10/31/2008

Take Calcium with Food

When is the best time to take vitamin and mineral supplements? Probably your favorite time of the day—mealtime.

It's not enough just to take your calcium tablet every day. The frequency and time that you take it count. Your best bet is to take calcium with meals, advises Susan J. Whiting, Ph.D. Although both calcium carbonate and citrate forms are quite absorbable, taking supplements with food allows peak calcium absorption. There's one exception: Avoid taking calcium with high-fiber wheat bran cereal, which can reduce absorption by 25 percent.

Meals also can serve as reminders, jogging your memory to consume calcium pills, adds Dr. Whiting. Taking supplements as part of a daily routine will keep you on track.

When it comes to amount, limit calcium to 500 milligrams per dose to promote the body's absorption. And don't combine calcium with any iron-containing supplement because calcium interferes with the body's iron uptake. That means you should buy a multivitamin that has either calcium or iron, but not both. If you need extra iron, take the two supplements at different times.

10/30/2008

Choose Your Calcium Carefully

Store shelves stock a dizzying array of calcium supplements. Arm yourself with these few simple facts for the best selection.

You can chew them, drink them in hot water, or swallow x them whole. Some look and taste like chocolate candy. Some seem large enough to choke a goat. You know you need more calcium, so how do you choose?

First off, focus on form. According to Susan J. Whiting, Ph.D., calcium carbonate is your best bet. True, the calcium citrate form may be absorbed slightly better by the body. But it costs more, and over the years the dollars add up. Calcium carbonate is still a good supplement, without making you broke, she adds.

You'll need to splurge for calcium citrate, however, if you suffer from atrophic gastritis, or low stomach acid. People with this condition can absorb calcium only in citrate form.

Also, question quality. Dr. Whiting recommends supplements sporting the USP insignia. USP stands for United States Pharmacopeia, an independent group that sets pharmaceutical standards. The USP stamp of approval means your calcium supplement will dissolve properly in your body, allowing absorption.
Finally, consider vitamin D. If you're not drinking enough vitamin D-fortified milk, or if you don't regularly take a multivitamin with D, you're probably falling short of this nutrient, which is needed to enhance the absorption of calcium in the body. Take a calcium supplement that will give you 400 to 600 international units (IU) of vitamin D and 1,500 milligrams of calcium daily, advises Dr. Whiting.

Be Inventive with Powdered Milk

You don't have to drink it straight to get powdered milk's impressive nutritional benefits.

Atablespoon of nonfat dry milk powder contains 94 milligrams of calcium. That's a third of the calcium contained in 8 ounces of fat-free milk—all for a mere 27 calories!

You can hardly find fault with that, except that powdered milk, when mixed with water, has the consistency (and some say the taste) of flour and water. So think of what you can sneak it in with, suggests Colleen Pierre, R.D.

Pierre promotes stirring a tablespoon of powdered milk into hot cereals prepared with water (like oatmeal or cream of wheat). She also suggests mixing it into hot cocoa or condensed cream soups. You can thicken casseroles with powdered dry milk. And here's the best tip—if you want to appeal to your and your children's sweet tooth, stir a tablespoon or two into homemade dough to pump up the calcium count of cookies.

Nobody will notice, but your skeleton will.

Broccoli with Lemon Sauce

pound broccoli florets cup fresh parsley teaspoon onion powder tablespoons ricotta cheese cup low-fat buttermilk Sprinkling of dried tarragon Juice of half a lemon Pepper, to taste

Steam the broccoli until tender, about 8 minutes. Meanwhile, in a food processor, finely chop the parsley with the onion powder and ricotta.


With the motor running, pour in the buttermilk, tarragon, and lemon juice. Process just until combined.

Drizzle the sauce over the broccoli and lightly sprinkle pepper on top.

Serves 2 to 4. •

10/26/2008

Reap Calcium from Your Greens

Dairy products don't have the only comer on calcium. Vegetables contain calcium, too, but you have to be resourceful in order to make produce a major calcium source.

