Your Bones

 
Osteoporosis is a weakening of the bones that can cause hip or other fractures. People with spinal cord injuries need to work hard to keep their bones strong, because they are at higher risk than able-bodied people for osteoporosis.  
  • Look at the table entitled "Can you pick out the factors that put you at risk for osteoporosis?" below, and pick out which factors you think put a person at risk for osteoporosis, then scroll down to the next table and check the answers which are shaded in pink.

  • Keep scrolling down to find out how much calcium is in different foods such as dairy products, fish and vegetables

  • Next you'll find calcium recommendations for different gender and age groups

  • Next, check out tips about taking calcium supplements

  • Finally, information about vitamin D and its relationship to calcium is presented

 
 
Can you pick out the factors that put you at risk for osteoporosis?

Female gender 

Male gender 

Cigarette smoking

Being Caucasian

Being Asian

Being African American

Low calcium intake

High calcium intake

Low vitamin D intake

High vitamin D intake

Low vitamin C intake

Low iron intake

Low body weight or small frame 

High body weight or large frame 

Heavy drinking

Light drinking

Low physical activity 

High physical activity 

High red meat intake

Older age 

Younger age

Family history of osteoporosis

                     Answers appear below!
 
 







The correct answers are shaded in pink below.  Scroll down to the end of the table for more
details about being at risk for osteoporosis, and what you can do to prevent it:


Female gender: women are at greater risk than men

Male gender 

Cigarette smoking: puts you at risk for osteporosis

Being Caucasian: Whites and Asians are at higher risk than African Americans or Hispanics

Being Asian: Asians and Whites are at higher risk than African Americans or Hispanics

Being African American

Low calcium intake: Calcium helps to keep bones strong (see chart below that lists calcium content of foods, and to find out how much calcium you should be getting every day)

High calcium intake

Low vitamin D intake: Vitamin D helps the body to absorb calcium

High vitamin D intake

Low vitamin C intake

Low iron intake

Low body weight or small frame: those with a small frame or who are thin are at higher risk for osteoporosis 

High body weight or large frame 

Heavy drinking: For reasons that are unclear, heavy drinking contributes to osteoporosis

Light drinking

Low physical activity:  Physical activity helps keep the bones strong, but only weight-bearing physical activity (see chart below that lists activities that help keep bones strong)

High physical activity 

High red meat intake

Older age: the older you get, the more at risk you become for osteoporosis

Younger age

Family history of osteoporosis: if osteoporosis runs in your family, then you are at higher risk for it, too

 

The table below lists the amount of calcium in different foods.

Food/beverage
Approximate calcium 
(milligrams)
yogurt, plain, nonfat (1 cup) 450
yogurt, plain, lowfat (1 cup) 415
Yogurt, fruit (1 cup) 315
Milk, skim (1 cup) 300
Milk, 2% (1 cup) 295
Milk, whole (1 cup) 290
Chocolate milk, 1% (1 cup) 285
Chocolate milk, 2% (1 cup) 285
Calcium-fortified soy milk (8 ounces) 250-300
Swiss cheese (1 ounce) 270
Tofu (processed with calcium sulfate) 
     (1/2 cup) 
260
Calcium-fortified orange juice (3/4 cup) 225
Cheese pizza (1/8 of a 15-inch pizza) 220
Cheddar cheese (1 ounce) 205
Salmon, canned with edible bones 
    (3 ounces)
205
Mozzerlla cheese, part skim (1 ounce) 185
Macaroni and cheese (1/2 cup) 180
Blackstrap molasses (1 tablespoon) 170
Pudding (1/2 cup) 150
Frozen yogurt (1/2 cup) 105
Turnip greens (1/2 cup) 100
Sardines with edible bones (1 ounce) 90
Ice cream (1/2 cup) 85
Dried figs (3) 80
Cottage cheese (1/2 cup) 75
Tempeh (1/2 cup) 75
Parmesan cheese (1 tablespoon) 70
Mustard greens (1/2 cup) 50
Okra (1/2 cup) 50
Orange (1) 50
Kale (1/2 cup) 45
Broccoli (1/2 cup) 45
Anchovies with edible bones (5) 45
Tortillas (made from lime-processed corn)  40
Pinto beans (1/2 cup) 40
Rutabaga (1/2 cup) 35
Chinese cabbage (1/2 cup) 30
Cream cheese (2 tablespoons) 25
Tuna, canned (3 ounces) 10
Lettuce greens (1/2 cup) 10

