Healthy eating habits/Answering Questions about Healthy Bones, Women and Calcium

The purpose of this guide is to answer common questions on serves of dairy for calcium requirements, different sources of calcium other than dairy and for using a variety of sources in meals for optimum calcium intake. It was developed for women over 35 years.

Background

There are over 170 uses for calcium in our body and 99% is used for bone strength. The calcium makes our bones strong and the bones in turn serve as a storage reservoir for calcium. If our diet is lacking in calcium, the body will take it from the reservoir in the bones, making them weaker (Whitney et al, 2011). Osteoporosis is the weakening of the internal structure of the bone. 3.4% of Australians have confirmed osteoporosis and significantly, 82% of these cases are women (Osteoporosis Australia, 2014). Healthy bones will be denser while weaker bones will have a more porous structure, which will fracture more easily. From 35 years onward, the process of bone regeneration slows down and after 60 years, 50% of all women experience osteoporotic fracture (Whitney et al, 2011).

How much Calcium do women need?

How much is a serve of dairy?

Milk is a good source of calcium

250 ml or 1 cup milk or calcium fortified soy
200 g or ¾ cup yogurt
40 g hard cheese

Cheese is a good source of calcium

How many serves per day do women require?

2½ serves per day until 50 years
4 serves per day after 50 years

                                (NHMRC, 2014)

How I can incorporate serves in my day? Examples

125 ml on cereal at breakfast; 200 g tub yogurt as a snack; 40 g cheddar on a sandwich
200 g yogurt with oats at breakfast; 125 ml skim milk in a latte as a snack; 30 g Parmesan on pasta

The Calcium in our food.

Animal and plant sources of calcium

ANIMAL SOURCES	SERVE SIZE	Mg Calcium	PLANT SOURCES	SERVE SIZE	Mg Calcium
Yogurt, low fat	3/4 cup or 200 g	450 mg	Tofu, calcium set	1/2 cup	135 mg
Sardines, with bones	45 g	212 mg	Bok Choy	1/2 cup	75 mg
Milk, reduced fat	250 ml	300 mg	Kale	1/2 cup	~75 mg
Cheese, Cheddar	40 g	300 mg	Tahini	1 heaped tsp.	129 mg
Egg, whole, chicken	2 x 60 g	50 mg	Broccoli	1/2 cup	40 mg
			Cauliflower	1/2 cup	~20 mg
			Almonds, raw, with skin	30 g	75 mg

                                        (compiled Whitney et al, 2011; Nuttab 2010 online)

Animal sources and plant sources NOT animal vs. plants!

When plant and animal sources are grouped together and served in the one meal, small milligrams of calcium add up to calcium rich meals. This adds variety to the diet as well as sources of Vitamins B, C, Folate and dietary fibre(Whitney et al, 2011). In addition there is increasing evidence that a dietary pattern with a wide variety of foods is important for good health, rather than the emphasis on one or two food groups (NHMRC, 2012).

Milk is one of the best food for bone health. Among plant-based sources, nuts are good for bone health. Cashew nuts are rich in copper, magnesium and calcium. Hence, they are good for bone health.^[1] Similarly, almonds and walnuts are also good choices.

Bioavailability

Bioavailability is the rate and extent to which calcium (or any nutrient) can be absorbed by the body and utilised for the requirements. Plant sources have greater bioavailability than animal sources (Whitney et al, 2011).

Calcium bioavailability of animal and plant sources

Leafy green sources of calcium

Calcium bioavailability	Food Source
> 50 %	bok choy, cauliflower, watercress, Brussels sprouts, broccoli
~ 30 %	cow and fortified soy milk, calcium set tofu, cheese and yogurt
~ 20 %	almonds, sesame seeds (tahini), pinto beans and sweet potatoes
< 5 %	spinach, rhubarb, silverbeet

                                                 (Whitney et al, 2011)

Bioavailability and plant sources

In countries like China where almost no dairy products are consumed, osteoporosis is uncommon, providing evidence that plant sources can play a vital role in strong bones. Grouping many different vegetables in the one meal not only provides for greater calcium, but takes advantage of the greater bioavailability of plant sourced calcium (Whitney et al, 2011).

Examples of Meals and Recipes

Stir Fry of Bok Choy, Tofu, Almonds and Broccoli

Serves 2

1 bunch Bok Choy

2 cups broccoli florets

1 red capsicum cut into thin strips

1 cup calcium set tofu, cut into cubes and marinated in 2 tbsp. of tamari, 1 tbsp. of grated fresh ginger, 1 tbsp. grated fresh garlic, and juice of 1 lemon

60 g almonds, lightly toasted in oven

2 tbsp. peanut or grape seed oil

½ tsp. toasted sesame oil

1 tsp. grated ginger extra

Juice of ½ lemon

Bake marinated tofu cubes in moderate oven for 20-30 minutes. Heat peanut oil and stir fry capsicum first followed by green vegetables.

Add marinade drained from tofu and continue until vegetables are just cooked.

Add another tsp. of grated ginger, sir though and add juice of half a lemon

Add tofu, almonds and sprinkle with sesame oil, stir gently through. Serve with brown rice

Calcium note: 2 cups of raw Bok Choy (which will wilt) can contain as much as 300 mg of calcium, the same as 250 ml serve of cow’s milk.

Sardine Fish Cakes with Sweet Potato

Sardines as a source of calcium

http://www.primalpalate.com/paleo-recipe/sardine-and-sweet-potato-fish-cakes/

Calcium note: Serve with a sauce of 3 heaped tsp. of tahini (387 mg calcium) thinned with 100 g of natural yogurt (225 mg calcium) and flavoured with finely chopped coriander.

Cauliflower and Brussels Sprout Cheese Gratin

http://www.canadianliving.com/food/cauliflower_and_brussels_sprouts_gratin.php

Calcium note: combining dairy sources with good plant sources increases total calcium intake in one meal.

Additional Resources

General

Australian Guide to Healthy Eating, http://www.eatforhealth.gov.au/

Better Health Channel: Calcium (see Osteoporosis risk quiz in sidebar) http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Calcium?open

Osteoporosis Australia at http://www.osteoporosis.org.au/

Individual Advice

Dietitians Association of Australia, http://daa.asn.au/ to find an accredited practicing dietitian

References

Whitney, E., Rolfes, S., Crowe, T., Cameron-Smith, D. & Walsh, A. (2011) Understanding Nutrition, Australia, Cengage Learning

Osteoporosis Australia (2014) Main Page http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Osteoporosis

National Health and Medical Research Council (NHMRC) (2012) Australian Dietary Guidelines for Healthy Eating accessed 20/08/14

http://www.eatforhealth.gov.au/sites/default/files/files/the_guidelines/n55g_adult_brochure.pdf

Food Standards Australia and New Zealand (2010) Nuttab Online 2010 accessed 20/08/14

http://www.foodstandards.gov.au/science/monitoringnutrients/nutrientables/nuttab/Pages/default.aspx

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