There's no doubt that green, leafy vegetables are valuable calcium sources, particularly broccoli, bok choy, turnip greens, and kale. But there's good and bad news about the calcium that plants can provide.
First, the good news. Generally speaking, calcium from vegetables is just as available to the body as the calcium in milk,'according to calcium expert Connie M. Weaver, Ph.D. One surprising exception: spinach. Nearly all of its calcium goes right through you, bound up by plant substances
What's the downside? The question of quantity, she says. While the body can absorb the calcium contained in most green, leafy vegetables, there just isn't a lot for the taking. For example, you must eat more than 2V2 cups of cooked broccoli or almost 2 cups of kale to get the calcium of 8 ounces of milk.
In other words, if you're going to try to make vegetables your main calcium source, you'd better like gigantic salads and be willing to find ways to work greens into most of your dishes.

This dish packs 489 grams of calcium by combining an entire pound of broccoli with dairy products.

10/19/2008

Nondairy Smoothie

1 cup frozen fruit, such as berries and banana chunks
V2 cup calcium-added orange juice V2 cup cold fortified soy milk
Whip all ingredients in a blender, and enjoy the calcium equivalent of one glass of whole milk.

Get Your Dairy— Discomfort-Free
Dairy doesn't agree with you? Don't ditch it altogether. You might be able to tolerate more calcium-rich milk products than you think.

If you're lactose intolerant, no one has to tell you that bloating, gas, and diarrhea are the unpleasant side effects of dairy foods.

But dairy foods affect everyone differently, so you need ©find your lactose limit, advises Tammy T. Baker, R.D. Fortunately, lactose intolerance might not mean your last Spoonful of your favorite yogurt.
She offers hope for dismayed dairy lovers with these tips.

• Drink milk with food. Milk is one of the most lactose-laden dairy foods, but downing it with food helps minimize any ill effects by slowing lactose digestion.
• Lean toward aged, hard cheeses. American, Cheddar, Swiss, Colby, and Parmesan are low-lactose choices.

• Feed on fat, in moderation. Higher-fat dairy foods, such as 2% reduced-fat milk and most regular cheeses, seem to mitigate lactose troubles.
• Focus on the fermented. Yogurt and buttermilk contain cultures that break down some of the lactose for you.
• When dining out, bring along a dairy digestive product in pill or liquid form, which provides the lactase enzyme your body lacks.

Choose Smart Snacks

It's tough to get all the bone-boosting nutrition you need when you live life on the go. Have some high-nutrient stashes handy for when you can't sit down to a meal.

Snacking has a bad reputation. Supposedly, snacks wreck your appetite for better meals and promote weight gain. But often a hectic lifestyle necessitates on-the-go munching. There are times when you wouldn't have a day of well-rounded nutrition if you didn't eat in the car or at your desk.

"If you make wise choices, snacks can supply the nutrients you need for strong bones," says Hillary M. Wright, R.D.
Take figs. Four dried figs supply about 100 milligrams of calcium for only 200 or so calories. That's the same number of calories in four creme-filled sandwich cookies, without the calcium (not to mention figs' whopping 9 grams of fiber).

Wright says soy nuts—whole soybeans that have been soaked in water, then baked—are also superior snacks. Soy nuts supply isoflavones, plant substances that may boost bone density.

Tote small packages of raisins, craisins (dried cranberries), banana chips, and other dried fruits to boost your potassium and magnesium count, which are important for strong bones. Yogurt or cottage cheese also makes for a calcium-boosting pick-me-up.

Richen Your Food and Enrich Your Bones

Adding evaporated milk to some of your favorite dishes will bring them to creamier levels of delight, while also doubling your calcium intake.

Maybe you purchase evaporated milk a few times a year to make that special sauce or dessert. But condensed milk should take a more prominent place in your cooking, according to Colleen Pierre, R.D. Try to work it into everyday cuisine, because it tastes great and also bolsters bones.
A cup of evaporated milk is loaded with 741 milligrams of calcium, versus 302 milligrams in regular fat-free (skim) milk.

