Calcium – the hows and whats!

A client of mine came to me with an issue she faced and asked for my advice.
I told her off my experience and with this also referred her on her GP and/or specialist.
I told her
“I was oesteopenic, genetic from my mothers side of the family where osteoporosis runs throughout the generations in both males and females.
With commitment and focus I have managed to increase my bone density to normal levels
1) Resistance exercise – weight bearing exercises
2) Taking calcium and vitamin D supplements
3) Eating well – not only food rich in calcium but an over all healthy nutritious food program.
The suggestions I had is to do a lot of what I did:
If this does not work I suggested she goes to see her specialist and/or her GP again and see if medication such as Fosomax might be appropriate.
a) Check your Vitamin D effective levels calcium absorption is compromised.
b) Very IMPORTANT – weight bearing exercises 3 times a week (optimal)
c) Not only to rely on supplements only:
Sunshine/light is very important.
15 minutes a day in the sun with your skin bear and your eyes without sunglasses is very important.
c) Eat food rich in calcium
  • Green vegetables like broccoli, curly kale, and bok choy
  • Some fruits such as oranges, apricots and dried figs
  • Canned fish with soft, edible bones (the calcium is in the bones) such as sardines, pilchards and salmon
  • Fish eaten not from cans great just you can’t eat the bones..sardines are fabulous!
  • Nuts, especially Brazil nuts and almonds
  • Sesame seeds, tchina
  • carobs
  • dairy products – natural yogurt, milk, cottage cheese
VERY IMPORTANT – You must be aware that Caffeine (coffee, tea, diet coke) and salt can increase calcium loss from the body and should not be taken in excessive amounts. Alcohol should also be taken in moderation as it detracts from bone health and is associated with falls and fractures.
DRINK only 2 cups of coffee a day MAXIMUM and I mean 250 ml cups (single shot)
Some leafy produce, like spinach and rhubarb, contain ‘oxalates’, which prevent the calcium present in these vegetables from being absorbed. However, they do not interfere with calcium absorption from other calcium-containing foods eaten at the same time. The same is true of ‘phytates’ in dried beans, cereal husks and seeds (thus you should always soak your seeds, grains and beans before you eat them)
IT IS VERY IMPORTANT TO SEEK MEDICAL ADVICE FROM YOUR GP OR/AND SPECIALIST. THE ABOVE IS FROM MY EXPERIENCE ONLY
A great website is:

http://www.osteopathy.org.au/ 

Calcium

What can high-calcium foods do for you?

  • Maintain healthy, strong bones
  • Support proper functioning of nerves and muscles
  • Help your blood clot

What events can indicate a need for more high-calcium foods?

  • Frequent bone fractures
  • Muscle pain or spasms
  • Tingling or numbness in your hands and feet
  • Bone deformities and growth retardation in children

Excellent sources of calcium include spinach, turnip greens, mustard greens, collard greens, and tofu.

Foods rich in calcium
Yogurt
Tofu
Sesame Seeds
Sardines
Milk – Goat
Milk
Collard Greens
Spinach4
Cheese
Turnip Greens

What is calcium?

One of the most abundant minerals in the human body, calcium accounts for approximately 1.5% of total body weight. Bones and teeth house 99% of the calcium in the body, while the remaining 1% is distributed in other areas.

In recent years, consumers have been bombarded with public health messages encouraging the consumption of foods rich in calcium. These messages are aimed at preventing osteoporosis, a disease characterized by brittle and porous bones that now affects more than 20 million individuals in the United States. A calcium-deficient diet is one of the causative factors of osteoporosis.

Our food ranking system—based on nutrient density—shows spinach, turnip greens, mustard greens, and collard greens to be excellent sources of calcium. Our ranking system looks not only at the amount of calcium in food, but also at the caloric content of food and how many calories of a food are necessary to provide the desired amount of calcium. Dairy foods—which are often listed as excellent sources of calcium—turn out to be very good sources of calcium in our ranking system (just one step below turnip greens, and mustard greens) because of their lower nutrient density.

