1. Vitamin D is necessary for absorption of calcium. It is formed by the body when the skin is exposed to sunlight (ultraviolet light). For those who avoid exposure to sunlight and for black people who are protected from ultraviolet light by skin pigment, vitamin D fortified milk or a vitamin D supplement may be necessary.
2. Phosphorus is a mineral people get from eating protein rich foods such as meat and milk. Some soft drinks, such as colas, also contain phosphorus. While phosphorus is needed to form bones and teeth, medical studies have shown that too much phosphorus in the diet may upset the calcium balance in humans. A good guide is not to go over twice the RDA of protein, and to limit the intake of carbonated beverages.
3. Fiber should be part of a healthy diet. There are certain types of fiber that can affect the amount of calcium the body absorbs. Rhubarb, spinach, chard, and beet greens contain oxalate, which may decrease the absorption of calcium. Phytic acid, found in wheat bran, combines with calcium and also decreases its absorption. Fiber, however, is very helpful to the digestive tract, so it is important to balance the level of calcium intake with the amount and type of fiber in the diet. A diet containing up to 35 grams of fiber per day should be adequate for healthy bowel movements, without adversely affecting calcium absorption.
4. Caffeine increases the loss of calcium through the kidneys and intestines. While a moderate amount of caffeine per day (300-400 mg) has only a small effect, more caffeine may cause a much greater loss of calcium. Therefore, avoid
   • drinking more than three cups
   • of regular coffee or other high
   • caffeine beverages a day.
5. Excessive alcohol intake may lead to loss of calcium in the bone. Poor nutrition is often related to abuse of alcohol. It has also been shown that alcohol has a toxic effect on the formation of bone cells. Do not have more than one or two drinks per day. One drink would be 12 oz of beer, 5 oz of wine, or 1.5 oz of 80 proof distilled spirits.
6. Lifestyle can have an effect on the risk of developing osteoporosis. Cigarette smoking increases bone loss, and it may cause lower estrogen levels. Regular exercise, including moderate weight-bearing exercise, helps prevent bone loss and increases the total amount of bone in the body. This is especially important for the elderly who tend to become sedentary. Examples of weight-bearing exercises include walking, cross-country skiing, jogging, aerobic dancing, and weight-training. The use of estrogen replacement therapy is very helpful for women who are no longer producing estrogen. Estrogen replacement must be prescribed by a physician.
7. Food sources of calcium include milk and dairy products, which are the best sources of absorbable calcium. About 25% to 35% of the calcium in dairy products is absorbed in normal healthy people. Dark green leafy vegetables also contain moderate amounts of calcium, but their content of oxalate and fiber may cause less of the calcium to be absorbed. Whole grain flours contain more calcium than milled white flours; however, whole grain flours contain more fiber and phytic acid. Fish and tofu (processed with calcium) are also good sources of calcium. Foods such as orange juice, breakfast cereals, breads, milk, and yogurt are often fortified with calcium. Product labels should be checked for the amount of calcium the foods contain.
8. Calcium supplements may be necessary to get adequate calcium intake. A physician or registered dietitian should be consulted about the need for calcium supplements. Several different forms of calcium supplements are available. Calcium carbonate is generally recommended because it contains the highest percentage of absorbable calcium, 40%. Calcium citrate is 21% calcium; calcium lactate is 13%; and calcium gluconade is only 9% calcium. Bone meal and dolomite are not recommended because they may contain toxic substances such as lead, mercury and arsenic. Chelated calcium iS expensive and has no advantage over other forms. Long-term ingestion of excessive amounts of calcium can lead to unhealthy side effects, but taking 1000 mg to 2000 mg of calciuma day should not produce any serious problems.

Children

1-5
6-10

800
800-1,200

ADolescents/Young Adults

11-24

1,200-1,500

Male Adults

25-64
65+

1,000
1,500

Female Adults

25-49
50-64 (on estrogen)
50-64 (not on estrogen)
65+

1,000
1,000
1,500
1,500

Pregnancy/Nursing

1,200-1,500

Tums™
Calcium Rich Rolaids™
TumEx™
Extra Strength Rolaids™
Titralac™ (lIquid, 1 tsp)
Os-Cal 500
Caltrate™ 600

200
220
300
400
400
500
600

Calcium Lactate

Formula™ 81

81

Calcium Citrate

Citracal™ 200

200

Lowfat Yogurt, 1 cup

345-415

Regular Tofu, 1/2 cup

108

Sardines, 7

322

Instant Nonfat Dry Milk, 2 Tbsp

105

Skim Milk, 1 cup

302

Almonds, 1/4 cup

94

2% Milk, 1 cup

297

Cooked Kale, 1/2 cup

90

Gruyere Cheese, 1 oz

287

Chicken Taco, 1

87

Salmon, 5 oz

278

Cooked Mustard Greens, 1/2 cup

75

Firm Tofu, 1/2 cup

258

Turkey Frankfurter, 1

58

Frozen Yogurt, 1 cup

240

Medium Orange, 1

52

Cheddar Cheese, 1 oz

204

Baked halibut, 3 oz

51

7" Homemade Waffle, 1

179

Cooked Broccoli,
1/2 cup

47

Vanilla Ice Cream,
1 cup

176

Fig Bar Cookie, 4

40

American Cheese, 1 oz

174

4" Frozen Waffle, 1

28

Cooked Rhubarb,
1/2 cup

174

Cream Cheese, 2`Tbsp

23

Rhcotta Cheese, 1/4 cup

167

Vhole Wheat Bread,
1 slice

20

Instant Oatmeal, 3/4 cup

163

Cooked Oatmeal, 1 cup

20

2% Cottage Cheese,
1 cup

155

Half & Half Cream,
1 Tbsp

16

Baked Custard, 1/2 cup

149

Baked Chicken Breast, 3 oz

14

Pudding, 1/2 cup

146

Medium Apple, 1

10

Blackstrap Molasses,
1 Tbsp

137

Cooked Pasta, 1 cup

10

Frozen Cooked Spinach, 1/2 cup

122

Lean Ground Beef,
3 oz

9

Medium Banana

7

• grapefruit 1/2
• dry cereal 3/4 cup
• banana 1/2 cup
• whole wheat toast
  2 slices
• margarine 2 tsp
• jelly or jam 1 Tbsp
• skim milk 1 cup
• coffee/tea

• vegetable soup 1 cup
• lean hamburger patty
  2 oz
• hamburger bun
• sliced tomato 2 oz
• lettuce with dressing
  1 Tbsp
• fresh fruit salad 1/2 cup
• oatmeal cookie 1
• fruit punch 1 cup

• tomato juice 1 cup
• broiled chicken breast
  2 oz
• her`ed brown rice
  1/2 cup
• broccodi spears 2
• cheese sauce 1/4 cup
• hard dinner roll 1
• margarine 1 tsp
• carrot/raisin qalad
  1/2 cup
• frozen strawberry yogurt 1/2 cup
• skim milk 1 cup

Calories

2120 Kcal

Fat

54 gm

Protein

84 gm

Sodium

3130 mg

Carbohydrates

326 gm

Calcium

1200 mg