What makes it so calcium-mighty? Removing more than half the water from milk causes the mineral's concentration to climb. Levels of vitamin D double, too, helping to promote calcium's uptake after digestion, not to mention improved absorption by your bones.

Pierre recommends you employ evaporated milk to:

• Mash potatoes
• Lighten coffee and tea
• Prepare condensed soups, such as tomato
• Make macaroni and cheese from a mix
• Prepare pudding and custard mixes

Where to Begin

Osteoporosis doesn't have to happen to you. It is preventable. By buying this book, you've already taken a major Step in preventing the disease. If you already have bone loss or have already been diagnosed with the disease, the tips in this book can help maximize the treatment outlined by your doctor.

According to Dr. Sartoris, it's never too late to make the most of your bone mass, even if you have genetics and past habits working against you. If you can add even 5 percent to your peak bone mass through lifestyle changes (or medication), you'll be able to reduce your fracture risk by a whopping 40 percent.

Optimum Nutrition introduces you to the role of nutrients, which play an undisputed part in building bone health. Calcium, phosphate, and other trace minerals form the crystalline latticework structure that gives bone its density, vitamin D is needed for the bones to actually absorb the calcium.

The close weave of tissue that holds the calcium in the bone's matrix requires vitamins and protein to do its work. Vitamins and minerals also support hormone levels that tare important to bone strength. Optimum Nutrition offers tasteful ideas for working the bone-essential nutrients into your diet.

Keeping your bones healthy through exercise is a vital, ongoing process. But even if you've never exercised, experts say it's never too late to reap the bone-building benefits. In a Finnish study, women age 80 and above who did strength and balance training reduced their risk of falling by more than 30 percent.

We offers you novel tips later in this blog on lowering many controllable risk factors, such as smoking or excess salt, protein, or caffeine. You'll also discover countless ways to make your lifestyle a little more bone-healthy and to protect whatever bone mass you have.

Living Well with Brittle Bones on page 95 is for the woman who refuses to compromise her quality of life and sense of adventure, despite the fact that she has osteoporosis. Read on for travel advice, fashion tips, and many other ideas to avoid possible fractures and pain while continuing to engage in your favorite activities.

Finally, Alternative Options on page 113 directs you to alternative health practitioners who have special strategies to avoid or cope with osteoporosis. Seek them out for your particular problems and concerns as a great adjunct to your doctor's care, or for an alternative approach to osteoporosis prevention and treatment.

10/18/2008

The Inside Story

Even people who fit into no specific risk category still can have osteoporosis and suffer fractures. One out of every 10 African-American women over 50 has the disease. Young Women—and even men—can get it.

So whether your risks for osteoporosis are high or not, finding out how strong your bones are is always a good idea. After all, osteoporosis is a preventable disease.

Bone mass measurements, also called bone mineral density tests, can determine whether you're experiencing bone loss, and at what stage. The testing is quick, noninvasive, and doesn't hurt. There are several different methods, some more revealing than others, according to David J. Sartoris, M.D., professor of radiology and director of bone densitometry at the University of California, San Diego, School of Medicine.

A standard x-ray, for instance, doesn't show evidence of osteoporosis until 30 to 40 percent of your bone mass is gone. Scans such as ultrasounds and single x-ray absorptiometries give you a snapshot of how the bone is faring in a particular part of the body, say, in the forearm or the heel.

Since the skeleton doesn't lose bone mass uniformly, says Dr. Sartoris, the only way you can truly assess early bone loss is to get a DEXA (dual-energy x-ray absorptiometry) scan. This test looks at bone density where it matters the most—in your hips and spine.

Whereas experts once waited to look closely at bone until a woman was in menopause, Dr. Sartoris believes that approach wastes 20 years or more of potential intervention. If you're a woman between the ages of 21 and 35 and are at high risk, he recommends that you ask your doctor to order a DEXA scan. Some insurance companies might not pay for this test until you're older, but Dr. Sartoris puts the #150 cost into perspective: "Women spend that much on a dress or a pair of shoes. This is a test that could mean the difference in their futures.'"

