Thursday, June 9, 2011

Make no bones about it

By Eveline Gan, TODAY
Posted: 16 May 2011

SINGAPORE - While I pay much attention to my skin, weight and, occasionally, cholesterol levels, rarely do I think about the state of my bones.

In fact, I consume calcium-rich foods so infrequently that I can't remember the last time I actually drank milk.

Apparently, I'm not alone. Adults aged 18 years and above in Singapore are recommended by the Health Promotion Board to consume 800mg of calcium daily.

Yet, local studies show that the average Singaporean consumes about 25 per cent less than the recommended amount - about 600mg or less, said Dr Manju Chandran, director of the Osteoporosis and Bone Metabolism Unit and consultant at the Department of Endocrinology at the Singapore General Hospital.

A good calcium intake helps build up your bone bank, which is essential in preventing thinning bones later in life.

According to Mrs Magdalin Cheong, chief dietitian and senior manager at the Dietetic and Food Services at Changi General Hospital, the body also needs calcium for blood-clotting functions, and to regulate biochemical reactions.

Ideally, she said, it is best to get your daily calcium requirements from natural food.

"With supplements, you're not sure how much of it is absorbed into your body. Calcium from food is better absorbed due to the presence of other nutrients such as protein and lactose," said Mrs Cheong.

However, the experts agreed that it may be difficult for certain groups of people to get enough calcium from their diet alone.

This is especially so if you are above the age of 51, or are pregnant or breastfeeding - your daily calcium intake should be about 1,000mg each day.

With so many types of calcium supplements to choose from, the question is: Where should you start?

Over-the-counter calcium supplements are sold in different forms. Calcium carbonate and calcium citrate are the most commonly available types, as both forms are well-absorbed by the body, according to Ms Chung Wing Lam, a resident pharmacist at IMM Watsons.

However, while calcium citrate can be easily absorbed even when taken without food, calcium carbonate works better with food, said Mrs Cheong.


Some tips to help you choose the best calcium supplement for your needs:

· Look at its source

According to Ms Chung, calcium supplements are made mainly from oyster shell extract. If you are vegetarian, go for those made from plant extracts.

· Check out its elemental calcium content

This is the actual content of calcium in the supplement, said Mrs Cheong. A 1,000mg tablet does not actually contain the same amount of calcium. Ms Chung cited some examples: Calcium carbonate contains 40 per cent elemental calcium, so the maximum amount of calcium you can absorb from a 1,000mg tablet is only 400mg. Calcium citrate contains only 21 per cent elemental calcium.

· Does it include Vitamin D?

This vitamin plays an important role in helping your body absorb calcium.


Here's what you can do:

· Split the dose

If the elemental calcium dose is greater than 500mg, you should split your supplement into several doses, Ms Chung advised. She explained that the higher the amount of actual calcium, the less it is absorbed by the body.

· Go easy on food high in phytates and caffeine

In general, phytates-rich foods are also high in fibre. They include vegetables such as spinach, rhubarb, wholegrains and bran.

"Too much caffeine can also affect the bioavailability of calcium by increasing the loss of calcium in the urine and stimulating the secretion of calcium into the gastrointestinal tract," said Mrs Cheong.

· Avoid taking calcium with any medications or other supplements

Ms Chung recommended an interval of at least two hours, if you have to take other supplements or medications such as certain antibiotics or medication for osteoporosis.

· Get clearance from your doctor before taking any supplements

If you have any medical conditions such as kidney disorder, do check with your doctor prior to taking any supplements. Excessive calcium supplementation may possibly cause constipation or an increased risk of kidney stones in the long term, said Ms Chung.

Mrs Cheong added that a high dietary calcium intake can also reduce iron and zinc absorption.


Taken from; source article is below:
Make no bones about it

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