Calcium and Other Bone Builders

Don’t forget your vitamin D, as well

By Deborah Jeanne Sergeant

Calcium has earned a reputation as a bone builder and rightfully so. 

Found in dairy products, dark leafy green vegetables, salmon and tofu, calcium is the main stuff that bones are made of. However, it takes more than just adequate calcium consumption to build strong bones.

Adequate calcium intake and supplementation, ranging from 1,000 to 1,200 mg. daily, depending upon age and gender. Joseph Catanese, pharmacist with Pine Pharmacy in Niagara Falls, said that in addition to taking enough calcium, the type and timing of the calcium dosage matters.

“The form of calcium is important in terms of absorbability,” Catanese said. “Calcium carbonate is more difficult to absorb. Calcium citrate and calcium glycinate are much better to absorb.”

Instead of taking the daily supplement all at once, he advises taking it in separate 500 to 600 mg. doses at different times of the day to improve absorption.

It’s always important to have vitamin D, as that helps with absorption,” Catanese said.

Since skin exposure to sunlight for 20 to 30 minutes three times weekly generates sufficient vitamin D production in the body, most people who live in the North lack it during the winter. Catanese recommends receiving a vitamin D blood test ordered by a care provider, which can indicate a deficiency. Reaching 800 international units (IU) of vitamin D should suffice.

Dietary sources of vitamin D include canned and fresh salmon, sardines and tuna; mushrooms; eggs, especially from pastured chickens; and fortified foods such as milk, cereal and oatmeal.

“Calcium can have a constipating effect and magnesium can have a laxative effect,” Catanese said. “It may be beneficial to have magnesium. It has many roles in the body, so it’s not a bad idea to get it in the diet in addition to calcium for bone health.”

Taking supplements can help fill in gaps in a healthful diet and aid in compensating for times when the diet is less than perfect or when stressors deplete the body to low stores of important nutrients.

Jessica Bennett, dietitian with Invision Health in Williamsville, said that many people turn to milk as a dietary source of calcium. However, other foods also provide calcium.

“I personally counsel a lot of patients who have to avoid dairy for different reasons,” Bennett said. “It’s inflammatory for a lot of people. I recommend getting it from another source, like collard greens, kale, tofu that’s fortified or other fortified foods.”

For people who must avoid dairy, such as people with lactose intolerance, Bennett stressed the importance of label reading, since milk may be used as the source of calcium such as in some fortified orange juice.

In addition to diet and moderate sun exposure, healthy bones also need exercise. Previously, experts believed that exercise builds only muscle. However, engaging in exercise also lays down bone.

“Weight bearing activities that put some pressure on the bones makes them stronger and muscles pulling against bones makes them stronger,” Bennett said.

She recommends both impact and low-impact exercise for bone health. Strength training might include lifting weights in the gym, using exercise bands or performing body weight exercises, like pull-ups, chin-ups, push-ups, squats and calf raises. Aerobic activity that is weight bearing might include walking on a treadmill, running or cross-country skiing.

In addition, managing stress, limiting alcohol and avoiding tobacco use also supports good bone health.

A primary health provider can recommend community resources to obtain a home fall risk assessment.