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Healthy eating habits/Osteoporosis and Diversifying Daily Calcium Intake

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Timothy Neumann_1717 3294

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This image illustrates the utilisation of various food sources to optimise nutrient intake, particularly calcium intake from sources other than simply milk and cheese

Sourced: tcneumann Timothy Charles Photography [1]

 
This image illustrates the concept of having fun with food. Utilising various food sources to enhance nutrient intake is essential for promoting optimum health, and prolonging dietary related disease

Sourced: tcneumann Timothy Charles Photography [2]

Calcium and Healthy Bones

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Strong, Healthy Bones

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The Australian Institute of Health and Welfare[3] defines a very common bone disease known as "Osteoporosis" as the onset of reduced bone strength. This may lead to the forming of pores or holes in the bone, making them very weak.[4] The reduced strength of 'porous' bones, may lead to a high chance of bone fracture. This is very common is older people resulting in a greater risk of falling, causing serious injury. [5]

Who is Most At Risk?

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Who Does it Typically Effect?
 
This is a graph illustrated in "Arthritis and Osteoporosis in Australia 2008" presented by the Australian Institute of Health and Welfare. What the graph identifies is the prevalence of diagnosed Osteoporosis in Australia during 2007-2008 in both Males and Females.
It is known, that a change in bone regulation occurs during older age, compared to younger living people. In young adults the rate of bone formation and bone breakdown is much the same, so bones maintain their solid structure. This change takes places in older adults (55 years +) and particularly in menopausal women, where bone 'resorption' (loss of calcium from bones) takes place more faster than bone formation. [6]

This table by the Australian Institute of Health and Welfare shows those people most affected by Osteoporosis in Australia during 2007-2008. [7]

Why is Osteoporosis Risk Affected by Age?
The mechanism for enhanced breakdown of bone structure or 'matrix' is due to reduced 'estrogen' hormone production that takes place during Postmenopause [8] females, which often occurs in women 55-65 years of age. [3]

Estrogen, plays an active role in calcium absorption from the diet as well as the uptake of calcium into the bones known as 'mineralization', required for strong healthy bone structure.
With a reduced production of the hormone following menopause, the female body experiences a reduced bone 'mineralization' and this results in reduced bone-calcium content. For this reason females particularly, over 55 years of age are at great risk of bone frailty [9] and therefore have higher risk of injury by bone fracture and fall. For this reason it is important to enhance and optimize calcium intake through the diet.

Dietary Calcium

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Why is Calcium Important?

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Calcium is a very essential mineral recommended in the diet, due to its important roles within the human body and the processes it is involved in. A scientific study investigating calcium and its role in the body throughout life describes the central roles that calcium play in bone and teeth structure (mineralization), promoting strong bones. [10]. It explains that calcium is also required for maintaining body cells, enzymes and hormone actions, all critical for life. Calcium plays a role in brain and nerve activity (transmission), is a component of muscle flexing and relaxing, this is known as 'contraction', and is vital for heart function. [11]

How much Calcium is Suggested?

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How much Calcium is Suggested?

According to the Australian Dietary Guidelines most Australian residents consume only half of their recommended quantity of calcium intake [12]

The Eat for Health, Australian Dietary Guidelines prepared by the National Health and Medical Research Council (NHMRC) suggests that 1300mg of calcium is the ideal dietary intake quantity to optimize health and prolong bone and neurological related disease. [10] The Australian Dietary Guidelines is a well- resourced body of evidence providing recommendations for the optimal intake of different of nutrients required to promote good health to Australians. The following table illustrates the increased calcium intake recommended for older males and females to promote strong healthy bones and support calcium-dependent processes. [10]

Men Recommended Dietary Intake (RDI) Women Recommended Dietary Intake (RDI)
19-30 yr. 1000mg / day 19-30 yr. 1000mg / day.
31-51 yr. 1000mg / day 31-50 yr. 1000mg / day.
51-70 yr. 1000mg / day 51-70 yr. 1300mg / day.
> 70 yr. 1300mg / day > 70 yr. 1300mg / day.

