Healthy eating habits/Answering Questions about Healthy Bones, Women and Calcium

The purpose of this guide is to answer common questions on serves of dairy for calcium requirements, different sources of calcium other than dairy and for using a variety of sources in meals for optimum calcium intake. It was developed for women over 35 years.



Background
There are over 170 uses for calcium in our body and 99% is used for bone strength. The calcium makes our bones strong and the bones in turn serve as a storage reservoir for calcium. If our diet is lacking in calcium, the body will take it from the reservoir in the bones, making them weaker (Whitney et al, 2011). Osteoporosis is the weakening of the internal structure of the bone. 3.4% of Australians have confirmed osteoporosis and significantly, 82% of these cases are women (Osteoporosis Australia, 2014). Healthy bones will be denser while weaker bones will have a more porous structure, which will fracture more easily. From 35 years onward, the process of bone regeneration slows down and after 60 years, 50% of all women experience osteoporotic fracture (Whitney et al, 2011).

How much is a serve of dairy?

 * 250 ml or 1 cup milk or calcium fortified soy
 * 200 g or ¾ cup yogurt
 * 40 g hard cheese

How many serves per day do women require?
(NHMRC, 2014)
 * 2½ serves per day until 50 years
 * 4 serves per day after 50 years

How I can incorporate serves in my day? Examples

 * 125 ml on cereal at breakfast; 200 g tub yogurt as a snack; 40 g cheddar on a sandwich
 * 200 g yogurt with oats at breakfast; 125 ml skim milk in a latte as a snack; 30 g Parmesan on pasta

Animal and plant sources of calcium
(compiled Whitney et al, 2011; Nuttab 2010 online)

Animal sources and plant sources NOT animal vs. plants!
When plant and animal sources are grouped together and served in the one meal, small milligrams of calcium add up to calcium rich meals. This adds variety to the diet as well as sources of Vitamins B, C, Folate and dietary fibre(Whitney et al, 2011). In addition there is increasing evidence that a dietary pattern with a wide variety of foods is important for good health, rather than the emphasis on one or two food groups (NHMRC, 2012).

Milk is one of the best food for bone health. Among plant-based sources, nuts are good for bone health. Cashew nuts are rich in copper, magnesium and calcium. Hence, they are good for bone health. Similarly, almonds and walnuts are also good choices.

Bioavailability
Bioavailability is the rate and extent to which calcium (or any nutrient) can be absorbed by the body and utilised for the requirements. Plant sources have greater bioavailability than animal sources (Whitney et al, 2011).

Calcium bioavailability of animal and plant sources
(Whitney et al, 2011)

Bioavailability and plant sources
In countries like China where almost no dairy products are consumed, osteoporosis is uncommon, providing evidence that plant sources can play a vital role in strong bones. Grouping many different vegetables in the one meal not only provides for greater calcium, but takes advantage of the greater bioavailability of plant sourced calcium (Whitney et al, 2011).

Stir Fry of Bok Choy, Tofu, Almonds and Broccoli
Serves 2

1 bunch Bok Choy

2 cups broccoli florets

1 red capsicum cut into thin strips

1 cup calcium set tofu, cut into cubes and marinated in 2 tbsp. of tamari, 1 tbsp. of grated fresh ginger, 1 tbsp. grated fresh garlic, and juice of 1 lemon

60 g almonds, lightly toasted in oven

2 tbsp. peanut or grape seed oil

½ tsp. toasted sesame oil

1 tsp. grated ginger extra

Juice of ½ lemon

Bake marinated tofu cubes in moderate oven for 20-30 minutes. Heat peanut oil and stir fry capsicum first followed by green vegetables.

Add marinade drained from tofu and continue until vegetables are just cooked.

Add another tsp. of grated ginger, sir though and add juice of half a lemon

Add tofu, almonds and sprinkle with sesame oil, stir gently through. Serve with brown rice

Calcium note: 2 cups of raw Bok Choy (which will wilt) can contain as much as 300 mg of calcium, the same as 250 ml serve of cow’s milk.

Sardine Fish Cakes with Sweet Potato
http://www.primalpalate.com/paleo-recipe/sardine-and-sweet-potato-fish-cakes/

Calcium note: Serve with a sauce of 3 heaped tsp. of tahini (387 mg calcium) thinned with 100 g of natural yogurt (225 mg calcium) and flavoured with finely chopped coriander.

Cauliflower and Brussels Sprout Cheese Gratin
http://www.canadianliving.com/food/cauliflower_and_brussels_sprouts_gratin.php

Calcium note: combining dairy sources with good plant sources increases total calcium intake in one meal.

General
Australian Guide to Healthy Eating, http://www.eatforhealth.gov.au/

Better Health Channel: Calcium (see Osteoporosis risk quiz in sidebar) http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Calcium?open

Osteoporosis Australia at http://www.osteoporosis.org.au/

Individual Advice
Dietitians Association of Australia, http://daa.asn.au/ to find an accredited practicing dietitian