You’ve been told since you were a child to drink your milk and eat your spinach. Calcium keeps bones and teeth strong! As a child you probably drank – or choked down – your milk at the urging of your parents. As an adult perhaps you’ve switched to supplements. But new research suggests that not only do calcium supplements not have as strong an impact on bone health as previously believed – they can also be detrimental to heart health. And with cardiovascular disease being the leading cause of death for women of all ages – that’s something to think about!New research suggests that not only do calcium supplements not have as strong an impact on bone health as previously believed – they can also be detrimental to heart health.
Calcium – all it’s cracked up to be?
Calcium supplements are often suggested to women as a means to keep osteoporosis, a degenerative loss of the bone mass, at bay as they age. Women are especially prone to develop osteoporosis, in part because they have smaller, thinner bones than men in general. But also because estrogen decreases sharply with age and estrogen plays a major role in preventing the leaching of calcium from bones into the blood stream. In fact, women account for more than 80% of all osteoporosis diagnoses in the U.S.
It is difficult to find a woman who has come through menopause and doesn’t have some concern about the possibility of developing osteoporosis. One bad fall can create catastrophic results when wrist, hip or leg bones are not healthy enough to withstand the impact. Loss of independence and/or income and becoming a burden to family members top the list of concerns for most women.
Our bodies are unable to produce calcium and so it must come from the foods that we eat. And calcium is indeed necessary for the health of bones and teeth, in fact – more than 99% of the calcium in our bodies is found in our bones and our teeth. But, calcium also plays an integral part of the circulatory system where it aids in healthy blood clotting, as well as our musculature system assisting with contraction.
Eat those sardines!
Calcium is a powerhouse mineral, the research is clear. And your parents were right to require you to get adequate amounts in childhood. Youth is a time for rapid bone regeneration and development. If you think of the strength of your bone structure like a bank account, it’s as if you make constant deposits up until about the age of 30 – at which point, you’re pretty much only making withdrawals. So, building up strong and substantive bone tissue in youth is pretty much the same as building up an impressive retirement fund. It can be hard to make up for lost time.And dairy isn’t the only good source of calcium, though it is one of the best. Calcium-fortified cereals and juices as well as leafy dark greens such as kale, spinach and collards are all high in calcium.
And dairy isn’t the only good source of calcium, though it is one of the best. Calcium-fortified cereals and juices as well as leafy dark greens such as kale, spinach and collards are all high in calcium. White beans and soy beans and some types of fish such as sardines and salmon are good sources as well.
One important note is that it is also vital to get enough vitamin D – either from sunlight exposure or supplements. There are very few foods that provide an adequate amount of vitamin D – but liver is a good source. (Chances are you were told to eat that as a child as well.) Vitamin D is essential to calcium absorption. Without adequate vitamin D, the body is unable to produce enough of the hormone that is a vital component of the body’s ability to use the calcium taken in through nutrition. This means without adequate vitamin D, even if you are eating the RDA of calcium for your age and gender, your body might still leach it from your bones.
Another important note on vitamin D – those who live in northern latitudes have a difficult time getting enough vitamin D due to cold weather and the need for clothing which covers the body. Supplementation may be necessary if this is your living situation.
But what if you are past the age of 30? What if you have a history of osteoporosis in your family? Studies show that osteoporosis has a strong genetic component. What if you are lactose intolerant or you just don’t like the taste of milk?
This is where calcium supplementation comes in. The recommended RDA for calcium for women over 30 is 1,000 mg/day – and there is no argument that it is easier to just pop a calcium vitamin than it is to track calcium intake.
However, new research suggests that calcium obtained from supplementation isn’t effective at strengthening bones or preventing bone loss. The famous Auckland Study, a five-year randomized control study of 1,471 post-menopausal women, found that there was no evidence of decreased risk for bone fractures overall. Neither were there significant improvements in bone density – a measure of the rate of bone loss – noted.
In addition, many adverse reactions were reported: a 20%-40% increased risk of myocardial infarction (heart attack), 17% increased risk for renal calculi (kidney stones), and increased gastrointestinal side effects requiring hospitalization. This is according to a 2015 review of literature by the Association for the Publication of Journal of Internal Medicine.
