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How much calcium do we need? IAge II Daily calcium requirement 14 to 8 19 to 18 119 to 50 150 + 1pregnant or lactating women 18+ 11800 mg 111300 mg 111000 mg 111200 mg* 111000 mg I 1 *As per current Health Canada recommendations. How to maximize your calcium intake through diet Make sure that you are getting an adequate amount of calcium every day Consult a reliable food chart - like the one below - which shows the calcium content of specific foods. Calculate your daily calcium intake and see if you are achieving the levels recommended by Osteoporosis Canada in the chart above. Eat foods that contain calcium that Is easily absorbed Dairy products such as milk, cheese and yogurt are excellent sources of calcium because they contain high amounts of calcium that are easily absorbed by the body. Skim milk products provide as much calcium as whole milk with the added advantage of less fat and cholesterol. Some calcium-fortified soy beverages and orange juices may contain as much calcium as milk (check the labels). Vegetables also provide calcium, as do fish products containing bones (canned salmon and sardines) and meat alternatives such as lentils and beans. Pay attention to foods that cause calcium loss There is evidence to suggest that calcium loss through the urine is increased by the consumption of excess salt and caffeine. 90% Salt (sodium): Over of sodium comes from food rather than from table salt. Therefore, it is advisable to keep the intake of salt and salty foods to a minimum. Caffeine: Most experts agree that two to three cups of coffee or cola a day is probably not detrimental if calcium intake is adequate. If you consume more than four cups a day, have at least one glass of milk for every cup of caffeine-containing beverage (or make your coffee a cafe latte). If you eat few or no dairy products, monitor your calcium intake carefully Some people are unable or choose not to eat dairy foods. If you are one of these individuals, we strongly recommend that you educate yourself on the calcium content of other foods. Monitor your calcium intake very carefully (possibly with the help of a dietitian) and consider a calcium supplement to make sure you meet your daily requirement. When you can't get enough calcium from food If you find it difficult to obtain the recommended amounts of calcium through diet alone, a combination of foods rich in calcium and calcium supplements is a good strategy. Calcium supplements are tablets, capsules or liquids containing the mineral calcium from a non-food source. These sources include: • Calcium carbonate, which can be refined from limestone, natural elements of the earth, or may come from shell sources, usually oyster. Shell sources are often described on the label as a "natural" source. Calcium carbonate from oyster shells is not "refined" and can contain variable amounts of lead. • Chelated calcium, which refers to a special way in which calcium is chemically combined with another substance. Calcium citrate is an example of such a chelated preparation. Calcium may also be combined with other substances to form preparations such as calcium lactate or calcium gluconate. • Powdered bone (bonemeal) or dolomite, a mineral found in rock. (Bonemeal is not recommended, as it may contain contaminants.) Vitamin 0: A key factor in good calcium absorption Vitamin D, as well as calcium, is essential to preventing osteoporosis and may reduce other health risks such as diabetes and immune system disorders. While exposure to sunlight provides vitamin D, Canadians are at risk of seasonal vitamin D deficiency because winter sunlight in northern latitudes above 35 0 does not contain enough ultraviolet B for vitamin D production. Milk fortified with vitamin D3 contains 100 IUs per 250 ml glass. Foods such as margarine, eggs, chicken livers, salmon, sardines, herring, mackerel, swordfish and fish oils (halibut and cod liver oils) all contain small amounts. Supplementation is necessary to obtain adequate levels as dietary intake has minimal impact. Most multivitamins provide 400 IUs of vitamin D3. Some calcium supplements also contain vitamin D3. Osteoporosis Canada's new guidelines (July 2010) recommend daily supplements of 400 to 1000 IU for adults under age 50 without osteoporosis or conditions affecting vitamin D absorption. For adults over 50, supplements of between 800 and 2000 IU are recommended. For people who need added supplementation to reach optimal vitamin D levels, doses up to the current "tolerable upper intake level" (2000 IU) are safely taken without medical supervision. Doses above that require medical supervision. A daily supplement of 800 IU should be regarded as a minimum dose for all adults with osteoporosis. New 2010 Vitamin D recommendations Frequently Asked Questions Q. 1 do not have osteoporosis; how much vitamin D do 1 need? A. If you are under 50, do not have osteoporosis, and do not have a condition that interferes with vitamin D absorption, Osteoporosis Canada recommends daily supplements of 400 - 1000 IU daily. If you are over 50, supplements of between 800 and 2000 IU are recommended. Q. 1 have been diagnosed with osteoporosis; how much vitamin D do 1 need? A. A daily supplement of 800 IU is the minimum dose for adults with osteoporosis, regardless of age and doses up to 2000 IU are often recommended. Doses above that level may be prescribed by your doctor. Q. The suggested range for all ages is quite broad; how do 1 know how much vitamin D 1 actually need? A. The actual requirements for an individual may vary considerably, depending on a number of factors, including sunlight exposure, and winter travel to a southern location (below 35 degrees latitude). Certain medical conditions such as celiac disease increase requirements. For a healthy individual, the dose ranges suggested are safe, but for more specific recommendations you should discuss this with a health professional. Q. What are some conditions that can interfere with vitamin D absorption? A. Absorption of vitamin D can be interfered with by the following: • Malabsorption syndrome: a condition or disease that causes poor absorption of vitamins and minerals, including celiac disease; cystic fibrosis; chronic liver disease or inflammatory bowel disease such as Crohn's disease or ulcerative colitis • Having had gastric bypass surgery Q. Do I need to take these supplements all year round? A. Exposure to sunlight does provide vitamin D. But Canadians are at risk of vitamin D deficiency from October to April because winter sunlight in northern latitudes above 350 does not contain enough ultraviolet B for vitamin D to be produced. As one ages, the skin is less able to make vitamin D from sunlight exposure. There are very few food sources of vitamin D. The only naturally occurring ones are fatty fish and egg yolks. Milk, margarine, some soy beverages and some orange juices are fortified with vitamin D. Cheese and yogurt can be made from vitamin D fortified milk. Therefore, those over 50 or having been diagnosed with osteoporOSis are advised to take vitamin D supplements all year round. Q. Is there a maximum amount I can safely take? A. Canadians can safely take daily vitamin D supplements up to the tolerable upper intake level of 2000 IU; doses above that require medical supervision. calcium http://www.osteoporosis.ca/index.php/<;:iid/5535/Iaid/1.htm vitamin D http://www.osteoporosis.ca/index.php/ciid/5536/laid/1.htm