Some slides adapted from University of Nebraska Lincoln (lancaster.unl.edu) and MyPyramid.gov

Project Sponsors

• School District of Philadelphia

• Nutrition Center, Department of Bioscience & Biotechnology Drexel University

• USDA project funded through the Food Stamp Program

Funded by the PENNSYLVANIA NUTRITION EDUCATION TRACKS, a part of USDA’s Food Stamp Program. To find out how the Food Stamp Program can help you buy healthy foods,

contact the PA Department of Public Welfare’s tool-free helpline at 800-692-7462. This institution is an equal opportunity provider and employer.

Why Worry About Calcium?• Helps control muscle

contraction

• Need to build and maintain strong bone throughout life

Bones are living organs

• Calcium is deposited and withdrawn from bones daily.

• Half of the adult skeleton is formed during adolescence.

• We need to build up a healthy bone “account” while young and continue to make “deposits” with age.

** Get as much calcium as you can now to prevent weak bones

Source: http://www.accessexcellence.org/HHQ/qow/qow06/qow061211.html

• After mid-30’s, you begin to slowly lose bone mass. Women lose bone mass faster after menopause, but it happens to men too.

• Bones can weaken early in life without a healthy diet and regular physical weight bear activities.

Source: The 2004 Surgeon General’s Report on Bone Health and Osteoporosis:What It Means to You at http://www.surgeongeneral.gov/library/bonehealth

Bone Mass

Osteoporosis OverviewOsteoporosis Overview

Bone withOsteoporosis

NormalBone

Source: The 2004 Surgeon General’s Report on Bone Health and Osteoporosis: What It Means to You at http://www.surgeongeneral.gov/library/bonehealth

• Osteoporosis causes weak bones

• In this common disease, bones lose minerals like calcium

• The bones become fragile and can break easily

• Osteoporosis can strike at any age female or male

Risk factors “Red flags” that you could be at high risk for

weak bones

• You are older than 65 • You smoke • You are underweight for your height • You have never gotten enough calcium • You are not active• Poor daily nutrition• Low bone density-Osteopenia*Remember: Prevention is the Key!

Source: The 2004 Surgeon General’s Report on Bone Health and Osteoporosis:What It Means to You at http://www.surgeongeneral.gov/library/bonehealth

What is Osteopenia?

• Loss or decrease of bone mineral density (BMD) that can progress to osteoporosis

• BMD is the measurement of levels of minerals in the bone– Indicates strength and density

• When BMD is very low compared to normal, it is called osteoporosis

Adapted from: http://www.webmd.com/osteoporosis/tc/Osteopenia-Overview

Risk Factors

• Being of Caucasian or Asian decent• Excessive alcohol use• Family history• Being underweight• Physical inactivity• Tobacco use• Diet deficient in Calcium and Vitamin D • Decrease in bone density

Adapted from: http://www.webmd.com/osteoporosis/tc/Osteopenia-Overview

The problem in America

• 1 in 2 women and 1 in 4 men over 50 will have an osteoporosis-related fracture

• Hip fractures account for 300,000 hospitalization annually

• 1 in 5 people with a hip fracture end up in a nursing home within a year

• Less than ½ of teens get recommended amount of Calcium they need for the day.

Source: http://www.accessexcellence.org/HHQ/qow/qow06/qow061211.html and National Osteoporosis Foundation Web site; retrieved July 2005 at http://www.nof.org

Breaks usually occur in the wrist, spine, and hip.

Source: The 2004 Surgeon General’s Report on Bone Health and Osteoporosis:

What It Means to You at http://www.surgeongeneral.gov/library/bonehealth

The most common breaks

The good news: Osteoporosis and Osteopenia are preventable for most

people!• Start building

healthy bones while young.

• Healthy diet and lifestyle are important for BOTH men and women.

Simple Prevention Steps

1. Get the recommended amount of calcium and vitamin D

2. Get regular weight bearing exercise

3. Avoid smoking and excessive alcohol

What’s the recommendation for calcium?

Calcium requirements vary by age

If this is your ageThen you need

this much calcium each day (mg)

0 to 6 months 210

7 to 12 months 270

1 to 3 years 500

4 to 8 years 800

9 to 18 years 1,300

19 to 50 years 1,000

Over 50 years 1,200

Growthspurt

Source: The 2004 Surgeon General’s Report on Bone Health and Osteoporosis:What It Means to You at http://www.surgeongeneral.gov/library/bonehealth

Food and supplement labels

• Percent Daily Value is used to show how much calcium is in a food

So, for this label there is 30% DV of Calcium

How many mg would that be?

Do the math:

300 mg 1000 mg = 30%

100% DV for calcium = 1000 milligrams (mg)

Eating Calcium at Every Meal• Breakfast

– Granola bar and 6oz. calcium fortified 100% juice

• Lunch– Turkey, lettuce, tomato and

cheese on whole wheat roll– Low-fat chocolate milk

• Dinner– Grilled chicken, ½ c

spinach salad and ¾ c macaroni and cheese

• Breakfast– Orange juice 300mg– Granola bar 150mg

• Lunch– Cheese 300mg– Chocolate milk 300mg

• Dinner – Spinach 123mg– Mac and cheese

300mg

Is it Enough Calcium?

