Patient Education | Nutritional Supplements and Bone Health

Calcium

Calcium is essential for blood clotting, nerve function and other metabolic processes.   It is also essential for building and maintaining a healthy skeleton.   Ninety-nine percent of the body's calcium reserve is stored in bone.   Because the body cannot produce calcium, it must be replaced through the diet.   When serum calcium levels are too low, and adequate calcium is not provided by the diet, calcium is taken from bone.   Long term calcium deficiency is a known risk factor for osteoporosis.   The recommended daily calcium intake is 1000 to 1500mg / day.

Dietary sources of calcium include dairy products (milk, yogurt and cheeses), fortified juices, breads and cereals, nuts and seeds, fish eaten with bones, soy milk and tofu processed with calcium salts, green vegetables such as turnip greens, broccoli and collards, beans such as chick peas and soy beans and some fruits such as oranges, raisins and dried figs.

If you are taking medication to rebuild your bone, (Fosamax, Evista, Miacalcin, Estrogen) you still need to take in an adequate amount of calcium daily.

The body can best handle about 500 mg of calcium at a time.   Calcium rich food and supplements should be consumed in small doses throughout the day, preferably with a meal.   

Vitamin D

Helps regulate intestinal calcium absorption and helps mineralize bone.   The most readily available source of vitamin D is direct sunlight because of skin cancer and wrinkles; the skin's ability to metabolize vitamin D diminishes with age.   Other sources of vitamin D include fish liver oils, fatty fish, eggs, and liver and fortified foods such as milk and cereal.

The adequate intake for age 50 is 10mcg / day (400 IU) and for age 70 is 15mcg / day (600 IU).  

Vitamin C

The recommended intake for vitamin C is 90 mg / day for men over 50 and 75 mg   / day for women over 50.   Higher intake of vitamin C (100-125mg / day) has been linked in some studies to reduced hip fracture risk and increases BMD in postmenopausal women.   This effect was found to be stronger in women with high calcium intake.  

Dietary sources of vitamin C include citrus fruits and juices also cantaloupe, strawberries, potatoes, cabbage, peppers and broccoli.

Protein

Recommended intake of protein is 63 grams / day for adult men and 50 grams / day for adult women.   A high - protein dies has been demonstrated to increase the body's need for calcium.   Studies have shown that in the presence of 500 mg / day of calcium and vitamin D, a high protein diet is beneficial to bone density.   Low intake of protein has been linked to low femoral neck BMD in institutionalized elderly.   Outcomes following hip fracture in such patients were significantly improved with protein supplementation, which resulted in reduced bone loss from the hip.

Phosphorus

The recommended intake for phosphorus is 700 mg /day for men and women.   Dietary sources of phosphorus include dairy products, meat, peas, eggs and some cereals.   Phosphorus is also found in cola beverages and many processed foods.   It has long been known that excess phosphorus intake increases the need for calcium by interfering with calcium absorption.