Tag Archives: bone loss

Getting Enough Calcium?

Q: My doctor recommended I take a calcium supplement. Which type do you suggest, and when is the best time of day to take it?

A: Calcium supplements come in two forms: calcium citrate or calcium carbonate. Calcium carbonate (e.g. Caltrate®, Viactiv®, Tums®) is cheaper than Calcium citrate (e.g. Citracal®), but research has shown that under normal circumstances, the two forms are equally absorbed and utilized by the body. The exception is in cases of reduced stomach acidity, which occurs often in the elderly or if you take medications that decrease gastric acid secretion. If this is the case, then calcium citrate is the way to go. Check the ingredient list on the back of supplements and multivitamins to know which form of calcium the product contains.

A few rules:

  1. Calcium carbonate products should be taken with meals.
  2. Calcium citrate products can be taken with food or on an empty stomach.
  3. Along with food and antacids, calcium supplements likely inhibit the absorption of medications intended to halt bone loss, such as Fosamax, Actonel or Didronel. After taking one of these drugs, wait at least 30 minutes before ingesting anything except plain water.
  4. Calcium may prevent iron absorption, so if you’re also on supplemental iron, space the two tablets several hours apart.

Healthy adults should aim for 1,000-1,200 mg elemental calcium per day. It’s important to buy a supplement that also contains vitamin D, which helps our body absorb calcium. The recommendation for vitamin D is set at 600 IU daily, but a number of researchers believe this number should even be doubled.

Let’s put things in perspective…One Caltrate®600+D tablet contains 600 mg calcium plus 400 IU of vitamin D. Daily goals can be met with two of these tablets daily. On the other hand, Citracal® Regular 250 mg + D contains 500 mg calcium and 400 IU vitamin D per serving, but a serving is 2 tablets! That means you would need to take 4 Citracal® tablets per day to meet the daily calcium requirement. Viactiv® flavoredchews each have 500 mg calcium and 500 IU vitamin D. Lastly, a single Tums® tablet contains 500 mg of calcium carbonate, but only 200 mg of that is elemental calcium. Bottom line? Be sure to read labels and, of course, inform your doctor of all vitamins, supplements and herbs you’re taking.

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Filed under Medical Conditions, Supplements, Vitamins & Minerals

Secrets of Greek Yogurt

Q: Is there a difference between Greek yogurt and regular, conventional yogurt?

A:All yogurts are a great source of calcium, protein and beneficial bacteria (“probiotics”), which aid in digestion. However, for those of you who dislike the thinner, runnier texture of conventional yogurt, Greek yogurt is a good alternative, because it’s richer and creamier. Three popular brands of Greek yogurt are Fage, Chobani and Stonyfield’s Oikos. No matter what yogurt you choose – conventional or Greek – make sure to purchase the low-fat or non-fat variety!

Let’s take a look at the specific differences in nutrient content…

Dannon’s Plain,    Non-fat (Regular Yogurt) Stonyfield’s Oikos Plain, 0% fat (Greek Yogurt) Fage’s Plain, 0% fat (Greek Yogurt)
Serving Size 6 oz 5.3 oz 6 oz
Calories 80 kcal 80 kcal 90 kcal
Sodium 120 mg 60 mg 65 mg
Sugar 12 g 6 g 7 g
Protein 9 g 15 g 15 g
Calcium 300 mg 200 mg 200 mg
  1. Greek yogurt contains about half the sodium of regular yogurt.  In general, yogurt is a great heart-healthy snack, but since we get way too much sodium in our processed-food diets as it is, Greek yogurt is a great option for salt-sensitive people.
  2. Greek yogurt is quite low in sugar.  With half the carbs of conventional yogurt, Greek yogurt won’t spike your blood sugar as high as a regular yogurt might.
  3. Greek yogurt is very high in protein. Dairy is always a solid source of protein, but with 15g of protein per 6-oz container, Greek yogurt will make you feel fuller longer than conventional yogurt.
  4. Greek yogurt is lower in calcium than regular yogurt. Unfortunately, conventional yogurt beats Greek yogurt in this category, at times packing 100 added milligrams of bone-building calcium per serving. While it’s important to meet your calcium requirement, adding any type of low-fat yogurt to your daily routine will bring you one step closer to a healthy, well-balanced diet.

