Calcium and Healthy Bones

Calcium and Healthy Bones

Everyone understands that calcium is essential for building and maintaining healthy bones. Calcium is used by our bone producing cells (osteoblasts) to formulate new bone. However most people aren’t aware of the role calcium plays in maintaining our body balance (homeostasis) in everyday life. A small amount of calcium is absorbed into the blood and used for the healthy functioning of the heart, muscles, blood and nerves.

Close to 99% of our calcium is stored in our bones. However we do gradually lose calcium through the skin, kidney and bowels from excretion. Your bones act like a calcium bank. If there is not enough calcium in your diet your body will take what is needed from your bones for use in other parts of the body. If this happens your bone density (bone strength) will gradually decline and you may be at risk of developing osteoporosis.

Osteoporosis (meaning ‘porous bones’)

is a condition that causes bones to become thin, weak and fragile. As a result, even a minor bump or accident can cause a fracture (broken bone). Fractures due to osteoporosis can result in chronic pain, disability, loss of independence and premature death.

Peak Bone Mass (PBM)
The best chance we have of avoiding Osteoporosis is to build up a really large calcium bank (strong bones) while we are young. Childhood and young adulthood are the bone building years. Bone mass increases by about sevenfold from birth to puberty and a further threefold during adolescence and then remains stable until about age 50 in men and until the menopause in women.

During the adolescent growth spurt, the required calcium retention is two to three times higher than that required for the development of peak bone mass (PBM) which occurs at the same time as maximum height. PBM is the greatest amount of bone an individual can attain. Children and adolescents who have higher PBM reduce their risk of osteoporosis later in life.

Calcium deficiency in young people can account for 5-10 percent lower peak bone mass and can significantly increase a person’s risk for hip fracture in later life.

Menopause and Calcium
Calcium balance deteriorates for women at menopause when there is a decline in intestinal calcium absorption and/or an increase in urinary calcium excretion. In post menopausal women, there is evidence that a high calcium intake will slow the rate of bone loss and may reduce the risk of fracture.

Calcium needs vary throughout life
The recommended dietary intake of calcium is different for people of different ages and life stages.

Calcium and food
The best way to achieve recommended calcium intake is to eat a diet rich in calcium. Calcium content in food varies so it is important to consume ‘calcium rich’ foods. Half of all Australian adults do not achieve their daily recommended intake of calcium. It is easy to add calcium to your diet by focusing on food groups which contain higher levels of calcium.

Click on the file below to see a more extensive table of calcium content in food.

Do we absorb all the calcium we eat?
Not all the calcium we consume is absorbed. A small amount of calcium will be lost and excreted from the body which is normal. This is factored into the recommended intake for your age. Other factors can impact calcium absorption and should be discussed with your doctor, for example:

  • Low vitamin D levels
  • Excessive caffeine and alcohol intake
  • Certain medical conditions (for example coeliac disease, kidney disease)

Calcium supplements
It is much better to get calcium from foods (which also provide other nutrients) than from calcium supplements. But if you have difficulty eating enough foods rich in calcium, you might need to consider a calcium supplement, especially if you are at risk of developing osteoporosis. Before taking supplements, it’s best to discuss this with your doctor or other registered healthcare professional.

If you do take calcium supplements, make sure you don’t take more than the amount recommended on the bottle. Too much calcium may cause gastrointestinal upsets such as bloating and constipation and, rarely, other complications such as kidney stones.

Lifestyle can affect bone strength
Some of the factors that can reduce calcium in your bones and lower your bone density (weaken your bones) include:

  • high-salt diet
  • more than six drinks per day of caffeine-containing drinks – for example, coffee, cola and energy drinks (and, to a lesser extent, tea)
  • excessive alcohol intake
  • very low body weight
  • very high intakes of fibre (more than 50 g per day, from wheat bran)
  • low levels of physical activity
  • low levels of vitamin D – people who are housebound or cover their bodies completely when they are outside are at increased risk
  • smoking.

