reduces the risk of an osteoporotic fracture by 50%
during adulthood.
Once peak bone mass s is achieved, bone turnover
is stable in both sexes until mid 1940s and so the
nutritional requirement for calcium remains stable
during this time. However, even after reaching full
skeletal growth, adequate calcium intake is important
because the body loses calcium every day through shed
skin, nails, hair, sweat, urine and feces.
Bone loss begins from about 40 years. It is part of
the normal ageing process and for women this bone
loss is also accelerated further at the time of meno-
pause. In addition, intestinal calcium absorption
decreases and calcium excretion in the urine increases,
so the body will compensate for low blood calcium
levels by drawing on calcium in the bones. A decreased
capacity of the skin to synthesize Vitamin D and less
exposure to sunlight due to decreased mobility also
makes the elderly high risk for low Vitamin D levels.
Increasing calcium and Vitamin D from the diet there-
fore becomes more important.
The guidelines are important for age related bone
loss as well as other groups at risk for developing
osteoporosis such as:
People allergic to diary products or with severe lac-
tose intolerance avoid milk based products and foods
containing milk products. Fortified soy or rice milks
are adequate substitutes to meet calcium require-
ments, but they are not suitable for infants. Special-
ized milk substitute formulae are required for infant
feeding. Green leafy vegetables, sardines, salmon,
soymilk and calcium-fortified foods are all milk -
free foods that are rich in calcium and vitamin D.
Some lactose intolerant individuals may be able to
tolerate some milk products as part of a meal, such as
Swiss cheese and cottage cheese, which are naturally
low in lactose.
Vegans do not eat any products of animal origin,
which includes milk and dairy products. Important
calcium foods for Vegans include tofu, fortified Soya
milk, green leafy vegetables, seeds, nuts and calcium
fortified foods.
Populations with limited exposure to sunlight, such
as those in the northern latitudes, cover up for reli-
gious reasons or use sunscreen due to concerns about
skin cancer and other skin diseases need to depend
more on dietary sources of Vitamin D. Darker
skinned people also make less Vitamin D from
sunlight.
Individuals who have problems with fat absorption
may have low Vitamin D levels. As Vitamin D is fat-
soluble, it requires some digestion of fat for absorp-tion. A reduced ability to absorb fat is associated
with conditions such as Cystic Fibrosis, Crohn’s Dis-
ease, and Celiac disease
Individuals on long-term oral corticosteroids,
including those with asthma, arthritis or chronic
obstructive pulmonary disease (COPD) have an
increased risk of developing osteoporosis. Steroids
contribute to increased osteoclast activity (bone
break down) and inhibit osteoblast formation (bone
building). Steroids also interfere with the absorption
of calcium in the small intestine.
For those populations at risk for osteoporosis,
calcium and Vitamin D supplements may be needed
to meet daily requirement. The types of supplements
available vary by country, so individuals should take
medical advice before using them.Benefits
Three portions of low fat diary foods along with
plenty of fruits and vegetables can help to lower blood
pressure as shown in the DASH (Dietary Approaches
to StopHypertension) study.
Research in 2003 looking at weight loss in over
weight individuals showed diets high in low fat diary
may contribute to lower body fat, especially in combi-
nation with a lower calorie intake. Increased dietary
calcium is thought to bind more fatty acids in the
colon, inhibiting fat absorption. It may also directly
affect whether adipocytes store or break down fat.
Research supported by the U. S. National Cancer
Institute and published in 2007 suggests diets rich in
calcium, Vitamin D and diary foods may reduce the
risk of colon cancer by 28%. The American Cancer
Society encourages the inclusion of low-fat and fat-
free dairy foods in a healthy diet, as part of their
recommendations for cancer risk reduction.Precautions
For those who have high cholesterol, low-fat dairy
products are recommended to meet their calcium
requirements. Low fat alternatives have the same
amount of protein and up to 20% higher in calcium,
with less total and saturated fat than full fat products.
Calcium also has the potential to compete with the
absorption of other importantminerals,suchasiron.
Individuals with iron deficiency and taking iron sup-
plements should avoid taking them at the same time.Risks
In the 2004 Nurses’ Health Study II study,
younger women age 27 to 44 who ate three or moreOsteoporosis diet