 
 
How much calcium should you be eating every day? There are no specific recommendations for people with spinal cord injuries; these recommendations are for the able-bodied.  It is possible that those with spinal cord injury may need more than the recommendations below.
Gender and age group Optimal daily intake 
(in mg of calcium)*
Adolescents/Young Adults .
11-24 years 1,200-1,500
. .
Men .
25-65 years 1,000
Over 65 years 1,500
. .
Women .
 25-50 years 1,000
Over 50 years (postmenopausal) 1,500
On estrogens 1,000
Not on estrogens 1,500
Over 65 years 1,500
Pregnant and nursing 1,200-1,500
*National Institutes of Health Consensus Development Conference Statement June 6-8, 1994

 
 
Tips about taking calcium supplements
Read the label.  Over-the-counter supplements are not the same. The amount of calcium differs among products.
Avoid calcium supplements with dolomite or bone meal. They might contain very small amounts of lead and other metals.
Take calcium supplements as intended -- as a supplement and not as your only important source of calcium.  Although supplements may boost calcium intake, they don't provide other nutrients your bones need, like vitamin D, magnesium, phosphorus, and boron. Milk, for example, provides vitamin D, which helps deposit calcium in your bones.
If you take both calcium and iron supplements, take them at different times of the day. They'll each be better absorbed when taken on their own.
If you take two or three tablets daily, space them throughout the day. That way, they'll be absorbed better.
Drink plenty of fluids with calcium supplements to avoid constipation. 
If you take your calcium supplement with milk, the lactose and vitamin D in the milk can help to enhance the absorption of the calcium.
Taken from: American Dietetic Association's Complete Food and Nutrition Guide

 
 
 
 
Vitamin D is necessary for optimal calcium absorption.  Below are sources of vitamin D. 400 IU per day is recommended for adults ages 51 through 70 years 600 IU per day for adults over 70 years of age.
Source of vitamin D Amount of vitamin  D (IUs)
Sunlight (see explanation below) Your body can make its own vitamin D if it's exposed to sunlight
Vitamin D-fortified milk (8 oz) 100 
Cod liver oil  (1 tablespoon) 1360 
Salmon (3 oz) 425
Herring (3 oz) 765
Shrimp, canned (3 oz) 90
Sardines, canned (3 oz) 255
Cereal, fortified (1 serving: usually 1 cup)  40 to 50
Egg yolk  25

 
Additional information about Vitamin D:

Sunlight exposure provides most people with their entire vitamin D requirement. Children and young adults who spend a short time outside two or three
times a week will generally synthesize all the vitamin D they need.  Elderly individuals have diminished capacity to synthesize vitamin D from sunlight exposure, and
frequently use sunscreen or protective clothing in order to prevent skin cancer and sun damage. The application of sunscreen with an SPF factor of 8 reduces
production of vitamin D by 95%. 

In latitudes around 40 degrees north or 40 degrees south (Boston is 40 degrees north), there is insufficient UVB light available for vitamin D synthesis from November to early March. Ten degrees farther north or south (Edmonton, Canada) this "vitamin D winter" extends from mid October to mid March. 

A survey of elderly people who took a multivitamin supplement or drank 3 glasses of milk daily found that about 80% of them were vitamin D deficient by the end of winter. These findings have led some experts to recommend small amounts of regular sun exposure to elderly individuals*. 

About 15 minutes of exposure on the hands, face, and forearms three times a week in the morning or late afternoon during the spring, summer, and fall should provide adequate vitamin D and allow for storage of any excess in fat for use during the winter with minimal risk of skin damage.  A sunscreen may be applied after the 15 minutes, if additional sun exposure is planned. 

*Holick, M.F. Vitamin D. In Shils, M. et al. Eds. Nutrition in Health and Disease, 9th Edition. Baltimore: Williams & Wilkins, 1999: pages 329-345.

Vitamin D information from: Linus Pauling Institute at Oregon State University

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