Week of: November 19, 2000

A GUIDE TO CALCIUM SUPPLEMENTS

Are you getting enough calcium? The newest recommendations encourage people 19-50 years to get 1000 mg of calcium every day, the equivalent of 3 glasses of milk. Adults over 50 should strive for 1200 mg a day, which equals 4 servings of milk products. Adequate amounts of calcium, combined with physical activity, are needed to build and maintain strong bones, which helps prevent osteoporosis.

Try to get as much calcium from food as you can. Milk products and other foods high in calcium contain other nutrients and protein not found in a calcium supplement. Add evaporated milk or skim milk powder to soups, hot cereal, pancake mix and baking. Add soybeans or white beans to soup, salmon with the bones to sandwiches or choose calcium-fortified orange juice or fortified soy beverages. If you are not able to get the recommended 3-4 servings of calcium-rich foods each day, you may want to use a supplement to make up the difference.

Supplements

There are many types of calcium supplements on the market. Here are some tips for choosing the best one:

• Calcium citrate maleate is the best absorbed, although calcium citrate and calcium carbonate are also acceptable. If you are not fond of popping pills, look for calcium "chews" that have a caramel-like consistency and taste. Check the label for the amount of "elemental" calcium in the supplement. This tells you how much calcium you are getting.
• Make sure you are getting enough vitamin D. From April to September, five to fifteen minutes of sun on your hands, face and arms (without sunscreen) two to three times a week will produce adequate amounts of vitamin D for most people. For the remaining months Canadians must rely on food sources of vitamin D. These include fluid milk, margarine and fatty fish such as herring, salmon, mackerel, sardines and tuna. If you are not getting vitamin D from the sun or food, take a multivitamin, or make sure your calcium supplement also contains vitamin D.
• Do not choose supplements made from oyster shell, dolomite or bone meal as they may be contaminated with lead.
• Make sure your supplement dissolves in vinegar. Drop one pill in 175 ml 3/4 cup) vinegar and stir occasionally. If the pill does not dissolve in 30 minutes, you may not be getting all of the calcium from your supplement.
• Take your calcium supplement with food, particularly if you are taking calcium carbonate. This will improve its absorption.
• Your body can only absorb about 500 mg of calcium at one time. If you need to take more than this, take two or more doses at different times of the day.

Any time a supplement is taken, there is a risk of getting too much of a nutrient. The recommended amount of calcium per day is 1000-1200 mg. Taking more than 1200 mg does not provide any additional benefit and over 2500 mg per day from all sources may be harmful.

If you require more information or need help deciding if you should take a supplement, contact a physician, dietitian or public health nutritionist.

WRITTEN BY THE PUBLIC HEALTH NUTRITIONISTS OF SASKATCHEWAN

Originator: Sheri Taylor

References:

Saskatchewan Dairy Foundation. (1998), "Fast Facts: Vitamin D Calcium's Partner in Bone Health."

Levenson, D.I. & Bockman, R.S. (1994). "A Review of Calcium Preparations," Nutrition Reviews, 52:7, 221-232.

Osteoporosis Society of Canada, "Calcium Supplementation: When You Can?t Get Enough From Food."