A primer on osteoporosis

Osteoporosis and the increased risk of fractures affects a large portion of the population over the age of 50. Osteoporosis is more common in women, but occurs in men, too. The risk of breaking a bone increases as we get older because bones tend to become less dense as we age. Calcium from the diet or from supplements is only one of many factors that play an important role in keeping bones strong and preventing fractures.

Current medical research tells us that 1,500 mg of dietary calcium is helpful in treating osteoporosis and preventing fractures. However, some cultures have a calcium intake that is about one tenth that recommendation and have a lower risk of osteoporosis than we do. How can that be?

Are you getting the calcium you eat?

The metabolism of calcium is complex. On average, only about 30 percent of the calcium that you consume gets into your body. So an average person who is consuming 1,500 mg of dietary or supplemental calcium is really only getting 500 mg that can be used to strengthen the bones.

Maximizing what your body does with the calcium you eat is very important.

Vitamin D dramatically improves intestinal calcium absorption. Did you know that vitamin D deficiency is epidemic in the northeast and likely increases as we age? Correcting low vitamin D levels not only improves calcium absorption and bone health, but it often helps improve muscle aches and strength in the elderly. A simple blood test can determine if you are vitamin D deficient. Ask your doctor. In lieu of a blood test, a daily intake of 1,000 IU of vitamin D3 is generally recognized as safe.

The absorbability of calcium also depends upon the type of calcium that you eat.

Calcium carbonate, which is found in most calcium supplements and in antacids, is cheap but poorly absorbed even under the best conditions. Calcium that naturally occurs in spinach is very poorly absorbed. The most absorbable form of calcium is calcium citrate-malate (with citric and malic acid). It is up to 50 percent more absorbable than calcium carbonate. Orange juice fortified with calcium citrate-malate is an excellent food-based source of calcium.

Through advertising, we are told how milk is good for healthy bones. The calcium in milk is well absorbed, but not as well absorbed as the fortified calcium in orange juice or the calcium that is naturally found in kale. Other vegetables with high levels of well absorbed calcium include: broccoli, kohlrabi, mustard greens, rutabaga, turnip greens, and watercress. Tofu set in calcium is also an excellent source. Ten ounces of these foods are approximately equal to one eight-ounce glass of milk in absorbable calcium content.

More next week on how to be certain the calcium you eat is getting to your bones. Richard Malik is a naturopathic doctor with a practice in Lakeville offering comprehensive health care for the entire family.