Prescriptions
Several foods besides milk are good sources of calcium

Eight-year-old Christie hates milk. Her mom is worried that if Christie doesn’t drink her milk, her bones will be weak.

On one hand, her mother is right for worrying about Christie’s calcium intake. But on the other hand, there are lots of foods other than milk that can help Christie get the calcium she needs.

It is calcium that is responsible for strong bones and teeth. Calcium may also be beneficial in lowering high blood pressure and preventing colon cancer.

The amount of calcium you need in a day depends on your age and your gender.

An 8-ounce cup of milk has 300 milligrams of calcium. Children under the age of 11 need 800 milligrams daily.

Teenagers and adults should shoot for a minimum of 1,000 milligrams daily. Pregnant and lactating women, and all adults over the age of 50, need at least 1,200 milligrams of calcium per day. Some experts even recommend 1,500 milligrams.

Many of the patients I see do not use dairy products, especially milk. After drinking milk, they complain of stomach cramps, bloating, gas or diarrhea.

The reason is that some folks have too little of an enzyme needed to digest the sugars in milk. This condition is called lactose intolerance. It is frequently seen in elderly people and people of African and Asian ancestry.

The good news is that people who are lactose-intolerant can consume small amounts of milk if taken with a meal (8 ounces at a meal), and up to 16 ounces daily.

Studies have also shown that repeated exposure to milk improves tolerance. Many people who experience symptoms from milk can still eat cheese, yogurt and ice cream because the lactose is partially digested in these foods. There are also special milks such as Lactaid and acidopholis-added milk that are well-tolerated by some people.

For those who would rather avoid dairy products altogether, there are other sources of calcium. Some common sources include tofu, broccoli, sardines, salmon with bones, and the nondairy drink Rice Dream.

Since keiki may turn their noses up at some of the common calcium alternatives just as much as they might with milk, you may be happy to know that calcium has been added to some kid-friendly foods.

Calcium-fortified orange juice contains as much calcium as milk. Eggo Homestyle Frozen Waffles, Kix cereal and Kellogg’s Nutri-Grain Bars are also good calcium sources.

If, after reading the list of calcium sources at right, you are still convinced you or your child isn’t getting enough calcium through foods, supplements are available.

Although calcium in milk may be better absorbed than that in supplements, the supplements still give you a healthy dose of calcium.

Look for calcium supplements that also contain vitamin D. This enhances calcium’s ability to strengthen bones.

I often recommend a calcium supplement called Viactive Soft Calcium Chews. It is a chocolate-flavored candy and has 500 milligram of calcium. Since it actually tastes good, it should be easy to give to kids.

Be careful not give them to children in unlimited amounts, as excess calcium can be harmful. One to two chews is plenty. This product contains sugar, so diabetics should choose a different supplement.

Tums is another excellent source of calcium. Vitamin companies also sell supplements. Although some companies try to tell you why one kind is better than another, all are absorbed pretty well.

The best way to figure out how much of a supplement to take is to estimate the amount of calcium you usually consume through diet first. Subtract that amount from the recommended amount for your age and sex. That difference is the amount you need to get through supplements.

Amy Tousman is a registered dietitian at Straub Clinic & Hospital Inc. and a member of the Hawai‘i Dietetic Association.

Hawai‘i experts in traditional medicine, naturopathic medicine, diet and exercise take turns writing the Prescriptions column. Send your questions to: Prescriptions, ‘Ohana Section, The Honolulu Advertiser, P.O. Box 3110, Honolulu, HI 96802; e-mail ohana@honoluluadvertiser.com; fax 535-8170. This column is not intended to provide medical advice; you should consult your doctor.

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