supplements if you take blood-thinning medication, such as coumadin. The calcium chews may contain vitamin K, which can block the action of your medicine.

Other Nutrients and Medicines

- Check with your caregiver to see if you should take extra phosphorus or vitamin D to help your body store calcium. Some people need 400-800 IU of vitamin D each day to help their bones store enough calcium. Avoid taking more than 5,000 IU of vitamin A or more than 1,000 IU of vitamin D. Too much of these can interfere with how calcium is absorbed.

- Get regular exercise to make sure your bones will absorb and store calcium as well as possible. Walking, jogging, running, aerobics, and other weight-bearing exercises are the best.

- Talk to your caregiver if you are a woman past menopause and osteoporosis runs in your family. Your caregiver may suggest that you take hormone replacements.

GUIDELINES FOR CALCIUM INTAKE: Amounts needed each day for bone health are listed in milligrams (mg). Check with your caregiver for the right calcium dose if you are taking steroid medicines or are a female after menopause.

• Infants

- 0-6 months: 210 mg

- 6-12 months: 270 mg

• Children

- 1-3 years: 500 mg

- 4-8 years: 800 mg

- 9-13 years: 1,300 mg

• Women (before menopause and those not pregnant or nursing) and men

- 14-18 years: 1,300 mg

- 19-50 years: 1,000 mg

- 51-70 years: 1,200 mg

- 70 and older: 1,200 mg

• Women (who are pregnant or who have gone through menopause)

- Pregnant or nursing up to 18 years: 1,200-1,300 mg

- Pregnant or nursing 19 years and older: 1,000-1,200 mg

- After menopause: 1,000-1,200 mg if taking estrogen

- After menopause: 1,200-1,500 mg if not taking estrogen

• All people taking steroid medicines: at least 1,500 mg

SOURCES OF CALCIUM IN FOOD: The estimated milligrams of calcium for each food are listed in parentheses. The actual amount of calcium may be slightly different depending on the brand of a type of food you eat. Oxalates and dietary fiber in plant foods can block part of the calcium absorbed by your body. The calcium from dairy foods and seafood are the best absorbed by most people.

Serving Sizes: Use this list to measure foods and serving sizes.

- 1½ cup (12 ounces) of liquid is the size of a soda-pop can.

- 1 cup (8 ounces) of food is the size of a large handful.

- ½ cup (4 ounces) of food is about half of a large handful.

- A serving size means the size of food after it is cooked. Three ounces of cooked meat, fish, or poultry is about the size of a deck of cards.

DAIRY

- 1 cup skim milk (302) - 1 ounce cheddar cheese (204)

- 1 cup 2% milk (297) - 1 ounce mozzarella cheese (147)

- 1 cup whole milk (291) - 1 ounce Swiss cheese (272)

- 1 cup chocolate milk, 2% fat (284) - ½ cup ricotta cheese (337)

- 1 cup buttermilk (285) - ½ cup 2% fat cottage cheese (78)

- 1 cup low-fat fruit yogurt (330) - ½ cup evaporated low-fat milk (318)

- 1 cup low-fat plain yogurt (415) - ¼ cup powdered nonfat milk (377)

• FRUITS AND VEGETABLES

- 1 cup calcium-fortified orange juice (400) - 1 cup cooked collard greens (358)

- 1 cup cooked rhubarb (270) - 1 cup cooked kale (180)

- 1 cup steamed broccoli (94) - 1 cup cooked turnip greens (249)

• SEAFOOD

- 3 ounces canned salmon, with bones (187) - 3 ounces canned sardines, with bones (342)

• PROTEIN FOODS

- 1 cup refried beans (140) - ½ cup tempeh (77)

- ½ cup tofu (130)

DESSERTS

- ½ cup custard (158) - ½ cup vanilla pudding (148)

- ½ cup ice milk (92) - 1 slice (1/6 of a pie) pumpkin pie (166)

CALL YOUR CAREGIVER IF:

• You have questions about the serving sizes on this diet.

• You have questions about how to prepare or cook foods on this diet.

• You have questions about how or where to buy foods on this diet.

• You have questions or concerns about your illness, medicine, or this diet.

Source: Klasco R & Auracher P (Eds): CareNotes™ System. MICROMEDEX Inc., Englewood, CO (Edition expires 9/2001).