Update: Upon further investigation of food labels, I’ve found a big difference in the calcium content of Greek yogurt flavors. The plain, 0% fat variety may contain 20-25% of the daily value (DV) of calcium, which is approximately 200 – 250 mg*, but honey & fruit flavors can have much less! The honey, cherry and peach flavors of Fage Greek yogurt contain only 10% of the DV! On the other hand, all of the low-fat Greek yogurt flavors made by Chobani contain 200 mg of calcium per 6 oz container. Clearly, it’s important to comparison shop by reading the nutrition label! Since yogurt packaged with fruit or honey will be higher in sugar, your best bet is to buy the plain, non-fat yogurt and add fresh fruit of your own!

*Remember: Adults should aim for 1,000-1,2000 mg calcium per day to maintain healthy bones!


Filed under Dairy, Heart Healthy Choices, Vitamins & Minerals

Building (and maintaining!) healthy bones

Q: How much calcium should I be getting and what are the best sources?

A: Adults (19-50 years old) should consume a minimum of 1,000mg calcium daily and adults 51+ years are recommended to get at least 1,200mg. Intakes for children and adolescents should be a little higher, since they are still accumulating bone mass. Aim to meet food pyramid recommendations and you’ll be well on your way to reaching calcium guidelines.

Most of us know that calcium is an integral part of bone structure, but this mineral does much more than that! Calcium plays an important role in maintaining normal blood pressure, blood clotting, muscle contraction and the transmission of nerve signals. The body tightly regulates blood calcium levels, and when intake is inadequate, the body draws on calcium stores in bones and teeth.

It’s important for kids and teens to get enough calcium, so that they are able to achieve their height potential and an optimal bone mass, which is reached by age 30. After age 40 or so, bone density inevitably begins to decline and a person with insufficient calcium stores is at risk for osteoporosis. Fortunately, bone loss can be slowed by a diet adequate in calcium and with regular physical activity!

It’s always best to obtain vitamins and minerals from food sources, rather than by taking a supplement. In fact, calcium supplements may be less effective at building strong bones, which may be due to the fact that other micronutrients found in a well-balanced diet – including vitamin D, vitamin K, magnesium and phosphorus – all play necessary roles in bone metabolism.

Some of the best sources of calcium come from the dairy group, but there are great vegetarian sources as well! Besides milk, yogurt and cheese, broccoli, collard greens, cauliflower, brussels sprouts, bok choy and kale are also excellent sources of calcium. Note that spinach, rhubarb and Swiss chard appear equal to milk in calcium content, but they actually provide little calcium to the body, because these foods also contain compounds that prevent absorption of the mineral.

1 cup milk = 300mg calcium

1.5 oz cheddar, mozzarella, muenster cheese = 250mg calcium

1 oz (~1 slice) American cheese = 160mg calcium

1 cup plain, nonfat yogurt = 300-400mg calcium

3 oz sardines (with bones) = 324mg calcium

1 cup enriched soymilk = 350mg calcium

1 cup soymilk, unfortified = 60mg calcium

1 cup calcium-fortified orange juice = 300mg calcium

1 egg = 25mg calcium

½ cup tofu = 275mg calcium

½ cup black-eyed peas (cooked) = 105mg calcium

1.5 cup broccoli (cooked) = 90mg calcium

100% whole grain waffle = 100-200mg calcium

So, what if you don’t drink milk? If you’re lactose intolerant, lower-lactose or lactose-free products are available, as well as enzymes that can be taken orally or added to the milk. Calcium-fortified juice and soy beverages provide calcium as well, but they may not provide other important nutrients found in dairy products.


Filed under Dairy, Medical Conditions, Vitamins & Minerals