(Nutrient Reference Values (NRVs) Sourced from [10]

Dietary Calcium Requirements

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What does 1300mg of Calcium look like?

The NHMRC highlights the need for an increased intake of Calcium during older age from a recommended dietary intake of 1000mg of calcium in middle aged adults (31-50 years) to 1300mg in the progression of older age (55 > 75 years+). [10]

How many Serves of Dairy is that?

The most commonly thought of calcium source that comes to mind when we’re asked to consider dietary calcium intake is dairy products, and the recommended intake can certainly be obtained in this way.

Serves of Dairy/ day required to obtain RDI
19-50 yrs. 51-70 yrs. >70 yrs.
Males 2 1/2 serves 2 1/2 serves 3 1/2 serves
Females 2 1/2 serves 4 serves 4 serves

However, the NHMRC supports and encourages the diversifying of dietary nutrient intake, utilizing quick, easy meal ideas, through efficient menu planning and meal preparation, particularly among older people. [13] This can be achieved by considering the dietary calcium sources of foods from the | NHMRC’s Australian Dietary Guidelines [12]

Where else can Dietary Calcium be found?

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Where else can Dietary Calcium be found?

Calcium can be found not only in milk but also in hundreds of varieties of vegetables, nuts, seeds, cheeses and assorted fish varieties (with edible bones), some examples of which are listed below:

Food Source Calcium Content % RDI (1300mg)/ 100g
Per 100g Per Serving
Almonds 250mg/ 100g 75mg/ 30g 19% RDI/ 100g
Broccoli 33mg/ 100g 43mg/ 1 cup 2% RDI/ 100g
Low Fat Mozzarella Cheese 950mg/ 100g 269mg/ 28g 73% RDI 100g
Almond (Chocolate) Milk 251mg/ 100g 502mg/ 1 cup 19% RDI/ 100g
Yoghurt, Natural 244mg/ 100mL 488mg/ 200mL 18% RDI/ 100g
Pak Choy (Dark Leafy Green Veg) 123mg/ 100g 822mg/ 1 head (840g) 9% RDI/ 100g
Pink Salmon, Canned (with edible bones) 310mg/ 100g 310mg/ 1 tin (100g) 23% RDI/ 100g
Chia Seeds 631mg/ 100g 180mg/ 30g 49% RDI/ 100g
Sesame Seeds 975mg/ 100g 390mg/ 30g 75% RDI/ 100g
Tahini (Sesame Seed Paste) 426mg/ 100g 121mg/ 30g 32% RDI/ 100g
Soy Beans 277mg/ 100g 515mg/ 1 cup 21% RDI/ 100g
Fortified Soy Products e.g. Tofu 320mg/ 100g 48mg/ piece (13g) 24% RDI/ 100g
Rhubarb 26mg/ 100g 105mg/ cup (122g) 2% RDI/ 100g
Whey Powder 796mg/ 100g 64mg/ tbsp 61% RDI/ 100g
(Nutrient composition sourced from Food Standards Australia and New Zealand (FSANZ) [14] and the United States Department of Agriculture (USDA) [15] )

For More Information

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More information regarding the association between Vitamin D status and Calcium absorption and Bone Mineralisation is presented here in a 2013 edition of the Medical Journal of Australia by a team of Australian Research team [16]


General Bone Health, Nutritional and Lifestyle Information for Bone Disease prevention for Older People can be found at Osteoporosis Australia


Another chapter in this Healthy eating habits Wikibook, found under Calcium in the Diet prepared by another 4th Year Dietetics student outlines further material on Dietary Calcium Intake.

