Aging Well: Strong bones need more than calcium

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Additional information on Healthy Aging is available on the Colorado State University Cooperative Extension Web site at www.ext.colostate... under Family/Consumer. Colorado State University Cooperative Extension brings the resources of the university to you. For more information, contact your county extension office.

My paternal grandmother was frequently the recipient of teasing by family members who pointed out that she seemed to be shrinking as time went by. Grandma graciously accepted the teasing, and neither she nor others seemed to think anymore about it until the next family gathering provided another opportunity to pester her.

Grandma was small and slender - about 5 feet tall - had a tiny frame and really did seem to grow shorter with age. She died at age 97 after developing pneumonia following a broken hip. She vehemently corrected those who said, "Grandma fell and broke her hip," by reprimanding them with, "My hip broke, and then I fell!"

In her last decade or so, my grandmother developed a dowager's hump, the increasing curvature of the spine often associated with osteoporosis. As I look back, I believe my grandmother suffered from osteoporosis, but we knew a lot less about the disease when I was a child. Obviously, I don't know if Grandma drank milk or consumed calcium-rich foods when she was growing, but I do know that I never saw her drink milk as an adult. She may have been lactose intolerant or allergic to milk.

Americans, especially American women, do not consume adequate calcium. Women and teenage girls often are concerned about weight gain and do not drink milk or eat enough calcium-rich foods in their effort to control caloric intakes. A minimum of 1,000 milligrams of calcium daily from food and supplements is needed by most adults. Women older than 50 and men older than 65 need 1,200 to 1,500 milligrams of calcium daily.

Adequate calcium intake is necessary to build strong bones, but those with a milk allergy or lactose intolerance may need to find alternate sources. Fortunately, there are a number of nondairy sources of calcium. This allows options for those who do not tolerate milk and provides additional selections for those looking for alternatives.

Following is a list of some of the best food sources of calcium and the amounts contained in a typical serving:

Food and Amount - Calcium in Milligrams

- yogurt, plain, non-fat, 1 cup - 450

- sardines with bones, 3 oz. - 370

- yogurt, fruit flavored, 1 cup - 300

- milk, 1 cup - 300

- Swiss cheese, 1 oz. - 270

- salmon, with bones, 3 oz. - 225

- collard greens, 1 cup - 225

- cheddar cheese, 1 oz. - 205

- turnip greens, cooked, 1 cup - 200

- oatmeal, fortified, 1 packet - 165

- orange juice, calcium fortified, 1/2 cup - 150

- tofu, 2 oz. - 115

- kale, cooked, 1 cup - 95

- ice cream or ice milk, 1/2 cup - 87

- white beans, canned, 1/2 cup - 80

- cottage cheese, 1/2 cup - 75

- soybeans, cooked, 1/2 cup - 65

- almonds, 1 oz. - 70

- broccoli, cooked, 1 cup - 70

- soybeans, cooked, 1/2 cup - 65

Surprisingly, at least half of a person's required daily calcium intake can be obtained from non-dairy sources such as those listed above. Constant attention to intakes of the all-important calcium mineral will yield major rewards in terms of bone health for men and women, especially in later years.

"Simply upping calcium consumption has never been shown to increase bone density or prevent fractures in older women," says Dr. Miriam Nelson, author of "Strong Women, Strong Bones" (UC Berkley Wellness Letter, 7/03, Nelson, "Strong Women, Strong Bones," Putnam 4/00). According to Nelson, adding adequate Vitamin D to the calcium intake increases bone density significantly and reduces fractures by 50 percent for post-menopausal women. She also points out that continuing research suggests the importance of additional nutrients. But adequate calcium, in addition to Vitamin D and possibly certain other nutrients, still may not tell the entire story of osteoporosis prevention. Many experts agree that exercise also is an important component.

Nelson suggests that walking can be good exercise for the heart, but it has only minor effects on bone health. In addition to walking, Nelson encourages women to engage in two or three strength training sessions weekly to halt bone loss and to possibly regain bone density. She points out that women need not worry about developing bulky muscles through strength training. Although high-impact exercises such as jumping or stair climbing can help with bone density, caution needs to be taken to do those exercises correctly. High-impact exercises take their toll on joints and may need to be adapted or avoided entirely by people with joint problems or arthritic conditions.

Bones that have thinned or become brittle due to aging or osteoporosis tend to break more easily. Women's smaller bodies generally have thinner bones than do men. This, added to their tendency to diet inappropriately, makes women more vulnerable to broken bones and osteoporosis as they get older. Men, although not immune from the deterioration of thinning bones, may fare better because they generally have larger bones than women. However, men can and do develop osteoporosis. Therefore, exercises that assist in balance training also can be useful in preventing falls that lead to broken bones.

If Grandmother was still alive, today's health and nutrition professionals probably would recommend that, in addition to eating a diet based on the Food Pyramid, she ingest adequate vitamin D and practice strength training to reduce her risk of osteoporosis.

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