Bone up on this!
The news that calcium supplementation is not as effective as previously believed, coupled with the disturbing knowledge that it could indeed be detrimental to heart health will come as a blow to many women who take their vitamins with the intention of strengthening their bones and preventing osteoporosis.
But all is not lost!
There are many other ways women can make a positive impact on bone health at any age – be sure to check with your doctor before making any drastic changes to your health regimen.
- Cardiovascular exercise – Weight bearing exercises are exercises that make you move against gravity while staying upright. You can choose high-impact exercise such as walking, hiking, dancing, jump-rope, or tennis if you haven’t already noted low bone density or are not recovering from a previous bone injury. If these situations do pertain to you – or you are a beginner to exercise – you should choose low-impact options such as the elliptical machine, stair climber set at a low grade and speed, or low-impact aerobics.
- Pumping iron – In addition to getting your heart pumping, you should consider pumping those muscles. Adding a weight-training regimen to your workout is easier than you think – and you don’t need to be a body builder to see results. Any weight that allows you to increase your resistance to gravity – even by a pound or two – can be helpful, and a great way to get started. Consider purchasing small dumbbells and holding them while you walk. You can also use elastic bands to work muscles while watching T.V. You can even use your own body weight as resistance by rising up and down on your toes while waiting in line.
- Stretch with guidance! – Yoga, Pilates and tai chi can improve strength, balance and flexibility – all good tools in your anti-fall arsenal. However, some poses and positions may not be safe for people with osteoporosis or those who are at risk. Be sure to consult with a licensed physical therapist to get specific recommendations on the best poses to incorporate into your practice – and those to avoid!
- Eat right – Just because you aren’t a kid anymore doesn’t mean you get a free pass on consuming your calcium. Be sure to include lots of calcium-rich foods, including calcium-fortified foods such as cereal and oatmeal, dairy, lots of leafy dark greens, white beans and plenty of dark-fleshed fish like sardines, salmon and rainbow trout.
- Go outside! – Adequate vitamin D intake is essential to your fight against bone loss. Use of sunscreen is important to prevent UV damage – but whenever possible expose your skin to the sun. If you live in an area where it is difficult to get adequate sunlight – or you live a mostly indoor lifestyle – adding a vitamin D supplement will be crucial. Food sources of vitamin D are scarce – but if you are already eating that dark fleshed fish from the previous point – that will help! Also, perhaps cultivate a recipe for liver that you can tolerate?
Make no bones about it!
Osteoporosis is a legitimate concern for a large percentage of women past child-bearing age, and while calcium supplementation might not be the best choice in regards to bone and heart health – there are many other options to consider.
Good nutrition and weight-bearing exercises will provide benefits far beyond your bone health. Perhaps it’s time to take up dancing, jump rope or find a new aerobics class. Like your mother always said about new things… Just try it, you might like it!
Bolland, M. J., Leung, W., Tai, V., Bastin, S., Gamble, G. D., Grey, A., & Reid, I. R. (2015). Calcium intake and risk of fracture: Systematic review. Bmj. doi:10.1136/bmj.h4580
Radford, L. T., Bolland, M. J., Mason, B., Horne, A., Gamble, G. D., Grey, A., & Reid, I. R. (2013). The Auckland calcium study: 5-year post-trial follow-up. Osteoporosis International, 25(1), 297-304. doi:10.1007/s00198-013-2526-z
Reid, I. R. (2013). Cardiovascular endocrinology: Calcium supplements—vascular risks versus bone benefits? Nature Reviews Endocrinology, 9(5), 255-256. doi:10.1038/nrendo.2013.61
Stewart, T. (2000). Role of genetic factors in the pathogenesis of osteoporosis. Journal of Endocrinology, 166(2), 235-245. doi:10.1677/joe.0.1660235
Osteoporosis – NIH Osteoporosis and Related Bone Diseases National Resource Center. (n.d.). Retrieved November 02, 2016, from http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/
Osteoporosis Exercise for Strong Bones – National Osteoporosis Foundation. (n.d.). Retrieved November 02, 2016, from https://www.nof.org/patients/fracturesfall-prevention/exercisesafe-movement/osteoporosis-exercise-for-strong-bones/
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