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Menopause: Calcium and Vitamin D

When you reach menopause, your dietary needs change again. Calcium requirements go back up to teen levels -- from 1,000 to 1,200 milligrams a day. Yet most women get only 600 milligrams a day and usually need to take supplements to make up the difference.

“It is important for menopausal women to get enough calcium,” says Ruth Frechman, MA, RD, a spokeswoman for the ADA. “If there isn't enough dietary calcium, the body will take calcium from the bones to use for nerves, muscles, and the heart. Estrogen helps deposit calcium in the bones. Menopausal women start losing their bone mass without estrogen.”

So what does that mean for menopausal women who are prescribed hormone replacement therapy to help reduce symptoms of menopause? “The estrogen in hormone replacement therapy will protect a woman's bones,” Frechman says. “However, it is still necessary to eat a high-fiber, low-fat diet, which includes enough calcium and vitamin D.”

Like calcium, vitamin D is important for retaining bone mass. It helps your body absorb calcium and helps with bone growth. Without it, bones can become brittle and thin, leading to osteoporosis.

Now that you're not menstruating, you don't need as much iron -- requirements drop from 18 milligrams a day to 8 milligrams when women turn 50.

Be sure to get enough fiber. Fiber helps reduce the risk of coronary heart disease, diabetes, diverticulosis, and irritable bowel syndrome. You should be able to get the recommended 21 grams per day by eating a healthy diet with plenty of fruits, vegetables, and whole grains. Don't rely on fiber supplements, says Frechman. “Fiber supplements are not intended to replace foods. They may be necessary, depending on the situation," she says. "Keep in mind, there may be more health benefits from eating whole foods.”

One common health problem for women over 50 is high blood pressure and high cholesterol. Frechman recommends the DASH (Dietary Approaches to Stop Hypertension) diet, which focuses on lowering sodium and eating fruits, vegetables, and low-fat dairy. “A dietary approach and losing weight can lower cholesterol 20% to 30%," Frechman says.

How much calcium you need: 1,200 milligrams per day for women 51 and older

Foods high in calcium: Milk, yogurt, cheese, tofu, fortified orange juice

How much vitamin D you need: 400 international units (IU) for women 51-70; 600 IU for women over 70

Foods high in vitamin D: Fish, milk, fortified cereals

Nutrition for Seniors

On average, as an older adult, you need the same nutrients as your younger counterparts. But you may not always get them. Problems with teeth and gums can make chewing food difficult, and health conditions can cause lack of appetite.

Frechman suggests that older women eat smaller, less frequent meals that include a sampling from all the food groups and include favorite foods. Older people often don't get enough protein, which you need to maintain muscle mass and keep your immune system healthy. If you have trouble chewing meat, you may have an easier time with tofu or even nutritional supplements; if you don't, you can opt for lean meats, Frechman suggests.

Frechman calls vitamin D the “must have” vitamin if you're over 70 because of the benefits for retaining bone mass. Fortified foods or vitamin B12 supplements are a good idea for anyone over 50, she says, because 10% to 30% of older adults may not be able to efficiently absorb the B12 that's found naturally in food. A doctor can perform a blood test to determine whether B12 levels are low.

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