1. Calcium Recommendations and Food Sources

2. Calcium Recommendations ◦ Adolescence: 1300 mg/day ◦ Ages 19-50: ______ mg/day ◦ Over 50: 1200 mg/day ◦ DRI for Calcium DRI for Calcium  http://www.cengage.com/nutrition/discipline _content/tables/0-534-558986-7_B.pdf http://www.cengage.com/nutrition/discipline _content/tables/0-534-558986-7_B.pdf

3. Calcium in foods ◦ Milk & milk products ◦ Calcium _____________ products ◦ Some vegetables

4. Label Key: Fruits Milk and milk products Legumes, nuts, seeds Meats Best sources per kcalorie Breads and cereals Vegetables CALCIUM As in the riboflavin figure, milk and milk products (white) dominate the calcium figure. Most people need at least three selections from the milk group to meet recommendations. a Values based on products containing added calcium salts; the calcium in 1 ⁄ 2 c soybeans is about 1 ⁄ 3 as much as in 1 ⁄ 2 c tofu. b If bones are discarded, calcium declines dramatically. Food Serving size (kcalories) Milligrams AI for men 19–50 AI for men 51+ AI for women 19–50 AI for women 51+ Calcium in Selected Foods

6. Percent Daily Value (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/bonehealthhttp://www.surgeongeneral.gov/library/bonehealth

7. % DV calcium: Milk group Yogurt 1 cup (8 oz.) = 30% DV Milk 1 cup = 30% DV Cheese 1 ½ oz. natural/2 oz. processed = 30% DV Milk pudding 1/2 cup = 15% DV Frozen yogurt, vanilla, soft serve ½ cup = 10% DV Ice cream, vanilla ½ cup = 8% DV Soy or rice milk, calcium-fortified 1 cup = varies—check label Choose fat-free or low fat most often

8. % DV calcium: Grain products group Cereal, calcium- fortified Serving size and amount of calcium varies— check label

9. % DV calcium: Vegetable group Broccoli, raw 1 cup = 9% DV Turnip greens, boiled 1/2 cup = 10% DV Collards 1/2 cup = 20% DV

10. % DV calcium: Fruit group Orange juice and other calcium- fortified beverages 6 oz. = 20 to 30% DV, varies—check label Look for 100% juice

11. % DV calcium: Meat & Beans Group Baked beans 1 cup = 14% DV Salmon, canned, with edible bones 3 oz. = 18% DV Tofu, firm, with calcium ½ cup = 20% DV; check label Soybeans, cooked 1 cup = 26% Sardines, canned, in oil, with edible bones 3 oz. = 32% DV

12. When you don’t like to “drink” milk

14. Vitamin D necessary for calcium absorption Vitamin D is like a key that unlocks the door and lets calcium into the body. It’s not necessary to consume calcium and vitamin D at the same time to get the benefit of enhanced calcium absorption.

15. Where can we get 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

16. 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 http://www.nof.org

17. Vitamin D Supplements Choose a supplement with vitamin D unless obtaining vitamin D from other sources. Follow age group recommendation. Avoid going over a daily combined total of 2,000 IU or 50 mcg from food and supplements.

18. Help for the lactose-intolerant Some people lack the enzyme _________ needed to digest lactose (milk sugar). Symptoms: diarrhea & intestinal gas

19. Lactose Intolerance Treatment: Individualized ◦ Small amounts of milk @ a time (2c/day; divided) ◦ Aged cheese ◦ Yogurt with live bacterial cultures ◦ Lactose free milk ◦ Specially prepared milk products treated with the enzyme ◦ Enzyme tablets ◦ Ca and Vitamin D supplements if needed

22. In 1994, Congress passed the Dietary Supplement Health Education Act (DSHEA) which severely restricted the FDA’s authority over dietary supplements so long as the product makes no claim to affect a disease. Supplements are presumed ______ until the FDA receives well-documented reports of adverse reactions. Supplements are not obliged to meet any standards of _____________ or safety.

23. Products cannot state on the label that they will “prevent,” “treat,” “diagnose,” ”mitigate,” or “cure” disease. Product must carry a disclaimer on the label - “This product has not been evaluated by the Food and Drug Administration.” FDA can require that supplements follow “good manufacturing practices.” This specifies sanitation standards, not efficacy or purity.

24. Not if we follow a well-balanced diet MyPlate & Dietary Guidelines Who may need a supplement? ◦ Very low kcalorie dieters ◦ Individuals on certain ______ ◦ Vegans ◦ Pregnant/breastfeeding women ◦ Women in child-bearing years ◦ Individuals with Lactose-Intolerance ◦ _________ ◦ Individuals with increased nutrient needs ◦ Those with alcohol or drug addictions

25. Correct a ____________ Decrease risk of ____________

26. Dietary insurance Belief that the food supply contains inadequate nutrients Belief that they can enhance athletic performance Belief that they can help one cope with stress Belief that they can prevent, treat, or cure conditions

27. Our problem is overnutrition. Most people need to change their eating and exercise habits….. much harder to swallow than a pill.

28. Risk of _________ Life-Threatening Misinformation False Sense of Security Nutrients taken in pure (concentrated) form at high levels are likely to interfere with the absorption of other nutrients.

29. More ___________ does not mean better Meets USP standards for manufacturing Check expiration date Contains ______ vitamins & minerals ◦ no more than _______% of the recommended DV for each Avoid products with PABA, hesperidin, inositol, and bee pollen

30. Natural is not better than synthetic ◦ Exception: vitamin E and folate __________ proof containers Avoid supplements with herbs  Should have a good balance of all needed nutrients to ensure adequate absorption of them Avoid supplements with ◦ > recommended amounts of vitamin A or D ◦ > 10x the recommended amount for any other nutrient