Your doctor should routinely order bone mineral density tests once you reach menopause. If you're undergoing osteoporosis treatment, you should get tested yearly.

Any time that you experience persistent back pain that doesn't go away, it could indicate a possible vertebral fracture caused by osteoporosis, and you should get an evaluation.

10/14/2008

A Matter of Risk

Ironically, in those years when you stood on tiptoes to appear taller, your body was busy brewing the best medicine known to protect you against osteoporosis: dense, sturdy, resilient bones.

Calcium is so important to building strong bones in adolescence that our need for it increases to 1,300 milligrams a day from ages 9 to 18, up from the 800 milligrams that children need daily from ages 4 through 8.

By age 20,98 percent of your peak bone mass should be reached, ideally providing you with enough bone to give you a comfortable safety margin for your critical postmenopausal years, when bone loss is extremely rapid. Estrogen, which is lost after menopause, also helps nurture and keep bones safe.

While genetics are a factor in your risk for osteoporosis, so are lifestyle choices. Smoking, alcohol, lack of exercise, and poor diet are part and parcel of the osteoporosis risk profile.

Here are some recognized genetic and lifestyle factors linked to greater-than-average risk of osteoporosis. Check to see how you measure up.

• Family history of osteoporosis
• History of fractures
• Caucasian or Asian race
• Childhood history of any disease that interfered with nutrition, growth, or exercise
• Slim build (women whose weight falls within the lowest quartile on weight charts)
• Amenorrhea, the abnormal cessation of menstrual periods
• Diet deficient in calcium or vitamin D
• Diet containing too much salt or caffeine
• Diets extremely deficient in protein or, ironically, diets with excess protein
• Heavy alcohol use
• Smoking
• Lack of exercise and physical activity or, inversely, excessive exercise, especially coupled with insufficient nutrition
• Estrogen deficiency (irregular menstrual history, removal of ovaries, menopause)
• Eating disorders or a history of "y°"y°" dieting
• Thyroid disease, hyper-calciurea (too much excreted calcium), and certain other diseases
• Medications such as corticosteroids, anti-convulsants, barbiturates, and blood thinners

Refuse to Lose

Remember that moment as a child when you realized you were taller than one of the grown-ups in your family? Chances are, the adult with whom you could finally see eye-to-eye was Grandma.

But if you dig through your old family albums and look at your grandmother in her high school graduation photo or in her wedding gown, you're likely to see a taller and straighter-standing woman than you remember. What robbed her of inches is a condition known as degenerative bone disease, or osteoporosis. And, in a tragic number of people, osteoporosis robs more than inches. It steals independence as well. The freedom of an energetic retirement all too often is cut short by complications of broken bones caused by this gradual, insidious disease.

One out of every two women in the United States has an osteoporosis-related fracture in her lifetime, adding up to 1.5 million broken bones a year. Of them, 300,000 are hip fractures, which can lead to disability or death. One-quarter of the women over 50 who experience hip fractures die within a year. A quarter of the women who survive hip fractures require long-term care.

Another 700,000 fractures experienced annually are vertebral. Vertebral compression fractures cause not only loss of height but also deformity of the skeleton in the form of a hunchback or a stooped posture. Many vertebral fractures also lead to decades of chronic pain. Fractures of the wrist and other bones can also restrict activities and cause pain.

In the United States, 10 million people already have osteoporosis; 8 million of them are women. Another 18 million people have dangerously low bone mass, putting them at a high risk for developing the disease.

Despite its prevalence and the terrible toll it takes on the active lives of older Americans, osteoporosis is quite misunderstood. You can't depend on pain to alert you to its presence, because pain occurs very late in the disease, when fractures already have Occurred. It's not like arthritis; your knees and finger joints won't ache or become stiff. The damage wrought by osteoporosis is silent, signaling its presence only when your bones begin to break.

This is a disease so under recognized that, in a recent study of 2,314 women at risk for osteoporosis, 93 percent of the women who met the diagnosis had no idea they had it.