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The Honolulu Advertiser
Posted on: Thursday, March 22, 2007

To absorb calcium efficiently, your body requires vitamin D

By Laurie Steelsmith

Milk is full of calcium, but if you are allergic to dairy pro-ducts, there are alternatives.

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CALCIUM

Dairy sources:

Plain yogurt, nonfat (8 ounces): 452 milligrams

1 percent low-fat milk (1 cup): 290 milligrams

2 percent reduced-fat milk (1 cup): 285 milligrams

Whole milk (1 cup): 276 milligrams

Romano cheese (1.5 ounces): 452 milligrams

Nondairy sources:

Soy milk, fortified (1 cup): 368 milligrams

Firm tofu, prepared with nigari (1/2 cup): 253 milligrams

Sardines, with bones (3 ounces): 325 milligrams

Blackstrap molasses (1 tablespoon): 172 milligrams

Collard greens, cooked from frozen (1/2 cup): 178 milligrams

Spinach, cooked from frozen (1/2 cup): 146 milligrams

Kale, cooked from frozen (1/2 cup): 90 milligrams

Pak-choi or Chinese cabbage, cooked from fresh (1/2 cup): 79 milligrams

Vitamin D3

Cod liver oil (1 tablespoon): 1,360 milligrams

Salmon, cooked (3.5 ounces): 360 milligrams

Mackerel, cooked (3.5 ounces): 345 milligrams

Tuna, canned in oil (3 ounces): 200 milligrams

Sardines, canned in oil, drained (1.75 ounces): 250 milligrams

Egg: 1 whole: 15 milligrams

Source: U.S. Department of Agriculture

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Q. I know that calcium is related to bone health, but what should I eat, which supplements should I take, and how much do I need? And is vitamin D also important for healthy bones?

A. Calcium is essential for maintaining and building your bones. It's a good idea to get as much calcium in your diet as you can and then take supplements if you need additional calcium.

Dairy products can be a significant part of your bone-building diet — but not if you're allergic to dairy or have lactose intolerance. Not only are they loaded with calcium, but researchers have discovered that they contain specific proteins, especially concentrated in whey, that can enhance bone density.

In addition, a sugar found in dairy products, lactulose, enhances calcium absorption. If you don't tolerate dairy products, there are other food sources rich in calcium.

According to the National Institutes of Health, the recommended daily amounts of calcium ingestion by age group are: 210 milligrams at under 6 months; 270 milligrams at 7 to 12 months; 500 milligrams at 1 to 3 years; 800 milligrams at 4 to 8 years; 1,300 milligrams at 9 to 18 years; 1,000 milligrams at 19 to 50 years; and 1,200 milligrams at over 51 years. Those with osteoporosis should take at least 1,500 milligrams a day.

If you take calcium supplements, use calcium citrate for maximum absorption. (Note: some people experience diarrhea if they ingest too much calcium citrate.)

Calcium needs vitamin D in order to be absorbed in your intestinal tract, so it's important to look at your vitamin D intake as well. You get one type of vitamin D, known as D3 (cholecalciferol), from exposure to sunlight and from eating fish oils and eggs; another type, D2 (ergocalciferol), is made in plants and used to fortify dairy products.

According to a study published in the Journal of Clinical Endocrinology & Metabolism in 2004, vitamin D2 is less effective than vitamin D3; the researchers found that D2 has less than one third the potency. Another study, published in the American Journal of Clinical Nutrition in 2006, reported that "vitamin D2 should not be regarded as a nutrient suitable for supplementation or fortification."

Be sure you're ingesting vitamin D3 for maximum effectiveness. To know if you have enough D3, ask your doctor to run a blood test. The recommended daily intake is 200 international units for people from birth to 50 years old, 400 for those aged 51 to 70, and 600 for those 71 or older. Most bone-building formulas contain 200 to 800 units of vitamin D.

Laurie Steelsmith is a naturopathic physician and licensed acupuncturist in Honolulu, as well as author of "Natural Choices for Women's Health" (Random House). Reach her and read columns at www.drsteelsmith.com. This column is for information only. Consult your health provider for medical advice.