Maintaining Strong Bones: The real story behind Calcium and Vitamin D
Keeping our bones strong and healthy is a big part of preventive health care for women. After all, osteoporotic fractures are a major cause of disability among postmenopausal women. Many women don’t realize that it is never too early in life to ensure that the bones remain strong. In fact, the younger we start building healthy bones, the better. Our bones become stronger and denser from the time of birth, until the age of 30. This is when we reach our “peak bone density”. During puberty, 50% of a woman’s bone calcium is laid down. From the age of 30 until menopause, the bone mass decreases, although very slowly. After menopause, if a woman is not taking hormones, the bone loss becomes more pronounced and she can run the risk of becoming ostoporotic. This is a state where the bones are weakened to the point where a woman is at a high risk of fracture, even with a simple fall. One professor I had stated that “osteoporosis is a pediatric illness”. Despite the fact that it is mainly seen in postmenopausal women, the real root of the problem is that in childhood and adolescence the bones did not become as strong as they should. How can we make sure that we keep our bones as strong as they can be? The key is adequate Calcium and Vitamin D intake for all ages. How much is enough? The National Osteoporosis Foundation recommends Calcium 1,000mg daily for adults under 50. Postmenopausal women should receive 1,000 to 1,500mg daily. Adolescents should receive 1,300mg daily. The best dietary source of calcium is low fat dairy products. One serving has roughly 300 mg Calcium. Adolescents should be consuming 3-4 servings a day of dairy products. For those that are lactose intolerant, many of the lactose free dairy products are fortified with calcium. For those who do not consume enough dietary calcium, supplements are appropriate. One should take care that the total Calcium intake should not exceed 2,000mg daily to minimize the risk of side effects such as kidney stones. What about Vitamin D? How do I know if I’m getting enough? The NOF recommends 400-800 IU/daily of Vitamin D for women under age 50 and 800-1000 IU day for adults over 50. Vitamin D fortification is found in some, but not all milk products in Israel. Read the label to see if the milk you are drinking contains Vitamin D. Ask your doctor about having your 25 Hydroxy-Vitamin D level measured. This is a relatively new test which shows whether you have enough Vitamin D is in your body. Despite our sunny climate, many of the women tested at Bishvilaych have been found to be deficient in this crucial vitamin. Without Vitamin D, the dietary calcium does not get absorbed and the bones do not get fortified. Furthermore, recent studies have shown that people with low vitamin D levels are at higher risks for many chronic diseases and cancers. If Vitamin D deficiency is diagnosed, it can be easily corrected with over the counter Vitamin D supplementation. Finally, all women should try and get 30 minutes a day of weight bearing exercise ( ie. Walking) to maintain strong and healthy bones.