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Supplements & Bone Health

Deanna's Story | When Are Supplements Useful? | Links

 

Here is Deanna's story about supplements and bone health…

In my busy life I sometimes don’t have time to eat properly so I rely on supplements to ensure I am getting enough nutrients into my body. Some weekdays are busy for me and I don’t have enough time to eat a good breakfast, and sometimes lunch too, so I can’t really pay much attention to food until I get home.

By participating in this project, I became more aware of different things about bone health such as the importance of the right supplements when you don’t have the time or desire to think too much about foods. Because I am over 50, I learned that taking vitamin D supplements according to Canada’s Food Guide is very important, especially during the months that we do not get vitamin D from the sun.

Although I do think that food choice is very important for good nutritional balance, I also believe that everybody needs to take supplements to ensure that their body is functioning at its best and to not have to worry about if they have eaten all the right foods to meet their needs. I believe that everybody should be well informed about the supplements that they are taking, and once you have learned good information, I think it is important to share it with family or friends, especially with younger people to make their lives better.

Some of the questions that I had previously are answered in the Healthy Tips section. I wondered about what is the best time to take supplements and what supplements go together. Also, I wondered what stress levels do to bone, because I think it is important not to create anxiety when you miss taking your supplements. Overall, I think taking supplements in combination with food and activity all contribute in a holistic way to bone health.

If you want to learn more about calcium and vitamin D supplements, and vitamin and mineral supplements, the following websites will provide you with reliable information.

 

When Are Supplements Useful?

When you are unable to meet your calcium or vitamin D needs through diet alone, supplements are useful. Before you start taking supplements, consult with your primary health care professional, as there may be medication interactions or side effects such as diarrhea, constipation or stomach upset.

Find a calcium supplement you like. If you find tablets difficult to swallow, try a chewable or liquid type. A one-a-day type of multivitamin and mineral supplement will provide you with some calcium, but if your diet is low in calcium a multivitamin and mineral supplement will likely not provide enough calcium for you to meet your daily requirement. Read the label to find the amount of elemental calcium in each dose. It is best to take no more than a 500 mg dose of elemental calcium in supplemental form at any one time. If you are relying on calcium supplements for most of your daily calcium intake, it will be best to take smaller doses (no more than 500 mg calcium) several times throughout the day to reach your recommended intake goal. Don’t over-consume calcium or vitamin D, as there are hazards to regularly consuming high intakes. The current maximum recommended intake for calcium is 2500 mg/day and for vitamin D is 2000 IU/day (50 mcg/day).

Getting enough calcium can be achieved through food intake, especially for people who consume milk and dairy products. (See example below for someone who doesn’t drink milk.) On days when your dietary intake is not enough, you should take a supplement to increase your intake up to a total of what is recommended for you. Calcium supplements are best taken with plenty of fluids and in amounts no greater than 500 mg of elemental calcium at any one time. Be sure to read the label to see how much elemental calcium is in one dose.

To improve absorption, supplements of calcium carbonate are best taken with or immediately following a meal. Tums®, a common antacid, contains calcium carbonate and should be taken with a meal. Most other calcium supplements can be taken at any time during the day (e.g. calcium citrate, calcium gluconate, calcium lactate). Try to take your calcium supplement at a time when you are otherwise not consuming calcium. For example, if you have a glass of milk with your breakfast and calcium-fortified orange juice with your lunch, then take your calcium supplement with dinner. Establishing a regular time to take your supplement will help you remember to take it!

Can you take too much calcium? While it is unlikely, it is important to follow the directions on the label of any supplement container, and not exceed a combined total of 2500 mg of calcium from foods and supplements each day.

Getting enough vitamin D from food sources can be challenging because very few foods naturally contain vitamin D. Supplements are often necessary to meet the daily recommendation for vitamin D intake. If you are over 50 years, you should take a daily vitamin D supplement (10 mcg or 400 IU) in addition to your intake from foods. Vitamin D supplements can be taken at any time.

 

How much calcium and vitamin D do I need?

Healthy Women and Men
Age Daily Calcium Intake Daily Vitamin D Intake
19-50 years 1000 mg 5 mcg 200 IU
51-70 years* 1200 mg 10 mcg 400 IU
71+ years* 1200 mg 15 mcg 600 IU

mg = milligrams; mcg or µg = micrograms
*If you are over 50 years, Health Canada recommends a daily vitamin D supplement (10 mcg or 400 IU) in addition to your intake from foods.
Note: On supplement containers IU (International Units) is used to indicate the amount of Vitamin D present in each dose. One microgram (mcg or µg) is equal to 40 IU.

 

What can I do if I don’t like to drink milk?

If you are a woman older than 50 years who doesn’t like to drink milk, here are ideas for calcium-containing foods and a supplement that will provide enough calcium for you to meet your recommended daily intake.

