What Is The Best Source Of Dietary Calcium

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Over the last two decades women have learned about the profound problems of osteoporosis and inadequate calcium intake. Unfortunately, for most people, it is too little, too late. This is because the need for increased calcium acquisition and storage begins very early in life – especially in the pre-adolescent years.

While many parents recall the admonitions to eat the four major food groups and to drink plenty of whole milk, these recommendations have fallen into disuse and disfavor for many legitimate reasons. However, in the US the decrease in children’s milk intake has created a serious shortfall in the amount of calcium that kids have an opportunity to obtain.

To maintain strong bones, the overall goal is to simply:

    • Eat or drink the recommended amount of calcium-containing food
    • Allow maximal absorption from the gut
    • Store as much calcium in the bone as one can
    • Prevent losses from the bone over the years

To attain the above goals, most children need to increase the amount of calcium they eat or drink on a daily basis to meet the daily-recommended requirements.

Recommended Calcium Intake for Children Ages 4 to 8

While there are no formal guidelines for prepubertal children, calcium requirements for children 4 to 8 years of age are estimated to be about 800 mg/day . This requirement is easily achieved by drinking three 8-oz glasses of milk per day, each containing 300 mg. Milk alternatives made from soy and rice are quite acceptable if they are vitamin and calcium fortified to match the nutritional content of milk.

For more reticent children, orange juice is an alternative, although it is less optimal as it contains neither the supplemental Vitamin D (a requirement for calcium absorption by the body) nor the protein and fat that milk does.

Unfortunately, this young age group also seems to retain less calcium in their bones than pubertal children do, which makes getting sufficient calcium intake critical.

Recommended Calcium Intake for Children Ages 9 to 18

Starting at age 9 the recommended adequate calcium intake increases to 1300 mg per day for the next 9 years. Unfortunately, a survey in 1994 by the US Department of Agriculture found that there is a serious deficiency in the amount of calcium most children are getting:

  • Children ages 9 to 13 averaged less than 1000 mg per day, with girls getting a paltry 800.
  • In teens ages 14 to 18, daily intake of calcium in boys increased to just over 1000 mg per day, and for girls decreased to less than 700 mg per day.  According to this study, the vast majority of girls actually were taking in only a little more than half the recommended amount of calcium per day. While it may seem pointless to mention the gender differences, the importance is magnified by the long-term impact of calcium wasting and usage in girls as they mature and bear children.

What is the best source of dietary calcium       Given that calcium is better absorbed and stored during the pubertal years, one would prefer to take advantage of this efficiency and take in more calcium.

Instead, it appears that teens are not using this period in their lives to invest in their later health. The good news is that studies of bone mineral content, a reflection of density and calcium stores, revealed that even small increases in milk consumption can lead to significant improvement in bone mineral content.

Any dietary source of calcium will count toward the child’s daily intake, but low-fat milk is clearly the most efficient and readily available. Lactose-free milk, soy and rice drinks have recently become more easily obtainable and less expensive.

In addition to milk, there are a variety of foods that contain calcium and can help children get sufficient levels of calcium in their daily diet. Some examples include:

Dairy foodsMilk, yogurt, cheese
Leafy green vegetablesBroccoli, kale, spinach
FruitsOranges
Beans and peasTofu, peanuts, peas, black beans, baked beans
FishSalmon, sardines
MiscellaneousSesame seeds, blackstrap molasses, corn tortillas, almonds, brown sugar

Vitamin D is also necessary to allow the body to absorb the calcium. In the US, milk is fortified with Vitamin D, and a few other foods are sometimes also vitamin D-fortified (such as some types of cereal and bread). This vitamin occurs naturally in only a few foods, such as fatty fish (salmon, sardines) and egg yolks. In addition to dietary sources, sunlight can provide the body with Vitamin D as it is synthesized through the skin.

Importantly, recent research has pointed to phosphorus and carbonated beverages (which contain phosphoric acid) as having a negative impact on bone density. Theoretically, the equilibrium between phosphorus and calcium causes the latter to be replaced in bone by the former. While this has yet to be proven as a significant cause of calcium loss, milk is still considered the preferred drink when compared with carbonated drinks of any sort.

