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Menopause and Bone Health

September is Menopause Awareness Month and October is Osteoporosis Awareness Month. If you are a woman in her forties, every month is menopause month when you are in the midst of symptoms. Beyond the common hot flashes, sleep disturbances and weight issues, there may be other causes for anxiety. Are you getting enough calcium and doing enough weight-bearing exercises to prevent osteoporosis? 

You may think this debilitating, crippling disease of the bones is just for old women who are postmenopausal. Actually, bones are constantly changing, almost like a bank account. You make deposits of bone when the calcium in your diet is absorbed by the body and withdrawals when the calcium intake is insufficient. We reach our peak bone mass in our mid-twenties, but after age 35 you could be losing bone mass faster than you are building. Unfortunately, you don’t get a notice in the mail that your account is overdrawn.

In simple terms, when your bones are overdrawn, tiny holes start to form. These holes continue to grow larger if calcium intake is inadequate. Bones then become fragile and are more likely to fracture. Most at risk are the weight-bearing bones in the hip and delicate bones in the wrist. Food is the best calcium source, especially dairy foods. One cup of milk has about 300 milligrams, a cup of yogurt about 350 milligrams, and an ounce of cheese about 175 milligrams.

But how much calcium should you be getting every day? During the bone-building years of 9-18, 1300 milligrams is the recommended intake. If you are 19-50 years old, try to get 1000 milligrams, and for 51-70 year olds, you need 1200 milligrams.

There are other products on the market now that are fortified with calcium, some more than others. Orange juice is a product that has added calcium. On the Nutrition Facts label, calcium content is expressed in percent Daily Values rather than milligrams. Since the percentage is based on 1000 milligrams, there is a simple way to determine the number of milligrams. For example, if a product has 10 percent calcium in one serving, this means it has 100 milligrams. A cup of milk contains 30 percent of the 1000 milligrams of calcium needed for the day, meaning it has 300 milligrams. Just drop the percentage and add a zero to get the number of milligrams.

If you do not care for the taste of milk or you are lactose intolerant, you may want to use other dairy products such as yogurt and cheese. There are also calcium supplements available. Shopping for a one can be confusing because there are so many choices. Look a little closer at the Supplement Facts label and you will see there are two main forms, calcium carbonate or calcium citrate. Whatever form you choose, purchase a supplement with vitamin D.

For proper absoprtion, calcium carbonate needs an acid environment. As we age, we have less stomach acid, so it is a good idea to take calcium carbonate at meals when more stomach acid is present. You can also take it with citrus or tomato juices to enhance its absorption. As the word carbonate indicates, this form may cause constipation, bloating and a gaseous feeling in the stomach. If this happens, try increasing fluids and fiber in your diet. A perimenopausal woman may already experience frequent indigestion, burping and gas. In this case, calcium citrate may be a better source.

Calcium citrate does not require stomach acid for absorption, so it may be taken any time. It is also more readily absorbed so you can take less, but it usually costs more. There are also fewer unpleasant symptoms than with the calcium carbonate. Look at the source of the calcium in the calcium fortified orange juice and other products you buy as well.

If you take a calcium supplement once daily, evening may be best. Dr. Miriam Nelson, from the School of Nutrition Science and Policy at Tufts University and author of Strong Women, Strong Bones, advises calcium carbonate at dinner time and calcium citrate before bed. Limit calcium intake at one time to about 500 milligrams from food and supplements. The National Academy of Sciences suggests a tolerable upper intake level no higher than 2500 milligrams daily from calcium containing foods and supplements combined. Excessive calcium intake interferes with iron absorption.

Excessive sodium and caffeine can increase urinary calcium excretion. Limit sodium to 2300 milligrams per day and caffeine to about 400 milligrams daily. A cup of coffee has about 125 milligrams of caffeine and a cup of tea about 50. Some soft drinks are comparable to tea, but also have phosphoric acid which interferes with calcium absorption. Some medications have caffeine too. Unbalanced, excessively high protein diets could increase urinary calcium excretion as well. 

Excessive fiber can also interfere with calcium absorption. Natural fiber that is part of a food is probably not a problem but fiber supplements are. In addition, consuming more than seven drinks containing alcohol a week is associated with greater risk of low bone density.

Support your bones. They support you. Men can also develop osteoporosis, so increased activity and healthy lifestyle is the recipe for any older adult. Now that the weather has cooled off, perhaps a weekend of pampering with active play and good food is in order for men and women over 50. Now that is a great idea.

Last Updated: 10/8/2014 9:14:54 AM
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