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Calcium: Gotta Have It for Healthy Bones

Milk and other calcium-rich foods are an important part of a bone-healthy lifestyle that can not only reduce the risk of fractures as you get older, but may also protect against certain cancers.

How to Get Enough Calcium continued...

In addition to diary products, Georgianna Donadio, PhD, MSc, program director for the National Institute of Whole Health in Boston, also says you can build up bone reserve by adding other calcium-rich foods such as leafy green vegetables (including kale, escarole, collard greens, and bok choy; nuts (especially almonds and pistachios); legumes; and seeds.

Limit sodas, Donadio adds, because too much phosphorus can also deplete calcium levels. Donadio also advises against:

  • Antacids (you need stomach acid to aid in calcium absorption)
  • Caffeine, which reduces calcium absorption
  • Excessive alcohol
  • Excess sodium
  • Excessive red meat

If you take a calcium supplement, take no more than 500 or 600 milligrams at a time. It will be absorbed better that way.

Importance of Vitamin D

While there's a possibility you may be taking in too much calcium, chances are you're not taking in enough vitamin D, Watts says. "Vitamin D is underutilized," he says, observing that the vitamin is not found naturally in most of the foods we eat, and the amount added to milk or multivitamins is not enough to maximize calcium absorption. Most of the vitamin D we get is produced by the body via exposure to sunlight.

"More D is better," says Watts, who believes that the recommended daily allowance is too low and advises patients to have their blood levels analyzed, and if needed, take additional vitamin D-3 as a supplement. Vitamin D-3, also called cholecalciferol, is the form of vitamin D that best supports bone health. (According to the Institute of Medicine, the tolerable upper intake for people 14 years and older is 2,000 IU, but many experts have challenged that limit.)

As a bone-building ingredient, don't overlook protein in your diet either, Watts advises. While very high levels of protein may cause "calcium-wasting," Watts says that researchers have found that hip fracture patients who were given a mild protein supplement were released from the hospital sooner than those who weren't.

"It's like a symphony orchestra," says Robert P. Heaney, MD, John A. Creighton University Professor and professor of medicine at Creighton University. "If you don't take in enough protein [Heaney recommends 62 grams a day], then calcium alone, or even with vitamin D, won't do the trick," he says. "It's the sum of the parts that's important, not the individual elements alone."

Exercise and Sunshine Part of the Program

Those elements include not only diet, but exercise and sunlight as well, Donadio says.

Those who exercise on a "regular and ongoing" basis have a significantly lower risk of osteoporosis, says Donadio, who recommends walking for at least 30 minutes a day, and preferably outdoors to get the benefits of sunlight, which provides natural vitamin D. Strength training, movement techniques such as tai chi (which improves balance and coordination, thereby reducing the risk of falls), even sexual activity can improve your bone health by increasing your estrogen levels.

The less stress you feel, the better, Donadio says, since stress hormones, especially cortisol, deplete calcium reserves.

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