Calcium

WHY WE NEED CALCIUM
You may know that calcium plays an important role in building healthy teeth and bones. What you may not know is that calcium is vital to every cell of the body for muscle function, nerve transmission, blood clotting and many other uses. When you don't get enough calcium in your diet, the calcium stored in your bones is "stolen" to supply the rest of your body. Hence, your bones suffer the consequences of a low-calcium diet and they become more susceptible to fractures.

RECOMMENDATIONS
The Dietary Reference Intakes (DRI's) for calcium vary by age and stage of life:

Age/Lifestage Group	New Calcium Goal (mg/day)
Birth-6 months	210
6 months-1 year	270
1-3 years old	500
4-8 years old	800
9-18 years old	1300
19-50 years old	1000
51 + years old	1200
Pregnant and/or lactating (18 years old and younger)	1300
Pregnant and/or lactating (19+ years old)	1000

From the Institute of Medicine of the National Academy of Sciences, Washington, DC: National Academy Press,
2101 Constitution Ave. NW, Washington, DC 20418; 1997.

Many good sources of calcium fit quite well into a healthy, low-fat diet. The following table includes some examples of low-fat sources of calcium from several food groups:

Group	Examples
Dairy	milk (skim or 1%), low-fat and fat-free yogurts, low-fat and fat-free cheeses
Meats/Beans	sardines/salmon with bones, calcium-set tofu
Fruits/Vegetables	collard greens, broccoli, calcium-fortified orange juice
Grains	pancakes, calcium-fortified breads and cereals
Combination Foods	cheese pizza (made with reduced-fat cheese), soups prepared with skim milk
Non-food sources	calcium supplements

CALCIUM SUPPLEMENTS
It is not difficult to make low-fat food choices that are also good sources of calcium. Although food is the preferred source of calcium, a supplement may be necessary to help you meet your daily calcium needs. Avoid oyster shell, dolomite and bone meal supplements because they can contain significant amounts of lead and are absorbed less efficiently than calcium carbonate. Calcium carbonate, the most popular form, is chewable and is marketed by a number of companies.

Common brand names of calcium carbonate include Tums™, Rolaids™, Viactiv™, Caltrate™, Oscal™ and Titralac™.  Other types of calcium supplements are calcium citrate and calcium gluconate. Most supplements provide 500 mg of calcium per serving – take no more than 500 mg of calcium at one time to maximize absorption. To avoid calcium toxicity, do not exceed 1500 mg of calcium per day.

BEST FOOD SOURCES OF CALCIUM
Dairy Sources:
One way to increase the amount of calcium in your diet is to consume calcium-rich foods like low-fat milk, cheese, broccoli and others.  Many foods are fortified with calcium and are readily available and affordable.  Foods like orange juice, cereals and breakfast bars have calcium added to them, so it is easier than ever before to get the recommended level of calcium everyday.

Food	Serving Size	Calcium (mg)
Milk, skim	8 oz.	302
Yogurt, low-fat fruit	8 oz.	350
Yogurt, plain	8 oz.	450
Yogurt, frozen	8 oz.	278
Cheese, American	1 oz.	202
Cheese, low-fat cottage	4 oz./1/2 cup	69
Cheese, cream	1 oz.	30
Cheese, cheddar	1 oz.	204
Cheese, mozzarella	1 oz.	203
Cheese, swiss	1 oz.	273
Cheese, parmesan	¼ cup	250
Cheese, colby/monterey jack	1 oz.	200
Ice cream, low-fat	4 oz./1/2 cup	100
Pudding	4 oz./1/2 cup	150

Another easy and economical way to boost the calcium content of many meals is to add non-fat powdered dry milk to pudding, homemade cookies, bread or muffins, soups, gravy, casseroles and even a glass of milk.  A single Tbsp. of non-fat dry powdered milk adds 52 mg of calcium, and 2-4 Tbsp. can be added to most recipes.

You may add:

• 3 Tbsp. to each cup of milk in pudding, cocoa or custard
• 4 Tbsp. to each cup of hot cereal before cooking
• 2 Tbsp. sifted into each cup of flour

Non-Dairy Sources & Others:

Food	Serving Size	Calcium (mg)
Broccoli, cooked	4 oz./1/2 cup	47
Spinach, cooked*	4 oz./1/2 cup	122
Greens, cooked	4 oz./1/2 cup	55
Tofu, raw, firm - calcium - set	4 oz./1/2 cup	258
Instant Oatmeal	1 package	150
Pancakes, buttermilk	1	80
Sardines	2	90
Salmon, canned, with bones	3 oz.	203
Taco with cheese	1 large	340
Quiche with cheese	1/8 of 8-inch pie	115
Macaroni and cheese, box	1 cup	100
Pizza with cheese	1/8 of 12-inch pizza	115
Breads and Cereals	1 slice or ½ cup	30
Tortilla, corn	1 medium	45
Tomato soup, prepared with milk	8 oz.	186

* contains substances that tend to block calcium absorption

FORTIFIED FOODS
Fortified foods are a great way to get dietary calcium. When looking for a calcium-fortified version of a product, look for words on the packaging like “calcium-fortified,” “excellent source of calcium (more than 200 mg of calcium)” or “good source of calcium (110-190 mg/serving).”

Some examples of calcium fortified foods include: Total Cereal™, select varieties of Crystal Light™ drink, Honey Maid™ Graham Crackers, Cheez-It™ Juniors, Kellogg’s Fruit Loops™, Special K Plus™, Eggo Waffles™, Country Crock Spread™ (tub only), select varieties of soy milks, select varieties of orange juice (Minute Maid™ & Tropicana™), select varieties of cranberry juices (OceanSpray™), some grapefruit juices (Ruby Red Grapefruit Juice™), and some apple juices, Wonder Bread™, and Hostess Mini-muffins™. Check packages for exact calcium content.

SUGGESTIONS

• Drink skim or 1% milk with meals or as a snack.
• Increase your intake of calcium-rich foods when under stress.
• Ask your doctor about your medications (some decrease calcium absorption).
• Don't smoke - it decreases calcium absorption.
• Do exercise - it increases bone density (especially weight-bearing exercise).
• Use skim milk in soup instead of water.
• Limit caffeine intake, it can decrease calcium absorption.
• Add low-fat cheese to sandwiches, salads, casseroles, etc.
• Eat low-fat yogurt or cheese as a snack.
• Choose calcium-rich desserts.
• Avoid or limit alcohol - it can increase calcium loss.

References
K. Chapman-Novakofski & L. Tussing. University of Illinois Cooperative Extension, 2001.

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