How it Functions

Calcium is best known for its role in maintaining the strength and density of bones. In a process known as bone mineralization, calcium and phosphorus join to form calcium phosphate. Calcium phosphate is a major component of the mineral complex (called hydroxyapatite) that gives structure and strength to bones.

Calcium also plays a role in many physiological activities not related to bones including blood clotting, nerve conduction, muscle contraction, regulation of enzyme activity, and cell membrane function. Because these physiological activities are essential to life, the body utilizes complex regulatory systems to tightly control the amount of calcium in the blood so that calcium is available for these activities. As a result, when dietary intake of calcium is too low to maintain normal blood levels of calcium, the body will draw on calcium stores in the bones to maintain normal blood concentrations, which, after many years, can lead to osteoporosis.

Deficiency Symptoms

Insufficient calcium intake, poor calcium absorption, and/or excessive calcium losses through the urine and feces can cause calcium deficiency. In children, calcium deficiency can cause improper bone mineralization, which leads to rickets, a condition characterized by bone deformities and growth retardation. In adults, calcium deficiency may result in osteomalacia, or softening of the bone. Calcium deficiency, along with other contributing factors, can also result in osteoporosis.

Low levels of calcium in the blood (especially one particular form of calcium, called free ionized calcium) may cause a condition called tetany, in which nerve activity becomes excessive. Symptoms of tetany include muscle pain and spasms, as well as tingling and/or numbness in the hands and feet.

Toxicity Symptoms

Excessive intakes of calcium (more than 3,000 mg per day) may result in elevated blood calcium levels, a condition known as hypercalcemia. If blood levels of phosphorus are low at the same time as calcium levels are high, hypercalcemia can lead to soft tissue calcification. This condition involves the unwanted accumulation of calcium in cells other than bone. Given some of these known risks associated with high intake of calcium, in 2010 the National Academy of Sciences established revised Tolerable Upper Intake Levels (ULs) for calcium as follows:

  • 0-6 months: 1000 mg
  • 6-12 months: 1500 mg
  • 1-3 years: 2500 mg
  • 4-8 years: 2500 mg
  • 9-13 years: 3000 mg
  • 14-18 years: 3000 mg
  • 19-30 years: 2500 mg
  • 31-50 years: 2500 mg
  • 51+ years: 2000 mg
  • Pregnant and lactating women (younger than 18 years): 3000 mg
  • Pregnant and lactating women (older than 18 years): 2500 mg

Impact of Cooking, Storage and Processing

The amount of calcium in foods is not adversely impacted by cooking or long-term storage.

Factors that Affect Function

Hypochlorhydria, a condition characterized by insufficient secretion of stomach acid, affects many people and is especially common in the elderly. Lack of stomach acid impairs the absorption of calcium and may lead to poor calcium status.

Adequate intake of vitamin D is necessary for the absorption and utilization of calcium. As a result, vitamin D deficiency, or impaired conversion of the inactive to the active form of vitamin D (which takes place in the liver and kidneys), may also lead to a poor calcium status.

Nutrient Interactions

The following nutrients impact the absorption, utilization and/or excretion of calcium:

  • Vitamin D accelerates the absorption of calcium from the gastrointestinal tract.
  • High consumption of potassium reduces the urinary excretion of calcium.
  • High intakes of sodium, caffeine, or protein cause an increase in the urinary excretion of calcium.
  • Certain types of dietary fiber like the fiber found in wheat and oat bran, may interfere with calcium absorption by decreasing transit time (the amount of time it takes for digested foods to move through the intestines), limiting the amount of time during digestion for calcium to be absorbed. Dietary fiber also stimulates the proliferation of “friendly” bacteria in the gut, which bind calcium and make it less available for absorption.
  • Phytic acid, found in whole grains, nuts, and legumes, can bind to calcium to form and insoluble complex, thereby decreasing the absorption of calcium.
  • Oxalic acid, found in spinach, beets, celery, pecans, peanuts, tea and cocoa, can bind to calcium and form an insoluble complex that is excreted in the feces. While research studies confirm the ability of phytic acid and oxalic acid in foods to lower availability of calcium, the decrease in available calcium is relatively small.