• Breakfast– Orange juice 300mg– Granola bar 150mg

• Lunch– Cheese 300mg– Chocolate milk 300mg

• Dinner – Spinach 123mg– Mac and cheese +300mg

Total Calcium: 1473mg

Milligrams (mg) and %DV of calcium in common foods

Approximate % DV for foods based in part on The 2004 Surgeon General’s Report on Bone Health and Osteoporosis: What It Means to You at http://www.surgeongeneral.gov/library/bonehealth

Calcium Sources: Milk group• Yogurt

1 cup (8 oz.) = 300mg (30% DV)• Milk

1 cup = 300mg (30% DV) • Cheese

1 ½ oz. natural/2 oz. processed = 300mg (30% DV)

• Milk pudding1/2 cup = 150mg (15% DV)

• Frozen yogurt, vanilla, soft serve½ cup = 100mg (10% DV)

• Ice cream, vanilla½ cup = 80mg (8% DV)

• Soy or rice milk, calcium-fortified1 cup = varies—check label

Choose fat-free or low fat

most often

Calcium Sources: Grain products group

• Cereal, calcium- fortifiedServing size and amount of calcium varies—check label

Calcium Sources: Vegetable group

• Broccoli, raw1 cup = 90mg (9% DV)

• Collard greens, cooked1/2 cup = 200mg (20% DV)

• Turnip greens, boiled1/2 cup = 100mg (10% DV)

Calcium Sources: Fruit group

• Orange juice and other calcium-fortified beverages6 oz. = 200mg to 300mg (20-30% DV, varies—check label)

Look for 100% juice

Calcium Sources: Meat & Beans Group

• Baked beans1 cup = 140mg (14% DV)

• Salmon, canned, with edible bones3 oz. = 180mg (18% DV)

• Sardines, canned, in oil, with edible bones3 oz. = 320mg (32% DV)

• Soybeans, cooked1 cup = 260mg (26% DV)

• Tofu, firm, with calcium ½ cup = 200mg (20mg% DV); check label

What’s the recommendation for vitamin D?

Why Do I Need Vitamin D?

• Helps the body more easily absorb calcium in the digestive tract.

• Promotes bone formation and mineralization

• Works with calcium to build a stronger more intact bone

Source: Vitamin D Overview http://healthlink.mcw.edu/article/982088787.html

You need more vitamin D as you age

Age

Daily vitamin D needs in International Units (IU)

600 IU

200 IU

400 IU

0

100

200

300

400

500

600

up to 50 51-70 over 70

What about Vitamin D?

Main dietary sources of vitamin D are:

• Fortified milk (400 IU per quart)

• Some fortified cereals

• Cold saltwater fish (Example: salmon, halibut, herring, tuna, oysters and shrimp)

• Some calcium and vitamin/mineral supplements

Vitamin D from sunlight exposure

• Vitamin D is manufactured in your skin following direct exposure to sun.

• Amount varies with time of day, season, latitude and skin pigmentation.

• 10–15 minutes exposure of hands, arms and face 2–3 times/week may be sufficient (depending on skin sensitivity).

• Clothing, sunscreen, window glass and pollution reduce amount produced.

Source: National Osteoporosis Foundation Web site; retrieved July 2005 at http://www.nof.org

Are You Lactose-intolerant?Some people lack the enzyme lactase needed to digest lactose (milk sugar).

Here are some tips which may help people obtain calcium from dairy products…

Tips for Lactose Intolerance

• Start with smaller portions

• Eat dairy in combination with meals

• Try dairy foods other than milk:– Hard cheeses have less lactose than milk:(ex: cheddar, Swiss, parmesan)

– Yogurt contains predigested lactose

• Try products like: Lactaid and soy milks and cheeses

I just don’t like milk

Add milk to coffee

Add powdered milk to food(1 tablespoon = 50 mg calcium)

Make oatmeal and cream-type soups with milk instead of water

Some ideas

Make instant hot cocoa with milk, not water.

Try chocolate milk. • 8-oz. has only 2 - 7 mg

caffeine.• Average glass provides

only 60 more calories than unflavored milk.

Serve milk-based desserts (puddings, tapioca, frozen yogurt, custard, ice cream). Limit fat and sugar.

Some more ideas

Enjoy plain or flavored low fat yogurt

Top baked potatoes with plain yogurt;

sprinkle with chives

Use flavored yogurt as a fruit salad dressing; experiment with

substituting plain yogurt for some or all of the sour cream in vegetable salad dressings

Even more ideas

Have It YOUR Way Smoothie(serves 2)

• 1 cup unsweetened, frozen raspberries or frozen fruit of choice

• 1/2 cup 100% calcium fortified orange

• 3/4 cup fruit-flavored, low- or non-fat yogurt

Blend all ingredients well in blender. Enjoy!

Calcium per serving: 243 mg.

Fantastic Fruit Parfait

Layer yogurt, low-fat granola and fruit in whatever proportions you’d like.

Add some nuts and you’ve included a 4th food group.

What about a supplement?

• Take no more than 500mg at a time

• Calcium citrate is recommended over calcium carbonate

500 mg

Remember to follow the prevention steps …

• Eat a healthy diet with plenty of foods high in calcium and vitamin D.

• Engage in regular exercise.

• Avoid smoking and excessive alcohol.

Support your

bones.

They support

you!

Questions ??