Calcium and Osteoporosis

Osteoporosis threatens 28 million Americans, according to the National Osteoporosis Foundation, 80 percent of them women; and it leads to over a million broken or fractured bones every year. (Read about "Bone Fractures") Osteoporosis - which literally means "porous bones" - develops as a result of a number of factors, among them genetics (Read about "Genetics"), aging and lifestyle.

Anyone can get osteoporosis (Read about "Osteoporosis"), but according to the American College of Obstetricians and Gynecologists (ACOG), women are most vulnerable because their bones are smaller and lighter than men's to begin with. Other groups at risk include:

• people with a family history of the disease (Read about "Family Health History")
• people of Caucasian or Asian descent
• smokers and heavy drinkers (Read about "Quit Smoking" "Alcoholism")
• people with thin or small builds
• people using steroid medications for other disease
• women in early menopause or prolonged menopause (Read about "Menopause")
• people over age 65
• inactive or bed-ridden people
• history of hip fracture in a parent (Read about "Hip Fractures")

The role of calcium

Where does calcium fit in? (Read about "Calcium") Calcium is one of the minerals that helps build strong bones, especially during childhood and teens. (Read about "Skeletal System") The amount of calcium in your body is kept in balance largely by hormones produced by the parathyroid glands and the thyroid gland. (Read about "Parathyroid Glands" "Thyroid") We all lose bone mass as we age, but if you've built up bone mass early in life, the loss is less likely to cause devastating problems. That's why dietitians stress the importance of calcium for children and teens.

For those over the age of one, the Institute of Medicine (IOM) recommends, depending on your age, sex and other health issues, between 700 and 1300 milligrams per day of calcium. You should discuss with your healthcare provider what your needs are. For those over the age of one year, IOM also says the upper intake level for calcium is between 2000 and 3000 milligrams per day. Once again, it depends on your age and other health factors how much calcium you should be getting. Upper intake levels represent the upper safe boundary and should not be misunderstood as amounts people need or should strive to consume, according to IOM.

To put the guidelines in perspective, an 8 ounce glass of milk has 300 mg. Dieticians recommend meeting your calcium needs with calcium-rich foods, including dairy products, dark-green leafy vegetables, broccoli, tofu and fortified breads and cereals. If you don't like these foods or if you're lactose intolerant (Read about "Lactose Intolerance"), talk with your doctor about supplements. Keep in mind however, that while supplements and fortified foods can be useful in getting enough calcium, it's important not to overdo it. Use of supplements should always be discussed with a doctor first. Those at risk of kidney stones (Read about "Kidney Stones") should also talk with their doctors about calcium intake.

It is interesting to note current calcium recommendations for nonpregnant women are the same for pregnant women because intestinal calcium absorption increases during pregnancy, according to NIH's Office of Dietary Supplements. (Read about "Healthy Pregnancy")

Ask your doctor, too, if any medications you're taking may affect your need for calcium. The American Dietetic Association says some medicines can decrease the body's ability to absorb calcium, including:

• Corticosteroids, which are prescribed for conditions such as rheumatoid arthritis and ulcerative colitis (Read about "Rheumatoid Arthritis" "Ulcerative Colitis")
• Too much thyroid hormone (Read about "Thyroid")
• Aluminum-containing antacids, when taken habitually (Read about "Medication and Digestion")

Remember too that along with calcium, vitamin D is needed to help absorb the calcium. (Read about "Vitamins & Minerals") NIH says most of us get enough vitamin D in our diet and because our skin produces it in sunlight. Food such as eggs, fatty fish, and cereal and milk fortified with vitamin D are considered good sources. For those over the age of one, IOM recommends, depending on your age, sex and other health issues, between 600 and 800 international units (IUs) of vitamin D per day to maintain health. Once again, you should discuss with your healthcare provider what your needs are. For those over the age of one, IOM also says the upper intake level for vitamin D is between 2500 and 4000 IUs per day, depending on your age and other health factors. Older people, people with a poor diet or those confined indoors may need supplements. Always ask your doctor first if supplements are really needed in your case.

The American Dietetic Association (ADA) says magnesium is also important for maintaining healthy bones and a healthy heart. The recommended amount, according to ADA is 400 milligrams of magnesium a day. Food sources include whole grain breads and cereals, as well as nuts, seeds, and fresh fruits and vegetables.

Other preventative measures

In addition to getting enough calcium, a lifestyle that includes regular weight-bearing exercise (such as walking) can help strengthen bones. If you've already been diagnosed with osteoporosis, ask your doctor about the best forms of exercise. (Read about "Menopause and Exercise") You can also help reduce your risk of osteoporosis by avoiding alcohol and by not smoking.

Women and men, at risk for osteoporosis, can have a bone mineral density scan. (Read about "DEXA Scan - Dual Energy X-Ray Absorptiometry/Densitometry") A "T-score" reading will allow the healthcare provider to ascertain if you have osteoporosis (abnormal bone loss) or osteopenia (reduced bone mass) and prescribe correct treatment. The "T-score" is calculated for each person against a chart using age and other factors to measure bone loss. The lower the score, the more serious the issue.

If you're concerned about osteoporosis, talk to your healthcare provider. Since bone loss increases after menopause, a doctor may suggest estrogen replacement therapy for a post-menopausal woman. There are other types of medications for osteoporosis as well, which can work by regulating the level of calcium in your blood, for example, or by blocking some of the breakdown of the bone. As with any medication, there are both benefits as well as disadvantages to all these treatments, so it's important to discuss all options with a qualified healthcare professional who knows your medical history.

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