By John R. Lee, M.D. and Virginia Hopkins

You May Be Surprised to Learn that this is Not a Calcium Deficiency Disease

Now that scientists know the process of preventing osteoporosis begins early in life, (check out other articles on osteoporosis as listed to your left) we're hearing about sugary drinks fortified with calcium for teenagers, antacids with calcium, and calcium supplements. Osteoporosis is not a calcium deficiency disease, it is a disease of excessive calcium loss. In other words, you can take all the calcium supplements you want, but if your diet and lifestyle choices are unhealthy, or you're taking prescription drugs that cause you to lose calcium, you will still lose more calcium from your bones than you can take in through diet.

In fact, getting adequate calcium is only a small part of the prevention picture. Please pass up the sugary drinks and antacids. The damage that refined sugar will do to a growing teenage body or even an adult body far outweighs any benefit that might come from a little calcium supplementation. There is even some evidence that sugar depletes calcium, so the added calcium in these drinks may only be balancing out the damage done by the sugar. The same goes for antacids containing calcium. Since antacids tend to cause you to lose calcium, the added calcium may only offset that damage.

Having pointed out that osteoporosis is not a calcium deficiency disease, I want to assure you that getting adequate calcium is an important factor in preventing osteoporosis. Some good food sources of calcium are snow peas, broccoli, leafy green vegetables such as spinach, kale, beet and turnip greens; almonds, figs, beans, nonfat milk, yogurt and cottage cheese. I don't want you to depend on milk to get your calcium. This is because milk has a poor calcium to magnesium ratio. Your body needs a certain amount of magnesium in order to get the calcium into your bones -- without magnesium, calcium can't build strong bones.

In fact, magnesium deficiency may be more common in women with osteoporosis than calcium deficiency. Although many fruits and vegetables have some magnesium in them, especially good sources of magnesium are whole grains, wheat bran, leafy green vegetables, nuts (almonds are a very rich source of magnesium and calcium), beans, bananas and apricots.

Trace minerals are also important in helping your body absorb calcium. Eating plenty of green leafy vegetables gives you calcium along with these helpful trace minerals. Boron and manganese are especially important. Foods that contain boron include apples, legumes, almonds, pears and green, leafy vegetables. Foods that include manganese include ginger, buckwheat and oats.

The organic matter in our bones consists mainly of collagen, the "glue" that holds together skin, ligaments, tendons and bones. Zinc, copper, beta carotene and vitamin C are all important to the formation and maintenance of collagen in the body.

A Calcium/Magnesium Supplement is Good Health Insurance

Everyone should have at least 600 mg of easy-to-absorb calcium daily. Although you can easily get that much with a healthy diet, taking a calcium/magnesium supplement is an excellent form of health insurance. In fact, calcium supplements can help slow bone loss in some women. To be incorporated into bone, calcium requires the help of enzymes, which require magnesium and vitamin B6 to work properly. We tend to be more deficient in magnesium and B6 than we do in calcium.

All calcium supplements are not the same. The best absorbed form is called calcium citrate. Avoid the oyster shell calcium, as it can be contaminated with heavy metals. If you're female and over the age of 12, you should be taking 300 mg of calcium, combined with 200 mg of magnesium every day. If you can find a formula that also includes vitamin B6, so much the better. Menopausal women can take 600 mg of calcium daily with 400 mg of magnesium.

Sunshine is the Best Medicine

Vitamin D is another important ingredient in the recipe for strong bones because it stimulates the absorption of calcium. A deficiency of vitamin D can cause calcium loss. The best way to get vitamin D is from direct sunlight on the skin. Sunlight stimulates a chain of events in the skin leading to the production of vitamin D in the liver and kidneys. (This is why liver and kidney disease can produce a vitamin D deficiency.) Going outside for just a few minutes a day can give us all the vitamin D we need, and yet many people don't even do that. They go from their home, to their car, to their office, and back home, without spending more than a few seconds outdoors. Many elderly people are unable to get outside without assistance, but this should be a priority for their caretakers.

Stomach Acid

As we age, we tend to produce less stomach acid. To be absorbed, calcium, requires vitamin D and stomach acid. For this reason, it's important to avoid antacids and the H2 blockers such as Tagamet and Zantac, which block or suppress the secretion of stomach acid. Contrary to what the makers of heartburn and indigestion remedies would have you believe, the last thing in the world most people need is less stomach acid. Heartburn and indigestion are caused by poor eating habits and a lack of stomach acid. Ulcers are caused by a bacteria, not by too much stomach acid. A simple way to improve your calcium absorption may be to take a betaine hydrochloride supplement just before or with meals, to increase your stomach acid. You can find betaine hydrochloride at your health food store.

The Collagen Vitamins and Minerals

Collagen is the tissue that makes up your bone. To build collagen you need vitamin A (or beta carotene), zinc and vitamin C. Vitamin C is especially important, as it is the primary ingredient in the collagen matrix. I recommend you take 1,000 mg daily of vitamin C, in an esterfied form to prevent stomach problems.

Diet

1. Reduce or eliminate soda pop and other carbonated beverages.
2. Keep meat consumption to a reasonable level (no more than once a day).
3. Eat plenty of fresh, green vegetables and whole grains.
4. Eat foods high in flavonoids, which help stabilize collagen structures, such as blueberries, raspberries and hawthorne berries.

Supplements

1. Calcium citrate, 600 mg daily with meals
2. Magnesium (citrate, glycinate, oxide or malate), 600-900 mg daily with meals
3. Folic acid, 200 mcg daily
4. Vitamin C, 1,000 mg twice daily
5. Vitamin B6, 50-100 mg daily between meals
6. Zinc, 15 mg daily with meals
7. Beta carotene, 15,000 iu daily
8. Trace Minerals, including 1-3 mg of boron and manganese.

For a more detailed osteoporosis program, please read the chapter on Osteoporosis in our book What Your Doctor May Not Tell You About Menopause

For a detailed article on what bone density tests really mean, and how to interpret them, please read the October 98 issue of my newsletter.