Calcium impacts the absorption of the following nutrients:

  • Calcium in food and supplements decreases the absorption of heme and nonheme iron.
  • Magnesium and calcium compete with each other for intestinal absorption. Consequently, calcium supplements should not be taken at the same time as magnesium supplements.

Health Conditions

What health conditions require special emphasis on calcium?

Calcium may play a role in the prevention and/or treatment of the following health conditions:

  • Cataracts
  • Colon cancer
  • High blood pressure
  • Inflammatory bowel disease
  • Kidney stones
  • Osteoporosis
  • Polycystic ovarian syndrome
  • Pregnancy induced hypertension and preeclampsia
  • Premenstrual syndrome

Food Sources

Excellent sources of calcium include spinach, turnip greens, mustard greens, collard greens and tofu.

Very good sources of calcium include blackstrap molasses, Swiss chard, yogurt, kale, mozzarella cheese, cow’s milk, and goat’s milk. Basil, thyme, dill seed, oregano, and cinnamon are also very good sources of calcium.

Good sources of calcium include romaine lettuce, celery, broccoli, sesame seeds, fennel, cabbage, summer squash, green beans, garlic, Brussel sprouts, oranges, asparagus, leeks and crimini mushrooms. Rosemary, cumin seeds, cloves, coriander seeds, scallops, and kelp (a sea vegetable) are also good sources of calcium.

Introduction to Nutrient Rating System Chart

In order to better help you identify foods that feature a high concentration of nutrients for the calories they contain, we created a Food Rating System. This system allows us to highlight the foods that are especially rich in particular nutrients. The following chart shows the World’s Healthiest Foods that are either an excellent, very good, or good source of calcium. Next to each food name, you’ll find the serving size we used to calculate the food’s nutrient composition, the calories contained in the serving, the amount of calcium contained in one serving size of the food, the percent Daily Value (DV%) that this amount represents, the nutrient density that we calculated for this food and nutrient, and the rating we established in our rating system. For most of our nutrient ratings, we adopted the government standards for food labeling that are found in the U.S. Food and Drug Administration’s “Reference Values for Nutrition Labeling.”

