If you are age 30 or older, your bones are slowly losing calcium. And if you aren’t eating right and exercising, you may be setting yourself up for bone fractures in the future.
Women have less bone tissue than men and lose bone more rapidly, particularly as we reach our 40s and beyond, when loss of estrogen begins to rob your bones of its needed calcium. As a woman, you have about a one in two chance of breaking a bone due to osteoporosis after age 50. In fact, a woman’s risk of a hip fracture is equal to her risk of breast, uterine and ovarian cancer combined, according to the National Osteoporosis Foundation.

But don’t put osteoporosis in the category of an old woman’s disease. The fact is that it can strike at any age and gender, although men account for only 20 percent of all cases. Small, thin-boned, Caucasian and Asian women are at high risk, as are those with a family history of osteoporosis. Vegetarians who do not eat dairy products may be vulnerable. Also, certain medications (e.g. steroids, contraceptives), diseases and conditions (e.g., lupus, cancer, thyroid) can raise your risk.

The problem is that we may not even know our bones are thinning and weakening. There are no symptoms until one day you fall and fracture a bone. The key is to prevent the disease or postpone its onset before you start to lose bone density.

What you can do

You may not be able to change your body type or hereditary factors, but you can get needed calcium in your diet, soak up some vitamin D, which helps calcium absorb, and

exercise to strengthen your bones. Stop smoking and limit excessive consumption of alcohol; they prevent calcium absorption.

The National Osteoporosis Foundation recommends that adults under age 50 need 1,000 mg of calcium from all sources every day. That includes a combination of calcium-rich foods like low-fat or non-fat milk, yogurt and cheese and, if necessary, calcium supplements. For people who are lactose intolerant, lactose-free dairy products and lactase enzyme pills are available. Other foods with smaller amounts of calcium include certain green vegetables, like spinach and broccoli, salmon (with bones) and foods fortified with calcium. The latter include some juices, breakfast foods, soymilk, cereals, snacks, breads and bottled water.

Your diet also affects how much calcium is eliminated from the body. High intakes of sodium and caffeine increase calcium excretion, as do diets high in protein and cereal grains. On the other hand, fruits and vegetables when metabolized produce bicarbonate, which reduces calcium loss.

An active lifestyle is another key to building bone density.

Walk. Jog. Dance. Play tennis. Do any kind of weight-bearing exercise. Resistance exercises (such as calisthenics and those that involve weights) also support bone health.

What about calcium supplements?

Last month, a study was released that suggests taking calcium supplements with or without vitamin D may increase the risk of heart attack and stroke. Calcium can clot blood, and researchers suspect that the sudden spike of high blood calcium levels leads to greater cardiovascular risk. The findings, which re-analyzed data from the Women’s Health Initiative (WHI), have been refuted by the original WHI researchers, however, claiming that the new study included selectively reviewed data from a subgroup of women. According to the Institute of Medicine’s Food and Nutrition Board, which reviewed various studies in 2010, the totality of the evidence does not support a link between calcium and cardiovascular disease risk.

So what’s a gal to do?

The National Osteoporosis Foundation recommends taking a supplement only if you are unable to get sufficient amounts of calcium from your diet and, then, only taking the amount needed to get you to the recommended dose of 1,200 mg a day. According to most experts, the safe upper limit for total daily calcium intake from all sources is 2,000 – 2,500 mg.

For best absorption, take calcium supplements in amounts of 500 mg or less. If you’re taking a total of 1,000 mg a day, break the total into two doses of 500 each.

Both of the two main forms of calcium supplements, carbonate and citrate, are similarly well absorbed. But the Office of Dietary Supplements of the National Institutes of Health suggests that individuals with reduced levels of stomach acid can absorb calcium citrate more easily. Calcium carbonate should be consumed with food, whereas calcium citrate supplements can be taken either with or without food.

Calcium supplements can interact with several types of medicines. Check with your doctor or pharmacist before beginning any supplement to discuss possible interactions with over-the-counter or prescription medications you are taking.

Diagnosis and treatment

Osteoporosis can be diagnosed with a bone density test and may be recommended for premenopausal women who are at high risk and have fractured bones. To prevent and treat osteoporosis, the Food and Drug Administration (FDA) has approved medicines that either slow or stop bone loss or rebuild bone. They are not approved for premenopausal women except for those who have osteoporosis due to taking steroid medicines.

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