Food or Supplement
Calcium (mg)
1 cup fortified soy beverage 300
1 grilled cheese sandwich (50 g (4x3x3 cm) of Cheddar cheese) 400
Other foods (for example: 250 mL (1 cup) of cooked green leafy vegetables (for example, kale, bok choy), 2 slices of bread, 1 orange, 60 mL (1/4 cup) dry roasted almonds) 200-200
Daily calcium supplement (preferably with vitamin D - read the label to ensure you are getting 500 mg of elemental calcium) 500
TOTAL calcium for the day 1400-1500mg

*Note: These are approximate values only. Source of information: Health Canada, Canadian Nutrient File
To learn more about supplements, please visit these reliable websites.

 

Selected Reliable Websites
(download PDF, 62 KB)

 

Office of Dietary Supplements • National Institutes of Health, USA
You will find information that is written for the consumer about a wide variety of vitamin, mineral and botanical supplements. For an overview of supplement use, check Tips For The Savvy Supplement User, Tips for Older Dietary Supplement Users, and How To Evaluate Health Information on the Internet: Questions and Answers.

There is also a long list of Dietary Supplement Fact Sheets for different supplements, including calcium and vitamin D. These fact sheets look at multiple aspects of calcium and vitamin D, including: what is calcium and vitamin D and how much we should be getting at different ages, where do we find these nutrients in foods and different supplements, how much can we rely on the sun to provide us with vitamin D, how do calcium and vitamin D affect our health, and interactions with different medications. Dietitians, academic and research experts have reviewed the information provided in the fact sheets. Draw on this information to help you decide, in consultation with your health care provider, if you should take supplements.
Dietary Supplement Fact Sheet: Calcium
Dietary Supplement Fact Sheet: Vitamin D


BC Women’s Hospital & Health Centre – Nutrition for Healthy Bones
This resource answers many common questions about taking calcium and vitamin D supplements for bone health. It explains when to take different types of calcium supplements for best absorption, how to determine how much calcium you are getting in one serving of a food from the calcium information on the food label, what to look for when buying a calcium supplement, whether you need a vitamin D supplement, and provides local (British Columbia) contacts for seeking further information.

The BC Women’s Hospital and Health Centre Osteoporosis Program offers an osteoporosis clinic for those who are at risk of or have osteoporosis and have a referral from their doctor. They also offer 2 to 3 osteoporosis education classes each year that do not require a doctor’s referral. Check with the health centre for the dates of these clinics and education classes. Health professionals from the Osteoporosis Program have developed the Osteofit exercise program. Osteofit classes are available at community centres throughout British Columbia. Check with your local community centre to see if they offer these classes. The Osteoporosis Program website provides downloadable resources on osteoporosis.


HealthLinkBC
This series of health-related resources has been written in an easy to understand language to help you make better decisions about your health. In addition to the three supplement-related health files provided here, use the search box to find information on topics such as Fitness, Osteoporosis, and Osteopenia.
Vitamin and Mineral Supplements for Adults
Healthy Eating and Healthy Aging for Adults
Food Sources of Calcium and Vitamin D


Dietitian Services at HealthLinkBC (formerly Dial-a-Dietitian)
If you live in British Columbia, Dietitian Services at HealthLinkBC is a one-stop resource for asking any nutrition-related questions you have to a Registered Dietitian at the other end of the phone line. They offer translation services in 130 languages! Call toll-free from anywhere in BC 1-800-667-3438, or if you live in the metro Vancouver area call 604-732-9191. You can view links and download resources about bone health and many other health issues from the website.


Osteoporosis Canada
Beyond offering further information regarding foods, exercise and supplements for bone health, this website provides basic information about the diagnosis of and possible treatment options for osteoporosis. You can use the Calcium Calculator™ to estimate your daily calcium intake from the foods you eat and beverages you drink. Try some of the calcium-rich recipes! They also offer a toll-free bilingual information line: 1-800-463-6842 English and 1-800-977-1778 French.


National (U.S.) Osteoporosis Foundation
This website provides a wide range of information about bone health and osteoporosis. Click Prevention on the left hand menu to learn more about getting enough calcium and vitamin D from foods and supplements.


Women’s Health Matters
This is a website that provides evidence-based information on a wide variety of women’s health topics with expert contributors from Ontario’s Women’s College Hospital. This link will take you directly to the Osteoporosis Health Centre where you will find information on different aspects of osteoporosis.


Mayo Clinic
The Mayo Clinic provides comprehensive information on a wide variety of health topics, including osteoporosis. This page of the website, Dietary supplements: Nutrition in a pill?, suggests considerations you should take into account before using dietary supplements.

 
     

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Sophia Morley
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The Learning Centre, Faculty of Land and Food Systems,
University of British Columbia

Special thanks to each woman who gave generously to create this website.