World’s Healthiest Foods ranked as quality sources of
calcium
Food Serving
Size
Cals Amount
(mg)
DV
(%)
Nutrient
Density
World’s
Healthiest
Foods Rating
Basil 2 tsp 7.0 59.16 5.9 15.1 very good
Turnip Greens 1 cup cooked 28.8 197.28 19.7 12.3 excellent
Thyme 2 tsp 7.7 52.92 5.3 12.3 very good
Oregano 2 tsp 9.5 57.49 5.7 10.8 very good
Spinach 1 cup cooked 41.4 244.80 24.5 10.6 excellent
Collard Greens 1 cup cooked 49.4 266.00 26.6 9.7 excellent
Dill 2 tsp 12.8 63.67 6.4 8.9 very good
Mustard Greens 1 cup cooked 21.0 103.60 10.4 8.9 excellent
Tofu 4 oz-wt 86.2 396.89 39.7 8.3 excellent
Cinnamon 2 tsp 12.8 52.10 5.2 7.3 very good
Sea Vegetables 0.25 cup 8.6 33.60 3.4 7.0 good
Rosemary 2 tsp 7.9 30.72 3.1 7.0 good
Blackstrap Molasses 2 tsp 32.1 117.56 11.8 6.6 very good
Cheese 1 oz-wt 72.0 221.69 22.2 5.5 very good
Yogurt 1 cup 154.3 448.35 44.8 5.2 very good
Swiss Chard 1 cup cooked 35.0 101.50 10.2 5.2 very good
Kale 1 cup cooked 36.4 93.60 9.4 4.6 very good
Celery 1 cup 16.2 40.40 4.0 4.5 good
Cumin 1 tsp 15.8 39.10 3.9 4.5 good
Milk 1 cup 122.0 292.80 29.3 4.3 very good
Cloves 2 tsp 13.6 27.13 2.7 3.6 good
Milk – Goat 1 cup 168.4 326.96 32.7 3.5 very good
Romaine Lettuce 2 cups 16.0 31.02 3.1 3.5 good
Sardines 3.20 oz-wt 188.7 346.54 34.7 3.3 good
Sesame Seeds 0.25 cup 206.3 351.00 35.1 3.1 good
Coriander 2 tsp 17.8 29.20 2.9 3.0 good
Cabbage 1 cup raw 17.5 28.00 2.8 2.9 good
Fennel 1 cup raw 27.0 42.63 4.3 2.8 good
Broccoli 1 cup raw 30.9 42.77 4.3 2.5 good
Garlic 1 oz-wt 26.8 32.58 3.3 2.2 good
Asparagus 1 cup raw 26.8 32.16 3.2 2.2 good
Green Beans 1 cup raw 31.0 37.00 3.7 2.1 good
Scallops 4 oz-wt 127.0 130.41 13.0 1.8 good
Brussels Sprouts 1 cup raw 37.8 36.96 3.7 1.8 good
Leeks 1 cup raw 54.3 52.51 5.3 1.7 good
Oranges 1 each 61.6 52.40 5.2 1.5 good
World’s Healthiest
Foods Rating
Rule
excellent DV>=75% OR
Density>=7.6 AND DV>=10%
very good DV>=50% OR
Density>=3.4 AND DV>=5%
good DV>=25% OR
Density>=1.5 AND DV>=2.5%

Public Health Recommendations

In 2010, the Institute of Medicine at the National Academy of Sciences issued revised Dietary Reference Intake (DRI) recommendation levels for calcium. These revised recommendation levels were determined to be necessary in light of the simultaneously revised recommendation levels for vitamin D. (Vitamin D and calcium work together in their support of our health, and it makes sense to coordinate nutrient recommendations for these two nutrients.) The 2010 revised recommendations for calcium included revised calcium Adequate Intake (AI) levels for infants as follows:

  • 0-6 months: 200 mg
  • 6-12 months: 260 mg

For children and adults, Recommended Dietary Allowance (RDA) levels were established in 2010 as follows:

  • 1-3 years: 700 mg
  • 4-8 years: 1000 mg
  • 9-13 years: 1300 mg
  • 14-18 years: 1300 mg
  • 19-30 years: 1000 mg
  • 31-50 years: 1000 mg
  • 51-70 years (male): 1000 mg
  • 51-70 years (female): 1200 mg
  • 70+ years: 1200mg
  • Pregnant and lactating women (younger than 18 years): 1300 mg
  • Pregnant and lactating women (older than 18 years): 1000 mgIn 2010 the National Academy of Sciences established revised Tolerable Upper Intake Levels (ULs) for calcium as follows:
    • 0-6 months: 1000 mg
    • 6-12 months: 1500 mg
    • 1-3 years: 2500 mg
    • 4-8 years: 2500 mg
    • 9-13 years: 3000 mg
    • 14-18 years: 3000 mg
    • 19-30 years: 2500 mg
    • 31-50 years: 2500 mg
    • 51+ years: 2000 mg
    • Pregnant and lactating women (younger than 18 years): 3000 mg
    • Pregnant and lactating women (older than 18 years): 2500 mg

    For more details on this, see the Toxicity Symptoms section above.

