New Calcium Guidelines - A Roadmap for Healthy Bones
For the first time since the Recommended Dietary Allowances (RDAs) were originally published in 1941, the requirements for calcium have been increased. Citing substantial evidence that most Americans do not consume enough calcium to protect against bone loss, the Institute of Medicine of the National Academy of Sciences (NAS) has released new calcium recommendations that call for increased intakes for most age groups1.
Report Recasts Nutrient Requirements
The NAS panel asserts that the DRIs represent a major leap forward in nutrition science, from a primary concern with prevention of a deficiency to an emphasis on reducing the risk of chronic deseases, such as osteoporosis, cancer, and cardiovasular disease.
Aiming Higher to Build Bone
Calcium recommendations were set at levels associated with maximum retention of body calcium, because bones that are calcium rich are known to be less susceptible to fractures. A more contemporary functional indicator of adequacy was considered by the panel: calcium intake levels that are thought to lead to the fewest diet-related osteoporotic fractures later in life.
Identifying Adequate Intakes
- For most adults, the new guidelines say they need 1,000 milligrams of calcium a day, rather than 800 milligrams, as specified in 1989 when the RDAs were last updated. That is equivalent to an extra serving from the Milk group, such as one 8-ounce glass of milk, one cup of yogurt, or 1 1/2 ounces of cheese.
- Adults over 50, who often suffer bone loss due to aging, need even more calcium: 1,200 mg. a day.
- For adolescents (ages 9 to 18), whose growing bones need adequate calcium to reach peak bone density, the guidelines call for 1,300 mg, or four servings from the Milk group each day. This is a major jump for children ages 9 and 10, who previously were advised to get 800 mg.
- The new guidelines indicate that pregnant and breast-feeding women should get the amount recommended for their age group - not more, as previously advised. Research suggests that hormonal changes during pregnancy and lactation boost a women's abiltiy to absorb calcium and to adapt to the demands on her body during this time. Any calcium loss appears to be regained following lactation.
New Calium Goal (mg/day)
Closing the Calcium Gap
- Unfortunately, most Americans miss the mark in meeting even the old calcium requirements. Osteoporsis causes 1.5 million hip fractures each year in the US alone, resulting in health care costs of $13.8 billion. The Institute concludes in its report that it will worsen unless improvements are made in the typical American diet.
The average adult consumes 500 to 700 mg of calcium per day. Women in particular fall short: 9 out of 10 women in this country fail to get enough calcium. After the age of 11, no age group of females achieves even 75% of the calcium it needs.
First Stop is Food
Increasing calcium intake is best accomplished by eating foods rich in that nutrient. In addition, foods contain nutrients other than calcium that contribute to building bone. Studies indicate that when milk is the calcium choice, rather than a supplement, the overall nutrient quality of the diet is enhanced. Milk also offers vitamin D, which enhances calcium absorption. Taking supplements, however, may be appropriate for those at high risk of health problems because of low calcium intake, the panel concluded.
Additional calcium sources include milk products such as yogurt and cheese, sardines, canned salmon with bones, broccoli, leafy greens, and calcium-fortified foods. The panel emphasizes that calcium may be poorly absorbed from foods rich in oxalic acid (spinach, sweet potatoes, and beans) or phytic acid (grains, nuts, and soy isolates).
Fitting It In
Increasing calcium intake through food can be simple:
- Substitute milk for water in soups, hot cereal, pancake mixes, scrambled eggs, and other recipes.
- Sprinkle shredded lowfat cheese and chopped broccoli on a salad of dark leafy greens or a baked potato.
- Leave a pitcher of milk on the table during mealtime, encouraging teens to drink more than one glass.
- Snack on string cheese. Wrap it in a tortilla with salsa and heat in the microwave.
For More Information
- Check out the ADA's website at http://www.eatright.org/adamnt.html
- Contact your local Dairy Council for educational materials on calcium.
1. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D and Fluride. Washington, DC: National Academy Press, 2101 Constitution Avenue NW, Washington, DC 20418; 1997.
Information from a fact sheet from the American Dietitic Association through a grant from the National Dairy Council.