Diet / Excercise

Remember the beneficial effects of healthy diet and regular exercise. Women who exercise and follow a healthy diet cope better with menopausal changes and also help protect themselves against other diseases such as heart disease and osteoporosis.

The Women’s Nutritional Advisory Service is run by nutritionists who will design individualized diets to help with hormonal problems.

Women’s Nutritional Advisory Service, PO BOX 268 Lewes East Sussex BN7 2QN Tel: 01273 487366. They have an excellent website www.wnas.org.uk claiming an 80% success rate in symptom control after following their recommended diet for four months.

Calcium – It is vital at this time that adequate calcium is included in the diet. Supplements of Calcium and Vitamin D can be taken if the recommended amount is not achieved but the body copes best with a dietary source of calcium. Maximizing Calcium is important to help prevent osteoporosis.

Vitamin D – Vitamin D is required to maintain bone health. It helps the body absorb calcium and is made in the skin due to sunlight action. Lack of sunlight due to climate or people either not going outside much or being covered up when outside, often leads to lack of vitamin D, particularly in the elderly. Dietary sources include oily fish, dairy products and margarine and 2 main course portions of oily fish per week are recommended.

Calcium rich foods and bone health

* RNI – Reference Nutrient Intake
** COMA notes that the additional increment may not be necessary with more recent evidence

Why do we need calcium?

calcium is a nutrient that we know has an important role to play in the maintenance of bone health. This Information Sheet contains a selection of calcium rich foods, which, as part of a well balanced diet, may contribute towards an adequate intake.

How much calcium do I need?

The Governments Committee on the Medical Aspects of Food and Nutrition Policy (COMA), now replaced by the Scientific Advisory Committee on Nutrition, sets recommended levels for nutrient intake (Reference Nutrient Intakes) for the UK population. The lower reference nutrient intake (LRNI) for calcium is 400 mg and the RNI is 700 mg for adults. This means that your calcium intake must be over 400 mg and it is recommended that your intake be above 700 mg to be compatible with bone health in the normal population, as based on current evidence. There is inconclusive evidence that more calcium may be needed but further research is necessary.

If you have been diagnosed with osteoporosis, you may need to boost your calcium levels to approximately 1200 mg for adults and consequently may be given a calcium supplement with your treatment. In the trials that have shown bisphosphonates to reduce fractures, the calcium supplementation used was 500 – 1000 mg. Therefore, extra calcium may be taken as part of the diet or as a supplement but the upper limit must not be exceeded.

Can I have too much calcium?

It is recommended that you do not exceed more than 2000 – 2500 mg of calcium a day. Exceeding the upper limit of 2000 – 2500 mg calcium could lead to medical problems including milk alkali syndrome (a high level of calcium in the blood) and may interfere with the absorption of other minerals such as iron.

Does it matter if I do not meet the exact daily amount?

It is important to remember that calcium intake should be looked at over a period of monthly intake rather than daily. A low calcium intake on one day, when most days you achieve more, will not have a detrimental effect on your bone density.

Do I need to supplement my diet with any other nutrients?

Other nutrients and minerals are also important but a well balanced, mixed diet including fresh fruit, vegetables, adequate protein and carbohydrate foods should contain sufficient amounts of the necessary nutrients. Some individuals may feel that they are not obtaining the calcium they need from their diet and there is no way that this can realistically be achieved. In such cases, supplemental calcium may be useful. Your local pharmacist is often an excellent source of information on over the counter products. There is evidence that older people can benefit from supplemental calcium and vitamin D and this is a useful treatment for osteoporosis in this age group.

What else can affect my risk of osteoporosis?

Dietary issues are just one of a variety of important components, which together, can influence an individuals osteoporosis risk. These include exercise levels, hormonal status, corticosteroid use, body stature, strong family history and previous minimal trauma fracture.

General advice to anyone who wishes to minimise the effects of osteoporosis includes taking a well balanced, calcium rich diet, avoiding smoking or excessive alcohol intake and taking regular weight bearing exercise.

Further details on diet and bone health can be obtained in a booklet available from the National Osteoporosis Society, Camerton, Bath BA2 0PJ Telephone number 01761 471771.

* may be calcium enriched
** different products vary considerably

Please note, the calcium contents (with the exception of milk and bread), have been calculated per 100 g and are therefore not portion size. This has been done to make comparisons between various foods easier.

Ref: Information provided courtesy of The Royal Society of Chemistry, Ministry of Agriculture, Fisheries & Food publication “The Composition of Foods” 1992.
Reproduced with permission from National Osteoporosis Society