After puberty, bone growth ends but bone density increases until roughly age 30.1 Absorption and retention of calcium decreases while calcium losses increase, leaving a requirement that is estimated to be 1000 mg/day.2

The drainage of calcium from bone occurs in all humans at a steady pace, but women are clearly more at risk for losses. Variability in calcium loss is best seen in pregnancy when calcium is taken from the mother’s stores for deposition in the fetus. Also, lactation creates an ongoing need for further calcium supplementation in women.

While most expectant mothers are able to replenish their needs by taking prenatal vitamins, some teens are not able to comprehend the necessity of increased calcium intake and comply. Vitamin D is also supplemented during this period in the prenatal pills, but even men and non-pregnant women should maintain adequate intake of this vitamin.

Exercise

A very important means of preserving bone density is exercise. Adults have been made aware of the benefits of exercise, especially in the elderly, for many reasons, including the preservation of bone mineral content.

It is also well accepted that increased activity will create forces on the bone that trigger increased bone density – a natural response to protect highly used bones by making them sturdier. Hence, it makes sense that kids who get more exercise will also have stronger bones.

In This Article:

  • Calcium Requirements for Kids’ Growing Bones
  • Sources of Calcium in Food
  • Preserving Bone Density

Summary

To maximize the beneficial effects of increased bone density in adults, we need to enhance the consumption, storage, and preservation of calcium in kids and teens. This starts with adequate and appropriate intake of milk or substitute drinks, plenty of exercise, replacement as needed for pregnancy and lactation, and the minimizing of carbonated beverages.

Any dietary source of calcium will count toward the child’s daily intake, but low-fat milk is clearly the most efficient and readily available. Lactose-free milk, soy and rice drinks have recently become more easily obtainable and less expensive.

Parents should contact their child’s pediatrician for specific details about calcium consumption or questions regarding supplements in a chewable form.

People with special calcium needs

It is particularly important that people from certain groups meet their calcium needs. These groups include:

  • Babies – formula-fed babies are estimated to need more calcium than babies that are breastfed, because the calcium in infant formula may not be absorbed as efficiently as that found in breastmilk.
  • Young children – skeletal tissue is constantly growing, so young children have high calcium requirements.
  • Pre-teens and teenagers – puberty prompts a growth spurt, which in turn increases calcium requirements. This group also needs more calcium to build peak bone mass. If the skeleton is strengthened with enough calcium during these years, diseases like osteoporosis in the later years are thought to be less likely.
  • Elderly people – as we age, the skeleton loses calcium. Women lose more calcium from their bones in the 5 to 10 years around the age of menopause. However, both men and women lose bone mass as they grow older and need to make sure they get enough calcium in their diet to offset these losses. While a diet high in calcium cannot reverse age-related bone loss, it can slow down the process.

Caucasian (white) people have larger frame sizes and generally have higher intakes of animal foods, caffeine and salt than non-Caucasian people. It is thought they may need more calcium as a result.

Pregnant and breastfeeding women and calcium

A developing baby needs a lot of calcium. However, there is no need for women to take additional dietary calcium during pregnancy because pregnant women absorb calcium from food more efficiently.

Breastfeeding women do not need to increase their calcium intake, unless they are adolescents.

Calcium supplements

It is much better to get calcium from foods (which also provide other nutrients) than from calcium supplements. But if you have difficulty eating enough foods rich in calcium, you might need to consider a calcium supplement, especially if you are at risk of developing osteoporosis. Before taking supplements, it’s best to discuss this with your doctor or other registered healthcare professional.

If you do take calcium supplements, make sure you don’t take more than the amount recommended on the bottle. Too much calcium may cause gastrointestinal upsets such as bloating and constipation and, rarely, other complications such as kidney stones.

Calcium supplements – complications

A report published in 2010, and widely reported in the media, found a possible link between calcium supplements and an increased risk of heart disease – particularly in older women. The levels of calcium intake of participants in the trials reviewed were up to 2,400 mg/day, achieved by taking supplements. This is above the Recommended Dietary Intake (RDI), which is between 1,000 and 1,300 mg/day for adults, depending on age.

Although high levels of calcium intake through supplementation may be of concern, calcium supplementation at levels of 500 to 600 mg/day is both safe and effective for reducing the risk fractures in people who don’t get enough calcium from their diet. If you have any concerns about calcium supplements, talk to your doctor or other registered healthcare professional.

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