Are you getting enough calcium for bone health?

Registered dietician Abby Courtenay discusses how much calcium is needed for healthy bones.

28 June 2017
By Meg de Jong

Calcium plays a vital role in our bodies – not just for healthy teeth and bones and guarding against osteoporosis, but also for functions like nerve transmission and muscle contraction. Are you getting enough of this important mineral? Registered dietician Abby Courtenay of Nutritional Solutions helps you figure this out.

Q: How important is calcium for bone health?

Abby Courtenay (AC): Calcium is the most abundant mineral in the body. Up to 99% of your body’s calcium stores are in the bones and teeth where the calcium supports their structure and function. The body also uses bone tissue as a reservoir for calcium in order to regulate and maintain your calcium concentrations in your blood, muscle and intercellular fluids.

Bone is continuously remodelling with calcium being reabsorbed and deposited into new bone. As you age, this remodelling changes. As a child, bone formation exceeds the breakdown, and in early and middle age this process is equal. However, in older age – especially in postmenopausal women – bone breakdown exceeds formation, which leads to bone loss that increases your risk of osteoporosis over time.

Q: What adverse effects may you experience if you don’t get enough?

AC: If you don’t have adequate calcium and the supporting vitamins and minerals like magnesium and vitamin D that assist with absorption, you may not notice any short-term symptoms. But in the long term, this lack will cause osteopenia (when the body doesn’t make new bone as quickly as it reabsorbs the old bone), which if left untreated can lead to osteoporosis as well as an increased risk of bone fractures.

Q: How much calcium should you be getting every day?

AC: Current calcium recommendations for healthy individuals are 1000mg/day for both men and women between the ages of 4 and 50 years. This recommendation increases to 1200mg/day for women over 50 years and men over 70 years. For children 1 to 3 years old, it’s 700mg daily. Chat to your doctor about the calcium needs of your baby if she’s younger than one.

Most South Africans only manage to consume 500 to 600mg/day, meaning that we are obviously falling short of our recommended daily allowance (RDA).

Q: What are the best sources of calcium?

AC: Milk and dairy products are a convenient source of calcium, phosphorous and vitamin D, but calcium is also found in other food sources such as broccoli, bok choy, kale and sweet potato.

Although plant foods such as the above have highly-available calcium, it occurs in lower quantities than that in milk, so you need to eat more of them to get the same amount of calcium out as a glass of milk. Practically, it’s easier to consume a glass of milk, but it’s not impossible to make up your calcium needs through other food sources.

Q: What is vitamin D’s role in the absorption of calcium?

AC: Vitamin D assists with calcium absorption. If you’re deficient in vitamin D, sufficient amounts of calcium may not be reabsorbed.

Q: Do you need to take a calcium supplement, and which one should you be taking?

AC: Natural calcium-rich foods are recommended to meet your calcium requirements. Only when you’re unable to get sufficient calcium from your diet, should you look to supplements to make up the difference. If your diet is deficient in calcium, you may experience symptoms like muscle fatigue and cramps.

Opting for a supplement of calcium carbonate is cost effective, but should be taken with meals to assist absorption. While calcium citrate is more expensive, it’s well absorbed regardless of meal timing, but has a lower concentration of elemental calcium, so more needs to be taken. Calcium lactate and calcium gluconate are less concentrated forms of calcium and so aren’t as practical for supplementation.

In terms of dosage, choose a supplement with approximately 500mg elemental calcium (elemental calcium is the calcium that will actually be absorbed) – any more than this and the excess won’t be absorbed and could aggravate gastrointestinal (GIT) discomfort. GIT complaints are the most common adverse effect of calcium supplements. This can be reduced by taking supplements as directed, increasing fluid and fibre intake, and increasing exercise.

For more information about calcium speak to your Clicks pharmacist, or see a dietician.

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