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 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Bones are living organs Calcium is deposited and withdrawn from bones daily.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:

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 Bone Mass

Osteoporosis Overview Osteoporosis Overview Bone with Osteoporosis Normal Bone Source: The 2004 Surgeon General’s Report on Bone Health and Osteoporosis: What It Means to You at 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

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:

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:

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: and National Osteoporosis Foundation Web site; retrieved July 2005 at

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 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 age Then you need this much calcium each day (mg) 0 to 6 months210 7 to 12 months270 1 to 3 years500 4 to 8 years800 9 to 18 years1, to 50 years1,000 Over 50 years1,200 Growth spurt Source: The 2004 Surgeon General’s Report on Bone Health and Osteoporosis: What It Means to You at

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 –Cheese300mg –Chocolate milk300mg Dinner –Spinach 123mg –Mac and cheese300mg

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

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 pudding 1/2 cup = 150mg (15% DV) Frozen yogurt, vanilla, soft serve ½ cup = 100mg (10% DV) Ice cream, vanilla ½ cup = 80mg (8% DV) Soy or rice milk, calcium-fortified 1 cup = varies—check label Choose fat-free or low fat most often

Calcium Sources: Grain products group Cereal, calcium- fortified Serving size and amount of calcium varies— check label

Calcium Sources: Vegetable group Broccoli, raw 1 cup = 90mg (9% DV) Collard greens, cooked 1/2 cup = 200mg (20% DV) Turnip greens, boiled 1/2 cup = 100mg (10% DV)

Calcium Sources: Fruit group Orange juice and other calcium-fortified beverages 6 oz. = 200mg to 300mg (20-30% DV, varies— check label ) Look for 100% juice

Calcium Sources: Meat & Beans Group Baked beans 1 cup = 140mg (14% DV) Salmon, canned, with edible bones 3 oz. = 180mg (18% DV) Sardines, canned, in oil, with edible bones 3 oz. = 320mg (32% DV) Soybeans, cooked 1 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

You need more vitamin D as you age Age Daily vitamin D needs in International Units (IU) 600 IU 200 IU 400 IU up to 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

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 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 ??