Food First

The reporting of health news is one of the most challenging parts of a registered dietitian’s job.  The news media or our culture as a whole has conditioned us to want sound bites.  But I don’t think that’s the best method to report on research.

Take several recent studies on calcium and vitamin D, for example. In the last two months, while driving to work, I heard conflicting reports on these nutrients. For years, we were advised to take calcium and vitamin D supplements to strengthen our bones and protect against fractures – especially for postmenopausal women. Then in June, the United States Preventive Services Task Force recommended against it. Their review of literature presented little evidence that these supplements prevent fractures.

This announcement was followed by a European study linking calcium supplements to a greater risk for heart attacks.

Then the next week, another analysis suggested calcium and vitamin D supplements help older adults live longer.

Are you confused yet?

There is no question that our bodies need calcium. Besides building and strengthening bones, calcium is important for nerve signal transmission to blood vessel health. Vitamin D is required to help the body absorb that calcium (that is the reason why these two nutrients are often paired together in a supplement).

According to the Institute of Medicine (IOM), women over age 50 need 1,200 milligrams of calcium a day and around 600 to 800 International Units (IU) of vitamin D a day. The issue is not whether we need calcium, but how we should get it. Should it come from our food or our medicine chest?

From the latest research listed above and the US Preventive Services Task Force, it appears that most of the calcium should come from our diet. IF we do not get enough from our diet alone, then add a supplement. “Food first” … that’s one of our registered dietitians’ favorite sound bites. Another top sound bite – “more is not better.”

So how do you know the amount of calcium in your food? Fortunately, every food label lists the percent of calcium in the food. Since the percent is based on 1,000 milligrams, it’s easy to do the math:

If calcium is listed at 20%, then 20% of 1,000 equals 200 milligrams.

*I like to look for shortcuts, so a quick tip is to simply add a zero to the percentage. So calcium at 15% would equal 150 milligrams and calcium at 30% would equal 300 milligrams.

Add up these numbers throughout the day to reach the total recommendation of 1,200 milligrams for women 50 and older. If your number falls short, then a calcium supplement should be used to make up the difference. But keep in mind that the body better absorbs a calcium supplement with a meal so limit your intake to only 500 to 600 milligram supplements at one dose.

Remember, dairy products are the best source of calcium. There are some calcium fortified products, such as orange juice and cereal. Kale and broccoli also contain some calcium, but in small amounts (less than 100 milligrams per cup). Milk and some yogurts are fortified with vitamin D. Our bodies also make vitamin D in the presence of sunlight, but not with the use of sunscreen. Any vitamin D supplementation should be discussed with your physician to determine the best amount for you.

So if you like sound bites, remember, “food first” and “more is not better” when it comes to the use of supplements.