Karate Athlete

Exercise and dietary intake of calcium are two lifestyle factors within our control that can greatly improve bone health. The optimal characteristics of a physical activity program that typically will increase bone mass and thereby minimize fracture risk are summarized in the table below. Examples of physical activities that best “fit the bill” are weight-training (by machines or free weights), tennis, handball, racquetball, squash, gymnastics, volleyball, stair climbing, heavy gardening and lawn work, and step aerobics. The very best regimen would include at least three different activities spaced out over each week. Walking alone is likely to be effective only for previously sedentary individuals.

Achieving Adequate Calcium Intake
Over the last decade calcium requirements have been carefully redefined and reflect higher calcium intakes than the previous Recommended Daily Allowance values. The graphs to the below illustrate “Adequate Intake” values (in green) as compared to actual average intakes. Clearly, too many men over 50 years of age and girls/ women over 10 years of age are missing the mark by a wide margin. The latter group is highly unlikely to achieve its true biological potential in peak bone mass.

The general rule that vitamin and mineral dietary requirements are best met by eating foods rather than in supplement form is true for calcium as well. How much of the ingested calcium that actually gets absorbed in the intestine depends on many cofactors that are often present in food. The USDA Food Guide Pyramid recommends 2-3 servings of dairy products and 3-5 servings of vegetables per day. But there are many other sources as well, including calcium-fortified orange juice, which contains about the same amount of calcium (350 mg/cup) as skim milk. Additional food items containing calcium are listed in the accompanying table. Good news for caffeine-lovers: There is a lot of calcium in that caffe latte!

For those who need more calcium than they can eat and drink on an average day, there are many calcium supplements on the market that come in forms such as calcium carbonate, calcium citrate, and calcium lactate. Those individuals with impaired gastric acid production cannot absorb calcium carbonate well on an empty stomach, so they should take those supplements with a meal. Otherwise, absorption is best when calcium supplements are taken between meals.

RECOMMENDED WEBSITES www.osteo.org Web page for NIH Osteoporosis and Related Bone Diseases National Resource Center, contains many links to other organizations including National Osteoporosis Foundation (www.nof.org)

www.dairycouncilofca.org Tremendous practical resource: estimate your own daily calcium intake, teaching aids and more.

http://text.nlm.nih.gov/nih/cdc/www/97.html Full text of Optimal Calcium Intake NIH Consensus Statement.

Calcium Content of Common Foods

Values provided by National Dairy Council

Plain, nonfat yogurt, 1 cup	452 mg
Swiss cheese, 1 1/2 oz	408 mg
American processed cheese, 2 oz	348 mg
Cheddar cheese, 1 1/2 oz	306 mg
Skim, nonfat, fat free milk, 1 cup	302 mg
2% reduced fat milk, 1 cup	297 mg
Chocolate milk, 1 cup	280 mg
Ice cream, 11% fat, 1/2 cup	88 mg
2% reduced fat cottage cheese	78 mg
Sardines with bones, 3 oz	371 mg
Canned salmon with bones, 3 oz	167 mg
Almonds, 1/2 cup	120 mg
Frozen cooked okra, 1/2 cup	88 mg
Frozen, cooked broccoli, 1/2 cup	47 mg
Orange, 1 medium	52 mg
Corn tortilla, 1, 6” diameter	42 mg
Cheese pizza, 1 slice, 1/2 of 15” diameter pie	220 mg
Caffe latte, 12 fl oz	412 mg
Cappuccino, 12 oz	262 mg