Do you Really Need Milk to get your Daily Dose of Calcium?

You don’t need milk, but you do need calcium and vitamin D. In many areas across the U.S., such as urban food deserts and rural areas, milk may be one of the only calcium-rich foods available. So unfortunately, people living in these areas might not have a choice. In other areas where a wide variety of foods is the norm, you could easily consume enough calcium without including milk in your diet.

According to the Office of Dietary Supplements of the National Institutes of Health (NIH):

Calcium is required for vascular contraction and vasodilation, muscle function, nerve transmission, intracellular signaling and hormonal secretion, though less than 1% of total body calcium is needed to support these critical metabolic functions. Serum calcium is very tightly regulated and does not fluctuate with changes in dietary intakes; the body uses bone tissue as a reservoir for, and source of calcium, to maintain constant concentrations of calcium in blood, muscle, and intercellular fluids. The remaining 99% of the body’s calcium supply is stored in the bones and teeth where it supports their structure and function.

The recommended daily intakes (RDI) are 1,300 mg for teens 14 to 18 years of age and 1,000 mg for adults ages 19 to 50 (males up to age 70). Females age 51 to 70 need 1,200 mg and all adults over 71 need 1,200 mg. Infants need the least amount of calcium, so the risk of inadequate intake is miniscule. Babies from 0 to 6 months need 200 mg and ages 7 to 12 months need 260 mg. Toddlers ages 1 to 3 need 700 mg, children ages 4 to 8 need 1,000 mg, and kids and tweens ages 9 to 13 should consume 1,300 mg.

Although milk has been heavily marketed as the best way to get the calcium you need for strong bones, there are many other foods that contain more or just as much calcium per serving as milk. Eight ounces of milk contains anywhere from 285 to 302 mg per serving, depending on whether it’s nonfat, reduced fat, lactose-reduced or whole. Foods that contain around the same or more calcium than milk include:

-Sardines (324 mg per serving)
-Cheddar cheese (306 mg)
-Calcium-fortified cereal (100-1,000 mg per serving)
-Soy milk (80-500 mg per serving)
-Yogurt (415 mg plain, 245-384 mg fruit)
-Calcium fortified orange juice (200-260 mg)
-Mozzarella (275 mg)

If you’re allergic to dairy products, you can still get enough calcium by eating sardines, salmon (181 mg per serving), spinach (120 mg), tofu (138 mg), turnip greens (99 mg), kale (90 mg), Chinese cabbage (74 mg), and instant breakfast drinks (105-250 mg). Bread, broccoli, sour cream, tortillas, frozen yogurt, cottage cheese, pudding and cream cheese also contain calcium.

Doctors agree that obtaining calcium mainly from food sources is best, but supplements can fill the gaps when needed. The two main forms of calcium in supplements are carbonate and citrate. Calcium carbonate is the most popular of the two, it’s widely available, and it’s inexpensive. Both forms of calcium are well absorbed, but calcium citrate is better tolerated and absorbed by individuals with reduced levels of stomach acid. The body can absorb calcium citrate effectively when taken with or without food. Calcium carbonate is absorbed more efficiently when consumed with food.

There are several other types of calcium that can be found in supplements and fortified foods. They are:

-Gluconate
-Lactate
-Phosphate

Several different forms of calcium can be found in calcium-fortified juices, but a popular type is calcium citrate malate. This form of calcium is well absorbed by the body and it’s also inexpensive.

For more information about calcium and to print a food chart that lists calcium rich foods along with daily values, visit the Office of Dietary Supplements of the National Institutes of Health at http://ods.od.nih.gov/.

  

Benefits of Vitamin D

Natural vitamin D is elusive. This necessary nutrient is naturally found in just a handful of foods, but it can be found as an additive in many processed and packaged foods. Vitamin D is also available in supplement form. Fortunately, the average healthy person gets enough vitamin D from sun exposure and food, so deficiencies among healthy adults is uncommon.

According to the Food and Nutrition Board of the Institute of Medicine of the National Academies (IOM), approximately 5–30 minutes of sun exposure between 10 AM and 3 PM at least twice a week to the face, arms, legs, or back without sunscreen usually lead to sufficient vitamin D synthesis. Moderate use of commercial tanning beds that emit two to six percent UVB radiation is also effective. Individuals with limited sun exposure need to include good sources of vitamin D in their diet or take a supplement to achieve recommended levels of intake.

The best food sources of vitamin D are the flesh of fatty fish such as tuna, salmon and mackerel. Fish liver oils, such as cod liver oil are also excellent sources. For example, one tablespoon of cod liver oil contains 1,360 IU (international units) of vitamin D. This is 340 percent of the recommended daily amount (RDA). Salmon, mackerel and tuna have 39-112 percent of the RDA. Small amounts of vitamin D can be found naturally in mushrooms, beef liver, egg yolks, and cheese. They contain anywhere from 2-15 percent of the RDA.

Fortified foods contain vitamin D as well. Fortified milk, orange juice, yogurt, breakfast cereals, margarine, and soymilk contain anywhere from 10 to 31 percent of the RDA. For example, fortified cereal contains 10 percent of the RDA and soymilk contains 30 percent. Fortified milk averages 29 to 31 percent.

The RDA for vitamin D is 400 IU for adults and children age 4 and older. For seniors, the RDA is between 400-600 IU. However, research shows that higher daily doses of 700-800 IU may reduce the risk of fracture in adults aged 60 and older by 25 percent. A reduced risk of fracture is just one benefit of vitamin D. Other benefits include:

-Helps maintain normal blood levels of calcium and phosphorus (vitamin D’s major biological function)
-Aids in the absorption of calcium
-Protects against osteoporosis and osteomalacia (hardens bones and teeth)
-Protects against hypertension (high blood pressure)
-Protects against cancer
-Protects against several autoimmune diseases
-Protects against rickets in children

Sun exposure and consumption through major and fortified food sources should provide enough vitamin D, so supplements are not usually necessary for healthy adults. However, vitamin D deficiency is possible, especially in the elderly population, obese people, exclusively breastfed babies, individuals with fat malabsorption syndromes, individual’s with inflammatory bowel disease, and individuals who have limited sun exposure. In these cases, a supplement may be necessary.

A physician will determine the amount needed to correct vitamin D deficiency, but the tolerable upper intake levels (ULs) are:

-0 to 6 months: 1,000 IU (25 mcg)
-7 to 12 months: 1,500 IU (38 mcg)
-1 to 3 years: 2,500 IU (63 mcg)
-4 to 8 years: 3,000 IU (75 mcg)
-9 years and older: 4,000 IU (100 mcg)
-Pregnant or lactating: 4,000 IU (100 mcg)

When vitamin D deficiency occurs, symptoms may or may not be present until disease has developed. If symptoms are present, they may include:

-Bone pain
-Delayed tooth formation
-Dental deformities
-Loss of height
-Muscle cramps
-Poor growth in children
-Poor posture
-Spine and other bone deformities
-Tingling
-Weakness

While the consuming the right amount of vitamin D has many benefits, over consumption can be dangerous. Taking too much vitamin D can cause nausea, weight loss, and irritability. Severe side effects include mental and physical growth retardation, movement of calcium from bones into soft tissues, and kidney damage.

For more information about vitamin D, visit the Office of Dietary Supplements, National Institutes of Health at http://ods.od.nih.gov/.

  

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