References

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  1. ↑ https://commons.wikimedia.org/wiki/File:Neumann_Calcium_Bone_Health_Juggle.jpg.
  2. ↑ https://commons.wikimedia.org/wiki/File:Neumann_Calcium_Sources_and_Bone_Health.jpg
  3. ↑ a b Australian Institute of Health and Welfare. (2013). AIHW Authoritative information and statistics to promote better health and wellbeing. Retrieved from http://www.aihw.gov.au/
  4. ↑ Australian Institute of Health and Welfare. (2008). Arthritis and Osteoporosis in Australia. p14. Retrieved from https://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442459795
  5. ↑ Marks R., Allegrante J. P., MacKenzie C. R. & Lane J. M. (2003). Hip fractures among the elderly: Causes, Consequences and Control. Elsevier Science Ireland Ltd. vol. 2 (1) pp57-93. doi:10.1016/S1568-1637(02)00045-4.
  6. ↑ Brown J. P., Albert C, Nassar B. A., Adachi J. D., Cole D, Davison K. S., Dooley K. C., Don-Wauchope A, Douville P, Hanley D. A., Jamal S. A., Josse R., Kaiser S., Krahn J., Krause R., Kremer R., Lepage R., Letendre E., Morin S, Ooi D. S., Papaioaonnou A. & Ste-Marie L. G. (2009). Bone turnover markers in the management of osteoporosis. Clinical Biochemistry: 42 (10-11), pp929-942. doi:10.1016/j.clinbiochem.2009.04.001
  7. ↑ Australian Institute of Health and Welfare. (2011). A snapshot of osteoporosis in Australia 2011. Canberra AIHW, pp 1-31. Retrieved from http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737418747&libID=10737418.
  8. ↑ WebMD. (2013). Your Health in Postmenopause. Retrieved from www.webmd.com/menopause/guide/health-after-menopause.
  9. ↑ The Free Dictionary. (2000). Frailty. Retrieved from http://www.thefreedictionary.com/frailty.
  10. ↑ a b c d e National Health and Medical Research Council. (2006). Nutrient Reference Values for Australia and New Zealand Including Recommended Dietary Intakes. NHMRC: pp155-163. Retrieved from http://www.nrv.gov.au/resources/_files/n35-calcium.pdf.
  11. ↑ Buppasiri P, Lumbiganon P, Thinkhamrop J, Ngamjarus C, Laopaiboon M. Calcium supplementation (other than for preventing or treating hypertension) for improving pregnancy and infant outcomes. Cochrane Collaboration Database of Systematic Reviews 2011, Issue 10, pp1-89. doi: 10.1002/14651858.CD007079.pub2.
  12. ↑ a b National Health and Medical Research Council. (2013). Australian Dietary Guidelines 2013, p4-24. Retrieved from http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n55a_australian_dietary_guidelines_summary_131014.pdf.
  13. ↑ NHMRC. (2013). Healthy Eating When You’re Older. NHMRC. Retrieved from https://www.eatforhealth.gov.au/eating-well/healthy-eating-throughout-all-life/healthy-eating-when-you’re-older.
  14. ↑ Food Standards Australia and New Zealand. (2010). NUTTAB 2010 Online Searchable Database. Retrieved from http://archive.foodstandards.gov.au/consumerinformation/nuttab2010/nuttab2010onlinesearchabledatabase/onlineversion_code.cfm?&action=default.
  15. ↑ U.S. Department of Agriculture, Agricultural Research Service. (2013). USDA National Nutrient Database for Standard Reference, Release 26. Nutrient Data Laboratory Home Page, Retrieved from http://www.ars.usda.gov/ba/bhnrc/ndl.
  16. ↑ Ebeling P.R., Daly R.M, Kerr D.A & Kimlin M.G. (2013). An evidence-informed strategy to prevent osteoporosis in Australia. The Medical Journal of Australia; 198 (2): 90-91. doi:10.5694/mja12.11363 www.mja.com.au/journal/2013/198/2/evidence-informed-strategy-prevent-osteoporosis-australia?0=ip_login_no_cache%3D0c8b67216c65dad50aa59dc53b6d2e1e.
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