From the Archives: Fall 2007 Issue of Lupus Now
Bye-Bye, Bone Loss: Boost the calcium in your diet tastefully
By Amy Paturel, M.S., M.P.H.
Calcium is critical for building bone. But meeting the recommended 1,000 milligrams a day is a challenge—and more than half of Americans fall short. Add a debilitating disease to the mix, plus its accompanying obstacles to absorbing the mineral, and you have a recipe for osteoporosis, right? Not necessarily.
Research shows that bone mass loss occurs as a direct result of lupus, although the reasons for this are not well understood. Lupus causes joint pain and fatigue, which may result in inactivity, further increasing the risk of bone loss, since weight-bearing exercise is vital to keeping bones strong. Avoiding the sun, which can trigger a flare of lupus, is another reason that bones can weaken, since sunlight is necessary for vitamin D production, a necessary component of calcium absorption. Also, the glucocorticoid medications, such as prednisone, that are often prescribed to treat lupus can trigger significant bone loss.
But that doesn’t mean you’re destined for bad bones if you have lupus! There are many ways you can keep your bones strong and healthy throughout your life.
“Food first is the best approach,” says Christine Gerbstadt, Ph.D., R.D., national spokesperson for the American Dietetic Association in Sarasota, Fla. She explains that three to four servings each day of dairy foods will provide about 1,200 milligrams of calcium (one serving equals 1 cup of milk or yogurt, 1 1/2 ounces of hard cheese, or 2 cups of cottage cheese).
Other calcium-rich foods include:
- Canned fish with bones, like sardines and salmon
- Dark-green leafy vegetables, such as kale, collards, and broccoli
- Calcium- and vitamin-D-fortified foods like orange juice and soy “milk”
- Fortified breakfast cereals
- Nuts
With the rise in calcium- and vitamin-D-fortified foods (not to mention tasty supplements like Viactiv), meeting your daily calcium needs is easier than ever. But, cautions Gerbstadt, “There’s a threshold for how much the body can absorb at one time. You can’t just take an 800-milligram supplement and get the same benefit as having three to four servings of dairy or fortified foods spread throughout the day.” The reason is that your body can’t use that much calcium at once and will excrete the excess in urine.
So, if you can’t reach your daily requirement through food alone, supplements are helpful. But remember: Your body can absorb only 500 to 600 milligrams at a time.
Choose a supplement containing 400 to 600 milligrams and take it three times a day (morning, noon, and night) with water and food, suggests Gerbstadt, since calcium can be constipating. Swallowing supplements with high-fiber foods and a lot of fluids not only enhances absorption but also helps keep things moving.
A few more tips for enhancing calcium absorption:
- Make sure you’re getting 400 to 800 international units of vitamin D, which helps transport calcium from the intestines and into the blood. Good sources include egg yolks, fatty fish, and fortified cereal and milk. If your doctor agrees, you also can get the same result from about 15 minutes of sun exposure daily.
- Avoid eating excessive amounts of protein, which can promote calcium depletion. (Gerbstadt recommends trying to restrict daily protein intake to no more than 0.8 grams per pound of body weight.)
- Don’t consume more than 2,000 milligrams of calcium a day—even though your body will excrete the excess, too much calcium can increase the chance of kidney problems for some individuals.
- Don’t take calcium at the same time as high-dose iron or other mineral supplements. They compete for absorption in the body.
- Limit caffeine. A diet high in caffeine increases calcium loss in the urine.
- Limit alcohol. Excessive alcohol consumption reduces absorption of calcium and can lead to poor absorption of nutrients needed for normal bone formation.
As you increase calcium in your diet, you’ll not only improve your bone health, but you’ll gain exposure to other important nutrients and phytochemicals like those featured in these recipes. Bon appétit!
Recipes courtesy of Helen Bishop-MacDonald, author of The Everyday Calcium Cookbook.
Great Granola
Serves 4
1 cup granola cereal
1/2 cup chopped dried fruit (raisins, apricots, dates)
1/4 cup walnuts or almonds
2 cups chopped fresh fruit (kiwi, peaches, bananas, grapes)
1 cup plain yogurt
honey (optional)
1. Combine all ingredients and serve.
Per serving: 358 calories, 11 g protein, 53 g carbohydrates, 14 g fat, 2.6 g saturated fat, 178 mg calcium.
Atlantic Salmon Chowder
Serves 6
1 tablespoon butter
1/2 cup chopped onion
1/2 cup chopped celery
1/4 cup chopped green bell pepper
1 garlic clove, finely chopped
3 cups diced potatoes
1 cup diced carrots
1 cup chicken broth
1/2 teaspoon dill seeds
1 cup diced zucchini
1 1/2 cup milk
1 10-ounce can cream-style corn
1 7.5-ounce can salmon, drained
pepper
1/2 cup chopped fresh parsley
French baguette, sliced
1. In a large saucepan, melt butter. Sauté onion, celery, green pepper, and garlic in butter for 5 minutes while stirring.
2. Stir in potatoes, carrots, broth, 1 cup water, and dill. Bring to a boil. Reduce heat, cover, and simmer for 20 minutes.
3. Add zucchini; cook for another 5 minutes.
4. Stir in milk, corn, and salmon; season to taste with pepper. Cook over low heat for 5 to 10 minutes.
5. Sprinkle with fresh parsley before serving. Serve with French baguette.
Per serving: 231 calories, 10 g protein, 36 g carbohydrates, 7 g fat, 3.2 g saturated fat, 159 mg calcium.
Havarti Apple Toss
Serves 4
1 cup sour cream
1/4 cup honey
2 teaspoons lemon juice
4 cups diced, cored red apples (about 4 medium)
1 1/4 cups diced Havarti cheese
1 cup sliced celery
1/2 cup crushed walnuts
leaf lettuce
1. In a small bowl, combine sour cream, honey, and lemon juice. Chill dressing at least 1 hour to blend flavors.
2. Just before serving, combine apples, Havarti cheese, celery, and walnuts in a large bowl.
3. Pour in dressing and toss lightly to
combine. Spoon into lettuce-lined bowls and serve.
Per serving: 455 calories, 16 g protein, 38 g carbohydrates, 29 g fat, 14.6 g saturated fat, 436 mg calcium.