Your Health by Dr. Rallie McAllister

Most women fully appreciate the importance of calcium in maintaining a strong skeleton and reducing the risk of osteoporosis. The best source of calcium, on the other hand, has been something of a mystery.

The results of a study published in the American Journal of Clinical Nutrition suggest that food sources of the mineral may build stronger, healthier bones than calcium obtained from dietary supplements. Researchers from Washington University School of Medicine in St. Louis evaluated calcium intake from food sources and nutritional supplements in 183 postmenopausal women.

Women who got most of their daily calcium from foods were found to have greater bone mineral density than women whose calcium came primarily from supplemental tablets.

Although the results of this study are not considered definitive, the preliminary findings imply that absorption of calcium from food sources may be better than from pills, underscoring the importance of a balanced, nutritious diet.

Packing sufficient quantities of calcium-rich foods into the daily diet isn't always as easy as it sounds. For a postmenopausal woman to meet the recommended daily calcium intake of 1200 to 1500 milligrams, she'd have to eat four or five servings of dairy products each day.

Leafy green vegetables, tofu, and bone-containing sardines and salmon are also rich in calcium, but most women don't eat nearly enough of these foods to meet their daily calcium requirements. Although dairy products are the most popular dietary source of calcium in the United States, many Americans are lactose intolerant, and the average adult consumes fewer than two servings of dairy foods daily.

Studies show that nearly two-thirds of American women do not get enough calcium for optimum health. For postmenopausal women whose diets don't provide adequate amounts of the mineral, most experts advocate the use of high quality nutritional supplements.

With dozens of calcium-containing products available, it's hard to know which one is best. Calcium carbonate is an inexpensive source of the mineral, but it requires an acidic stomach for optimum absorption, and it should be taken after meals.

Familiar sources of calcium carbonate are the nutritional products Caltrate and OsCal, as well as some antacids, including Tums and Rolaids. Compared to calcium carbonate, supplements containing calcium citrate tend to be a little more expensive, but they may be more convenient to use since it's not necessary to take them after meals.

Because calcium citrate can be absorbed in a less acidic stomach, it's a good choice for women taking acid-suppressing drugs for the treatment of gastro-esophageal reflux disease (GERD).

Regardless of the supplement used, calcium is absorbed best when it's taken in doses of 500 milligrams or less. Rather than taking a single tablet containing 1,000 milligrams of the mineral daily, it's better to take a 500 milligram dose twice a day.

Once women have their calcium requirements covered, it's a good idea to take a look at vitamin D intake. Although vitamin D is critical for the absorption and transport of calcium into bones, most women in the United States aren't getting nearly enough.

Research suggests that roughly 70 percent of American women over the age of 51 don't meet their daily requirements for the vitamin. Most nutrition experts recommend a daily intake of at least 1,000 international units of vitamin D for menopausal women.

Postmenopausal women with low levels of vitamin D have been found to have a greater risk of hip fracture. Recent research suggests that in addition to improving bone health, vitamin D may be protective against some types of cancers and several diseases involving the immune system, such as multiple sclerosis and rheumatoid arthritis.

In young, healthy women, just 10 to 15 minutes of sun exposure allows the skin to manufacture adequate amounts of vitamin D. For older women and for those with limited sun exposure, dietary sources of the vitamin are especially important.

Certain foods, including milk, orange juice, breakfast cereals and breads are often fortified with both calcium and vitamin D. Cod liver oil and fatty fish, including salmon and mackerel, are naturally rich in the vitamin.

Getting adequate amounts of dietary calcium and vitamin D can be challenging for adults, even when they strive to eat foods that are wholesome and nutritious. For postmenopausal women whose diets are less than ideal, taking calcium and vitamin D supplements to reduce the risk of osteoporosis makes good sense.

Rallie McAllister is a board-certified family physician, speaker and the author of several books, including "Healthy Lunchbox: The Working Mom's Guide to Keeping You and Your Kids Trim." Her Website is www.rallieonhealth.com. To find out more about Rallie McAllister, M.D., and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com.

COPYRIGHT 2009 CREATORS SYNDICATE INC.

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