Perth Diet Clinic

The best source of dietary calcium is dairy foods eg milk, cheese, and yoghurt. Aim for 3 serves of dairy foods daily or 3 serves of calcium fortified soy products.

If fat or cholesterol is a problem, choose low fat dairy products. Smaller sources of calcium are obtained from canned fish with bones, grains, vegetables, nuts and seeds.

FOOD SOURCES PROVIDING APPROXIMATELY 300 mg CALCIUM
Quantity	Food	Kilojoules	Calories
250 ml	Whole Milk	700	167
215 ml	Hilo Milk	510	122
200 ml	Browne’s Non-fat Milk	315	75
175 ml	Pura Tone	335	80
160 ml	Calcium Plus or Fitness Milk	360	85
24 g (3 level tabsp)	Skim Milk Powder	360	85
250 ml	So Good Soy Milk	650	155
200 g	Yoghurt- Natural No-fat	500	120
200 g	Yoghurt- Flavoured Non-fat	690	165
35 g	Cheddar Cheese	580	140
38 g	Devondale No 7 (7%fat) Cheese	220	52
360 g	Creamed Cottage Cheese	1635	390
260 g	Low fat Cottage Cheese	995	240
100 g	Canned Sardines with bones	835	200
100 g	Canned Salmon with bones	670	160
6 only	Oranges	1758	420
1 kg	Broccoli	980	230
20 slices	Wholemeal Bread	2600	620
120 g	Chocolate (20 squares)	2680	640
230 g	Ice cream (over 4 large scoops)	1725	414
30 g	Sesame seeds not hulled, they usually are	730	175
130 g	Almonds	3080	735

Calcium Supplements

If it is difficult for you to obtain adequate calcium from your diet, you need to consider a calcium supplement. Calcium supplements are best taken before bed because calcium uptake by bones peaks during the night.

Excess calcium can accumulate in the kidneys causing kidney stones. Check with your doctor before taking calcium supplements, especially if there is a family history of kidney stones.

Test for Osteoporosis

There is now available a Bone Mineral Density (BMD) test which accurately predicts the chances of developing osteoporosis. The BMD measures the concentration of minerals in bones to determine how strong and resistant to fractures they are.

It is advisable to have a BMD at the start of menopause before the damage is done. If treatment is begun at the time of menopause calcium loss from bones can be minimised. Once humping of the spine or fractures have occurred it is difficult to replace the calcium that has been leached out.

Treatment

The best treatment requires calcium supplementation and hormone replacement therapy (HRT), together with regular weight-bearing exercise eg walking and exercise using light-weights.

HRT is the most effective method of preventing osteoporosis. It maintains bone size and strength and minimises fractures.

HRT is usually a combination of oestrogen and progesterone and ideally therapy begins when oestrogen deficiency first appear early in menopause.

Risk Factors in Osteoporosis

• Age - The longer we live the more likely we are to develop osteoporosis.
• Hereditary Factors - Genetic factors are important in determining the density of your bones. You have a higher than average risk if your mother, grandmother or sisters have developed osteoporosis. You can help to offset this by ensuring a healthy lifestyle and a calcium rich diet.
• Race - Caucasian (fair skinned) and Asian women are at a greater risk as these racesl have less dense bones.
• Build - Thin and small boned people have greater risk because of their lighter bones.
• Menopause - The loss of production of the female hormones, oestrogen and progesterone, at the time of the menopause is the major cause of osteoporosis. The earlier the menopause, the longer a woman spends in the post-menopausal state and the greater her chances of developing osteoporosis.
• Diet
  • Alcohol, Salt, Caffeine- Those who have a high intake of alcohol, salt and caffeine drinks eg tea, coffee and cola have a greater risk of osteoporosis.
  • Kilojoules (Calories)- The amount of oestrogen produced by the body is affected by the amount of body fat. Trying to attain an 'ultra slim' body may result in low levels of oestrogen causing a risk of osteoporosis.
  • Chronic dieters, who consume a low kilojoule diet, especially if their menstrual periods are infrequent, may suffer with a premature oestrogen deficiency causing osteoporosis.
  • Calcium and Vitamin D-There is a greater risk of osteoporosis if the diet is lacking in calcium and/or vitamin D. Vitamin D is essential for calcium absorption. Vitamin D is synthesised in the skin when it is exposed to direct sunlight. Vitamin D deficiency is not common in Australia except for some elderly people who are house- bound and therefore not exposed to sunlight.
• Smoking - This reduces the production of female hormones from the ovaries thereby increasing calcium and mineral loss from the bones and increasing the risk of osteoporosis.
• Exercise - Those who do not do regular weight-bearing exercise have a greater risk of osteoporosis. Recommended activities include walking, jogging, tennis, golf, dancing, lawn bowls and working out at the gym with light weights.
• Medications - Long term use of antacids containing aluminium may increase loss of calcium from the bones. Cortisone type drugs also accelerate loss of calcium from the bones.

In Summary - How can we prevent osteoporosis

Although there are some risk factors we cannot alter, there are things we can do to increase or maintain the strength of our bones to help protect ourselves against osteoporosis.

These habits should start in childhood and continue through out life.

• Maintain an adequate dietary calcium intake by eating a varied and balanced diet.
• Participate in regular weight-bearing exercise, eg walking, running, tennis and dancing, on a regular basis.
• Moderate alcohol, coffee and salt intakes and avoid smoking.
• Seek medical advice around the time of menopause regarding bone density measurement and hormone replacement therapy.