Question: I don't get enough calcium in my diet. How much do I need, and are there different kinds?
E.A., Columbia, Missouri
Answer:Although many people are aware of the importance of calcium, it is among the nutrients most lacking in the American diet. Guidelines by the National Institutes of Health indicate adults need 1,000-1,500 milligrams a day. Surveys show we average only about 500-600 milligrams daily.
I recommend that men and women supplement their diets with 1,000 milligrams. The other 500 milligrams can come from the diet, through such sources as low-fat dairy; soy products; and spinach, kale and other leafy green vegetables.
What kind of calcium should you take? The key is to take more than one type, through a supplement that combines various kinds.
Calcium citrate is the supplemental form the body absorbs best, but it's difficult to manufacture in pill form. To get the proper amount, you need to take three large calcium-citrate tablets daily.
The most highly concentrated form of calcium is calcium carbonate. Its advantage is that because it is concentrated fewer milligrams are needed. But it would be a mistake to take only a calcium carbonate supplement.
The reason is that stomach acid plays a vital role in the body's ability to absorb calcium carbonate. As we age, we all develop a common condition known as "atrophic gastritis" that causes a slight deficiency of stomach acid. But by consuming a calcium supplement with meals, as part of your daily nutrient supplement, you will ensure its absorption.
In formulating an ideal calcium supplement, I have found that it is better to pick a variety of forms. A combination of types will ensure ideal utilization and uptake by the body.
I recommend, in fact, four forms of calcium--citrate, carbonate, ascorbate and gluconate--at a total dosage of 1,000 milligrams daily. This will ensure maximum concentration and maximum absorption. Also, remember that vitamin D is essential for your body to make proper use of calcium. Therefore, include 400 IU (International Units) of vitamin D daily, as well.
So the next time you consider your calcium needs, think beyond one type only. Find a quality supplement that contains all four kinds.
But don't forget to include some great food sources--such as nonfat milk, yogurt, spinach, salmon and almonds--to fulfill your daily calcium requirements.
Question: Can drinking cola weaken my bones even if I get a lot of calcium in my diet?
S.P., Lexington, Kentucky
Answer:Unfortunately, drinking more milk or eating more dairy products does not compensate for the damage cola can have on your bones.
In a Tufts University study, women who drank cola daily had lower bone-mineral density than those who drank cola once a week (or less often) or drank clear soda. Both groups had similar calcium intake.
The decrease in bone density wasn't caused by lower calcium, according to Katherine Tucker, Ph.D., associate professor of nutritional epidemiology at Tufts. It apparently resulted from increased levels of phosphoric acid, which can interfere with absorption of calcium.
Cola contains 44-62 milligrams of phosphoric acid per 12-ounce serving (the volume of a typical can). It is added to cola, but not to other sodas, to give it tartness.
In everyday foods, including dairy products, phosphoric acid doesn't appear to cause the same problem, because when it's packed with other nutrients the body absorbs it normally. Cola combines phosphoric acid without any calcium, and as a result "that extra phosphorus binds with calcium and prevents it from being absorbed," Tucker stated.
Colas, and all soft drinks for that matter, don't have any nutritional value and are virtually "empty calories." It's best to substitute soft drinks for more nutritious beverages such as sugar-free, all-natural juices; nonfat or low-fat milk; and water. All of these are very good for your health and your bones.
Reginald B. Cherry, M.D., has been practicing diagnostic and preventive medicine for more than 30 years and specializes in the use of nutrition, exercise and natural supplements to lower disease risk. He is the author of several best-selling books and teaches health and healing through his weekly television program, The Doctor and the Word. For more about his ministry, visit www.drcherry.org. Before taking any nutritional supplement, consult your doctor.