    References

    • Bell L, et al. Cholesterol-lowering effects of calcium carbonate in patients with mild to moderate hypercholesterolemia. Arch Intern Med 1992;152:2441-2444. 1992.
    • Bostick RM, et al. Effect of calcium supplementation on serum cholesterol and blood pressure. Arch Fam Med 2000; 9:31-39. 2000.
    • Buckley LM, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. Ann Intern Med 1996; 125:961-968. 1996.
    • Cappuccio FP, et al. Epidemiologic association between dietary calcium intake and blood pressure: a meta-analysis of published data. Am J Epidemiol 1995;142:935-945. 1995.
    • Cook JD, Dassenko SA, Whittaker P. Calcium supplementation: effect on iron absorption. Am J Clin Nutr 1991;53:106-11. 1991.
    • Garland CF, Garland FC, Gorham ED. Calcium and vitamin D: Their potential roles in colon and breast cancer prevention. Ann N Y Acad Sci 1999;889:107-19. 1999.
    • Groff JL, Gropper SS, Hunt SM. Advanced Nutrition and Human Metabolism. West Publishing Company, New York, 1995. 1995.
    • Hallberg L. Does calcium interfere with iron absorption. Am J Clin Nutr 1998;63:3-4. 1998.
    • Lee SJ, Kanis JA. An association between osteoporosis and premenstrual symptoms and postmenopausal symptoms. Bone and Mineral 1994;24:127-134. 1994.
    • Lininger SW, et al. A-Z guide to drug-herb-vitamin interactions. Prima Health, Rocklin, CA, 2000. 2000.
    • Miller JZ, et al. Calcium absorption from calcium carbonate and a new form of calcium (CCM) in healthy male and female adolescents. Am J Clin Nutr 1988;48:1291-4. 1988.
    • Minihane AM, et al. Effect of calcium supplementation on daily nonheme-iron absorption and long-term iron status. Am J Clin Nutr 1998;68:96-102. 1998.
    • Sakhaee K, Bhuket T, et al. Meta-analysis of calcium bioavailability: A comparison of calcium citrate with calcium carbonate. American Journal of Therapeutics 1999;6:313-321. 1999.
    • Thys-Jacobs S, Starkey P, Bernstein D, Tian J. Calcium carbonate and the premenstrual syndrome: effects on premenstrual and menstrual symptoms. Premestrual syndrome study group. Am J Obstet Gynecol 1998;179(2): 444-52. 1998.
    • Weaver CM, Proulx WR, Heaney R. Choices for achieving adequate dietary calcium with a vegetarian diet. Am J Clin Nutr 1999;70(suppl):543S-8S. 1999.
    • Wu K, Willet WC, Fuchs CS et al. Calcium intake and risk of colon cancer in women and men. J Natl Cancer Inst 2002 Mar 20;94(6):437-46. 2002.

5 thoughts on “Calcium – the hows and whats!

  1. Galy, as you are a fab personal trainer, could you give some examples of weight baring exercises. Not everyone with osteoporosis would be able to do bodypump or skipping.
    Love all the calcium food sources.

    Like

    • Hi Nicole
      Weight bearing exercises do not need to be extreme sports 🙂
      Lifting light weights in a variety of ways is perfect. Starting with light weights using good form and technique first and then progressing by adding weight. Your own body weight can also be used. Body weight squats, lunges, knee push ups and many others.
      The total gym, Power tower (can be found in all Virgin Gyms), is perfect, the Power Plate another great option.
      In the BLOG itself you can down load a variety of programs to do which include weights, body weight, Power Plate and others.
      In Young at Heart and soon Heart Moves we do a variety of weight bearing exercises…
      Hope this helps and I am VERY HAPPY to go over this with anyone who needs a bit more guidance.

      Like

  2. Dear Galy, you really are a legend!! Busy as you are getting your own health back and getting ready for Mongolia, here you also are getting us on the right track for osteoporosic health. Having dealt with my own osteo journey for more than 20 years, I thought I couldn’t learn more about the subject … but I have! Many thanks. Britta

    Like

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