Vitamin Supplements

 

How Much Calcium Do You Need?

Not everyone agrees with the formal RDAs for calcium. A National Institutes of Health consensus panel on osteoporosis has advised that women consume more calcium than recommended in the RDAs-1,500 mg in the years after menopause if they are not taking supplemental estrogen. The National Osteoporosis Foundation recommends 1,000 mg per day for postmenopausal women who are not on estrogen replacement therapy.

 

Optimal Daily Allowance

Although the RDAs call for only 800 mg of calcium for men and women over the age of 25 (with an increase to 1,200 mg for pregnant and lactating women), we recommend a daily intake of 1,500 mg for everyone. Women clearly need more calcium to help protect them against osteoporosis, even if they are postmenopausal and on hormonal replacement therapy (which can also help protect their bones).

Men can benefit from extra calcium as well. According to some research, if men lived as long as women, the sexes would have similar incidences of osteoporosis. To be safe, men too should consume 1,500 mg of calcium per day.

 

Calcium Supplements

All calcium supplements are not created equal. As you browse through the supplement section at the health food store or pharmacy, read some labels. Calcium carbonate tablets (Os-Cal, Turns and others) provide a concentrated supply of calcium-40 percent pure calcium per tablet. Oyster shells are a source of calcium carbonate, so a label that says “oyster shell calcium” simply means that the product contains calcium carbonate.

When calcium carbonate makes contact with stomach acids, it is transformed into calcium chloride, which the body can easily absorb and utilize. People who have inadequate levels of stomach acid—a common condition among older people—may have trouble absorbing calcium, although taking calcium supplements with meals can help with this problem.

Supplements of other types of calcium—calcium citrate, calcium lactate, or calcium gluconate—have lower calcium concentrations: 24 percent, 13 percent, and 9 percent, respectively. Studies show that the body absorbs calcium citrate more efficiently than any other form of calcium.

When choosing a form of calcium, stay away from dolomite or bone meal supplements. These supplements contain large amounts of calcium but can be contaminated with toxins such as lead.

 

Calcium Food Sources

People get most of their dietary calcium from milk and milk products such as cheeses. Since milk also contains vitamin D, which helps the body absorb calcium, milk is an especially good choice—whether whole, low-fat, or nonfat. (Milk producers call their product “fortified” because the vitamin D has been added.)

Other good sources of calcium include certain green leafy vegetables (such as broccoli and spinach), beans, nuts, and fish with edible bones (such as sardines and anchovies).

In addition to consuming foods that are naturally rich in calcium, look for products in your supermarket that are calcium-fortified. These include common items such as orange juice, breakfast cereals, and bread.

 

How Much Calcium Are You Getting?

Before you decide that you need to take vitamin supplements or change the way you eat, you should know where you stand and how much improvement you really need. To help you analyze your current diet, we’ve developed a system you can use to calculate your approximate calcium intake. Following is a list of calcium food sources, arranged according to the percentage of our Optimal Daily Allowance (1,500 mg) of calcium contained in them. Since 1 ounce of blue cheese contains 150 mg of calcium and the ODA for calcium is 1,500 mg, we’ve listed blue cheese in the 10 Percent category (We have erred on the conservative side when rounding off percentages.)

To determine your average daily intake of calcium, start by keeping an accurate food diary for three or four days. The longer you keep the diary, the more accurate your calculations will be. Write down exactly what you eat and drink, together with an estimate of the serving size. Don’t concern yourself with precisely how much calcium each food item contains; simply use the list to find the food item and the percentage of the ODA that it provides. Then add up all these percentages to see if you reach 100 percent each day.

If a particular item in your meals is missing from this list (it would be impossible for us to include every food item here), use the nutritional information on the food packaging. Most packaged foods are required to list their vitamin and mineral contents on the label.

After you’ve determined how much calcium you are obtaining from your diet each day, you can calculate whether you need to take supplements to reach the ODA. Let’s say that you determine that you are getting 50 percent of your calcium target through diet alone. You are consuming 750 mg of calcium in your diet (50 percent x 1,500 mg = 750 mg). To make up the difference, we would advise you to supplement your diet with 750 mg of calcium in tablet form (1,500 — 750 mg = 750 mg).

Note that you may not find calcium pills sold in the exact dose you are looking for. We recommend that you get as close as you can to your target dose without taking several tablets just to get the precise amount.

HOW MUCH CALCIUM DO YOU NEED TO ACHIEVE OPTIMAL HEALTH?

We recommend an optimal intake of 1,500 mg of calcium per day for both men and women.

WHAT SPECIAL CIRCUMSTANCES MIGHT AFFECT THE AMOUNT OF CALCIUM YOU NEED TO TAKE?

You should be particularly conscientious about taking calcium if you are an older person, are pregnant or breast-feeding, exercise frequently, take diuretics, have a diet high in phytates or oxylates, or eat a low-fat, high-protein, high-phosphorus, or high-fiber diet.

IS IT POSSIBLE TO CONSUME THE OPTIMAL AMOUNT OF CALCIUM THROUGH DIET ALONE?

You can meet your optimal calcium needs by drinking three glasses of low-fat (1%) milk and eating two 8 ounce servings of low-fat yogurt per day, for example. Most people, however, consume less than half of our ODA through diet alone. You may find it more practical to get part of your calcium through supplements.

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