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Osteoporosis & Calcium:
Understanding the Connection
by:
Coral S. May, RN, BSN, CME
“The Menopause Diva”
www.menopauseconnection.com
According to the National Osteoporosis Foundation, osteoporosis is defined
as a disease characterized by low bone mass and structural deterioration
of bone tissue leading to bone fragility and an increased susceptibility
to fractures of the hip, spine and wrist. The condition that precedes
osteoporosis is osteopenia or bone mass less than normal but not significant
enough to be osteoporosis. Osteopenia increases a person’s risk
for developing osteoporosis.
The pictures below compare normal bone mass to osteoporotic bone. It is quite easy to see why the osteoporotic bone would be at a greater risk for fracture.
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Normal
Bone |
Osteoporotic
Bone |
Approximately 44 million Americans currently have osteoporosis with another 34 million well on their way. Women over age 50 have a one in two chance of developing an osteoporosis related fracture in their lifetime. Men have a one in eight lifetime risk. This means that 80% of the population with osteoporosis is women.
Because the process of bone loss is slow and gradual, there are no early warning signs! Typically, the first sign of a problem is either severe back pain, loss of height or kyphosis (more commonly known as the “dowager’s hump”).
- Risk factors for osteoporosis are:
- advanced age
- Caucasian or Asian ethnicity
- female gender
- family history of osteoporosis
- small boned
- thin (< 127 pounds)
- sedentary lifestyle
- lack of adequate calcium intake
- amenorrhea (not having regular menstrual periods)
- anorexia nervosa
- history of use of bone-robbing medications (i.e. steroids, antiseizure drugs)
- postmenopausal
- low testosterone levels in men
- cigarette smoking
- excessive use of alcohol
When reviewing the risk factors for osteoporosis, it is readily apparent that some of them can be changed and some of them can not. To prevent losing bone mass and developing osteoporosis, a person must understand their particular risk factors and make the changes that are appropriate to offset them. The one risk factor that affects most people is an inadequate amount of daily calcium intake.
Women in their reproductive years require 1000 mg per day of total calcium intake. In the perimenopause years, 1200 mg per day is recommended and for postmenopausal women, 1500 mg per day. Men require 1000 mg per day of total calcium intake.
Foods that are rich in calcium include dairy products and dark green leafy vegetables. These foods constitute approximately ¾ of the calcium intake in the average North American diet. A single 8 ounce glass of milk has approximately 300 mg of calcium. Yogurt has approximately 400 mg per 8 ounce serving and cheese 200 mg per ounce. Lesser amounts are contained in dark green leafy vegetables, broccoli, nuts and dried beans.
Most Americans do not ingest the recommended amounts of calcium in their dietary intake. Because of this, supplemental calcium is usually a necessity. The amount of calcium that should be supplemented is dependant on the amount consumed by the person. If you are wondering how much calcium to supplement, calculate how much you consume on a daily basis and subtract that from your recommended daily intake – simply supplement the remainder.
Calcium absorption is limited, meaning that your body only absorbs about 500-600 mg at one time. This absorption is the same regardless of the calcium source (food vs. supplements). When using calcium supplements several factors need to be kept in mind. Iron and caffeine appear to compete with calcium for absorption. Avoid taking your calcium supplements at the same time that you ingest these elements. Additionally, for some people, calcium tends to cause gastrointestinal disturbances. This can be minimized by taking the supplement with meals, and by drinking plenty of fluids with the meal. If you are still having gastrointestinal difficulties, try to gradually build up your intake of supplemental calcium (i.e. 500 mg per day for 2 weeks and then add the second 500 mg).
Calcium supplements come in two basic forms. The least expensive is calcium carbonate that provides 40% elemental calcium. These supplements are very effective but may cause gas and constipation. They also work best when taken with food. Calcium citrate preparations contain 21% elemental calcium and may be taken with of without food. The “best” calcium supplement is the one that you actually take. If you chose a supplement that does not work for you (in that you don’t take it), it will do you absolutely no good!
There is much discussion regarding the need to supplement Vitamin D and Magnesium in addition to the calcium. According to most experts, if a person has a cumulative 15 minute daily exposure to the sun, their body manufactures all of the Vitamin D they require. Additionally, it is generally believed that a well-balanced diet provides adequate amounts of Magnesium. For the person who does not meet the daily sun exposure requirement and/or have a well-balanced diet, supplements should be considered to maximize the absorption and effectiveness of calcium supplements.
According to the National Osteoporosis Foundation, there are four important steps to preventing osteoporosis. They are:
- A balanced diet rich in calcium and vitamin D
- Weight-bearing exercise (walking, dancing, weight lifting, etc.)
- A healthy lifestyle with no smoking or excessive alcohol intake
- Bone density testing and medication when appropriate
Enjoy and drink a glass of
milk for your health!! For more information on perimenopause and menopause,
visit The Menopause Connection.
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