What to know about calcium and bone density

What you need to know about calcium supplements, yoga and bone density Millions of postmenopausal women take a calcium supplement due to low bone density — either osteopenia (mild low bone density) or osteoporosis (low bone density). However, newer research has called into question whether taking calcium supplements is advisable. Foods rich in calcium may be a better choice. Here's what the newest findings on calcium supplements have shown. No reduction in fractures Numerous studies have found that calcium supplements do not reduce the incidence of bone fractures in postmenopausal women. According to research published in the Journal of Bone Metabolism, "…recent meta-analyses suggest no significant prevention of fractures. In summary, there is little substantive evidence of benefit to bone health from the use of calcium supplements." Meta-analyses are an analysis of many research studies. Meta-analyses summarize the results of numerous studies. Therefore, their conclusions are typically more accurate than the findings of a single research study. The researchers also state the promotion of calcium supplements "was based on the belief that increasing calcium intake would increase bone formation. Our current (newer) understanding of the biology of bone suggest that this does not occur." Since bones are composed of calcium (and many other minerals), it seemed logical that increasing one of the minerals needed to make bone would build more bone. Researchers do note that "calcium does act as a weak antiresorptive." ("Anti" means against. Resorptive means the breakdown.) Thus, taking calcium reduces the breakdown (or loss) of bone tissue. The various brands of bisphosphonate drugs given to postmenopausal women also act as antiresorptives. In humans, bones are constantly being broken down (by cells called osteoclasts) and new bone is built by cells called osteoblasts. That is, old bone tissue is constantly being broken down and replaced with new bone tissue. (This is similar to many cells in our body. For example, the body constantly sloughs off old skin and grows new skin cells.) It is good to break down old cells and replace them with newer, stronger cells. Neither calcium nor bisphosphonate drugs prescribed to treat osteoporosis stimulate the osteoblasts to build new, stronger bones. So, what has been proved to build new bone tissue and to increase bone density? Weight-bearing activity Muscles are connected to our bones by tendons. It is the pull (or stress) of the tendons on bones that stimulates bones to build new bone (to support the increased pull of the muscles). Without this pull on the bones, the body will not make new bone — no matter how much calcium and vitamin D people take. Regular weight lifting (or lifting any heavy object, including exercises using our own body weight) tells our body that stronger bones are needed. As muscles become stronger, our bones become stronger. This pull on the bones by tendons and muscles causes the osteoblasts to build new, stronger bone tissue. Interestingly, it also reduces the activity of the osteoclasts that break down bone. With more and stronger bone tissue, the incidence of bone fractures decreases. Lifting weights or other heavy objects also increases muscle mass and balance. This significantly reduces the risk of falls. Falls are the leading cause of fractures. However, you don't need to go out and buy weights, go to a gym or hire a trainer. There is a free way proven to increase bone density and reduce the risk of fractures: yoga. 12 yoga poses A 10-year study of seniors daily doing 12 yoga poses showed an increase in bone density in the hip, spine (lumbar vertebrae) and femoral neck. The study, titled "Twelve-Minute Daily Yoga Regimen Reverses Osteoporotic Bone Loss," was published in the journal of Top Geriatric Rehabilitation. The journal article includes a list and photos of the 12 poses done in the study. You may look up the study at tinyurl.com/fm7nved7. One of the researchers, Dr. Loren Fishman, has a website, www.sciatica.org. He has also published DVDs and a book titled, "Yoga for Osteoporosis." At his website, you can find a video and descriptions of how to do the poses. The website has pictures showing three ways to do each pose: one for people without low bone density, a simpler pose for people with osteopenia and an even easier pose for people with osteoporosis. Dr. Fishman explains that each pose must be held for at least 30 seconds to achieve bone benefits. Bending at the hips, not at the waist is important to protect your spine. Other weight-bearing activities shown to increase bone density include the plank, pushups, tennis and raquetball. Risks of calcium supplements Many people take calcium supplements due to lactose intolerance or a dislike for milk. Many well-known medical institutions, such as John