Diagnosed osteoporosis and calcium.
For people with diagnosed osteoporosis calcium alone is not sufficient, osteoporosis medication is generally required as directed by your doctor. It is common practice for doctors to prescribe calcium supplementation to accompany osteoporosis medication. Adequate calcium intake throughout adult life helps support bone health but may not prevent osteoporosis as other factors can negatively impact your bone health.

Vitamin D and Healthy Bones

Vitamin D and Healthy Bones

Did you know vitamin D is really not a vitamin. Vitamins are special nutrients that the body needs but cannot make on its own, so they must be obtained from what we eat or by supplements. Our bodies actually make vitamin D in our skin when it is exposed to good sunlight, therefore Vitamin D is considered a hormone. Vitamin D is an essential nutrient that helps your body absorb the calcium it needs to keep your bones and muscles strong and healthy.

What happens if I don’t have enough vitamin D?
Children and infants who lack vitamin D develop the condition called rickets, which causes bone weakness, bowed legs, and other skeletal deformities, such as stooped posture.

Adults who lack vitamin D are at risk of developing Osteoporosis (meaning ‘porous bones’), which is a condition that causes bones to become thin, weak, fragile and more susceptible to fracture. Osteoporosis occurs when your bones lose calcium and other minerals. Vitamin D is required to help your body to absorb calcium to help build strong bones.

People with very low levels of vitamin D (moderate to severe deficiency) are the most at risk of developing health problems. A number of diseases have been linked to low vitamin D levels such as increased risk of death from cardiovascular disease, cognitive impairment in older adults, severe asthma in children and cancer. Research suggests that vitamin D could play a role in the prevention and treatment of a number of different conditions, including type1 and type 2 diabetes, hypertension, glucose intolerance, multiple sclerosis, severe symptoms of COVID.

People most at risk of vitamin D deficiency are the elderly and people with certain medical conditions such as liver disease and kidney disease, and those with problems absorbing food, including cystic fibrosis, coeliac disease and inflammatory bowel disease. Some medicines can also contribute to vitamin D deficiency. A blood test can confirm whether you have a vitamin D deficiency.

Where do we obtain Vitamin D?
Vitamin D is obtained from 3 sources:

  • sunlight exposure
  • foods
  • supplements

Most Australians get their vitamin D when they expose bare skin to ultraviolet B (UVB) light from the sun. But we all know that increased sun exposure can lead to increased risk of developing skin cancer. So how much sun exposure is the right amount? Recommendations on this are a little tricky because a fair-skinned person might get enough vitamin D from 15 minutes of sun exposure per day, whereas someone with darker skin might require an hour or two of sun exposure to get enough Vitamin D. Other factors that impact your ability to make vitamin D from sunlight include : the time of day, how far you live from the equator, how much skin you expose to sunlight and whether you’re wearing sunscreen. People who live farther away from the equator typically need more sunlight because the sun’s UV rays are weaker in these areas.

Be sensible with sun exposure and make sure not to burn your skin. Also, never use a solarium to boost vitamin D levels because they emit dangerous levels of ultraviolet (UV) radiation that increase your risk of skin cancer.

If you live further from the equator or need to avoid sun exposure you will need to obtain a larger proportion of your vitamin D from foods, particularly through the winter months. Foods that contain small amounts of vitamin D include :

Fatty fish, like salmon, tuna, and mackerel

  • Beef liver, some cheeses, and egg yolks
  • Foods with added vitamin D, such as milk, orange juice, and cereal
  • Infant formula is also fortified with vitamin D in Australia.

Other dairy products — such as yogurt and cheese — are typically not fortified with vitamin D.

It can be difficult to get enough vitamin D from food so it may be easier to take a vitamin D supplement. Experts recommend 600 international units (IU) of vitamin D per day for adults up to age 70, and 800 IU for people 71 and older.

Vitamin D supplements come in many different strengths and dosages. They can be low dose — which you take every day — or high dose, which you take monthly or less frequently.

Too much vitamin D can also cause health problems including weight loss, heart rhythm problems or damage to the heart, blood vessels and kidneys.

It’s not possible to get too much vitamin D from sunlight, but if you are taking vitamin D supplements it’s important to speak to your doctor or pharmacist to check you are taking the right dose.