En español | For every adult who heard the childhood warning Drink your milk or you won't have strong bones, Jeri Nieves has another message. "It's never too late to take care of your skeleton," says Nieves, director of bone density testing for the Clinical Research Center at New York's Helen Hayes Hospital.
"Think of it as a bank account," Nieves says. "You were putting calcium into the account when you were younger to accumulate, and now that you're older, you're mostly looking to maintain what you have." To do that, she says, people age 50 and over may need to increase their consumption of some foods and beverages, and cut back on others.
"We want people to get the amount of calcium recommended for them but not necessarily to exceed it," says Nieves. Too much calcium, she says, may contribute to ailments such as kidney stones, prostate cancer and heart disease. For women over age 50, that's about 1,200 milligrams a day. Men need 1,000 milligrams a day up to age 70, and 1,200 milligrams a day from age 71 on. Good sources include:
- Low-fat dairy foods.
- Leafy green vegetables such as kale, collard greens and broccoli rabe,
- Calcium-fortified products, including soy milk and juices.
- The calcium content of many dishes, from puddings and baked goods to stews and soups, can be increased by about 50 milligrams for every tablespoon of nonfat dried milk added to a recipe.
Nieves counsels consumers to estimate their daily calcium intake from foods generally, and then take only enough calcium supplements to hit their recommended dietary allowance (RDA).
For example, Nieves says, "If you start every day with calcium-fortified orange juice and have yogurt for lunch, you could already be getting 800 milligrams of calcium and you can simply add another serving of a high calcium food to get your required amounts. (The National Osteoporosis Foundation has a worksheet that can be used to calculate the calcium in a consumer's daily diet, and the organization Osteoporosis Canada has a "calculate my calcium" tool online.)
This vitamin helps the body absorb calcium, so getting enough of it every day is vital, Nieves says. While it is found in fatty fish such as salmon, tuna and halibut, most people will need to supplement their diet to get their RDA — 600 international units (IU) a day up to age 70, 800IU a day for those 71 and older. By reading food labels, consumers can choose foods that have been fortified with Vitamin D, and then can take a supplement to round out their RDA. Going a little over the requirement isn't a problem, she says, as a person would have to consume about four times the RDA of Vitamin D to do yourself any harm.
This vitamin is derived from two sources: retinoids (from animal food sources) and carotenoids (found in fruits and vegetables). Nieves encourages consumers to eat healthy amounts of Vitamin A-rich fruits and vegetables. Good sources include:
- Lettuce (romaine and loose leaf)
- Sweet potatoes
More on bone health
Some factors that affect bone health — generally measured in terms of bone density, or bone mass — are beyond a person's control, Nieves says. Women are more prone than men to low bone mass that can progress to osteoporosis. Caucasians and Asians are at greater risk than Hispanics, and those three groups are at greater risk than African Americans. (For a detailed list of risk factors, visit the National Osteoporosis Foundation website.)
"While people can't control all risk factors for bone disease, there is one they can control: their diet," Nieves says. "Bone is living tissue that needs calcium and vitamins and nutrients because, constantly through the lifespan, there's an ongoing process of bone remodeling to refresh the skeleton."