Hopkins, recommend getting calcium from food rather than supplements. Eight ounces of milk delivers about 300 milligrams of calcium. Calcium supplements deliver a larger dose of calcium at one time. Taking calcium supplements causes a temporary spike in blood calcium. This may increase the risk of various health issues, such as: — Kidney stonesThe body can only absorb so much calcium at one time. The excess is excreted in the urine. This increases the risk of forming painful kidney stones. — Gastrointestinal issuesSome people have been hospitalized with acute gastrointestinal issues. A common side effect is constipation. —Possible increased risk of heart diseaseAccording to Tufts University, some studies also have shown that daily taking large doses of calcium (such as 1,400 milligrams or more) may double the risk of a heart attack. (As a reference, the recommended calcium intake is 1,000- 1,200 milligrams per day.) According to the Cleveland Clinic, it is easy to overdose on calcium, especially if you take antacids (such as Tums or Rolaids) which also contain calcium. For example, two Rolaids contains 540 milligrams of calcium. Studies on whether or not calcium supplements increase the risk of atherosclerosis (hardening of the arteries) have shown mixed results. The plaque that lines (and clogs) arteries is "hardened" with calcium. In some studies, people who took calcium supplements had increased hardening of the arteries. Other studies have failed to show this. If you do take calcium, always take it with vitamin D. Vitamin D is needed for the absorption of calcium. However, until further research is done, the Cleveland Clinic recommends getting calcium from food rather than supplements. Foods contain more than calcium and vitamin DUnlike supplements, foods, such as dairy products, contain many other nutrients needed to build new bone. To build bones, we need sufficient protein, calcium, vitamin D, phosphorous, magnesium, vitamin A, fluoride, vitamin K2, vitamin C, copper, manganese, zinc and iron. For people who cannot tolerate cow's milk, there are many other types of milk and cheeses.These include Lact- Aid milk, goat milk, goat cheeses, soy or almond milk and others. Dairy foods are the richest food sources of calcium. Other foods, such as leafy greens contain smaller amounts of calcium, which is poorly absorbed. Only five percent of the calcium in leafy greens is absorbed due to its oxalate content which binds the calcium. So, instead of reaching for a calcium supplement, try enjoying more dairy products — made with cow's milk or any type of milk you like. And lastly, daily do some yoga poses or other weight-bearing activity so the body uses those nutrients to build stronger, denser bones. Here's to stronger women (and men). Phyllis J. Molnar is a registered and licensed dietitian who writes about food and health for The Chronicle-Telegram and The Gazette. Email her at pjmolnar56@gmail.com. Broccoli cheese soup 2 cups finely chopped broccoli½ cup chopped onion2 tablespoons oil2 tablespoons flourA few dashes of pepper preferably white pepper1 cup evaporated milk(Or low-fat milk with 1 tablespoon dissolved cornstarch to thicken milk)1 (14 ounce) can reduced sodium chicken broth½ teaspoon dried thyme leaves, crushed between your fingers1 small bay leafDash of garlic powderShredded cheddar cheese, about 1 cup or to taste Wash and chop broccoli. Bring 1 ½ inches water in a medium saucepan with a lid to a boil. Place broccoli in a steamer basket and place over the water. Reduce heat to low. Cover and steam broccoli for 3 minutes. Remove the steamer basket with broccoli and set aside. Discard water. Heat oil in the same pan. Sauté onion until soft and translucent. Stir in the flour and pepper. While stirring, add milk all at once. Cook until thickened. Stir in the broth, thyme, bay leaf and garlic powder. Cover and simmer for 10 minutes. Remove bay leaf. Stir in the steamed broccoli.Remove soup from the stove and stir the shredded cheddar cheese into the hot soup. Serve immediately. For a smooth, creamy soup, blend soup in a blender before adding the cheese. (I blend half the soup at one time to prevent it from exploding out of the blender.) Makes: three to four servings SOURCE: Based on a recipe from Better Homes and Garden New Cookbook with modifications by Phyllis Molnar Nutrition notes:-Instead of cooking the broccoli in the broth (as the original recipe directs), steam the broccoli to preserve its anti-cancer nutrient called sulforaphane. Cooking broccoli for 10 minutes in the broth would destroy the sulforaphane. -Evaporated milk contains twice the calcium as regular milk: 658 milligrams vs.300 per cup.One cup shredded cheddar cheese adds 800 mg. calcium.Two cups chopped raw broccoli contain about 86 milligrams calcium.Thus, based on 4 servings, one serving of soup provides about 388 milligrams calcium.