Dr. Arturo M. Volpe

This scenario plays itself out on a daily basis: women are administered a bone density test and found to have some degree of bone loss labeled osteopenia in milder cases or osteoporosis in more severe ones. They are then prescribed one of several drugs known as bisphosphonates that include Fosamax, Actonel, Boniva, and a few others. At the same time they are instructed to take large daily doses of calcium.

The drugs do work. When repeated, bone density tests show improvement. WebMD tells us how they work: they “slow or stop the natural process that dissolves bone tissue, resulting in maintained or increased bone density.”

Stopping the bones from dissolving might seem like just the right thing to do

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, except that these natural processes are essential for bone tissue to remain healthy. Bones need to be continuously broken down and rebuilt, and if you disrupt this process you generate bones that are denser but also unhealthy and brittle. Read More »

Tags: Bone Issues, Calcium, Osteoporosis
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A few years ago I wrote a piece entitled “The Calcium Story” that can be found in Newsletters. It dealt with how much calcium we need and how we can get it, especially in a dairy-free diet. Although a great deal of new information has surfaced since I wrote it, readers will still find it informative.

This article follows up on that older one and discusses what happens to calcium inside the body. Although doctors frequently recommend taking 1,000 or even 1,500 mg of calcium, how can we tell if the calcium we take actually goes to strengthen bones and doesn’t instead do something completely different, and possibly even harmful?

Let’s consider some facts: a majority of women past the age of forty or fifty today are being diagnosed with osteopenia, if not full-blown osteoporosis, and a growing number of men are found to have the same problem. This means that, in an aging population, bones are losing calcium at an alarming rate.
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If there is one thing Iíve learned, itís that when it comes to diet and nutrition, what we’ve been told all along is often wrong. One such thing is that to protect our bones we need more
calcium. It makes sense, right? Donít bones contain calcium? But maybe itís not so simple!

What always struck me as odd is that Americans already drink more milk and take more calcium supplements than just about anyone else and yet also have record rates of
osteoporosis and old age fractures. Could we be missing something?

An article recently published in the journal Medical Hypotheses provides a shocking new theory. According to the authors, a number of studies prove definitively that a lower lifetime
intake of calcium is associated with fewer – not more – fractures in old age and that this is not the result of genetic differences!

The authors then theorize that taking too much calcium somehow inhibits the innate ability of bones to heal tiny fractures that happen inevitably with aging. Once the bones lose the ability to repair these minor traumas, more severe ones ensue. (1)

Of course it is important to realize that if the intake of calcium fell below a certain threshold the number of fractures would increase again, so as for everything else in nature, there is
an optimal balance and more is not better. In my opinion this optimal balance not only relates to the total amount of calcium but, maybe even more importantly, to the ratio of calcium
with magnesium and other minerals.

But this is not all. A second article, also recently published in the same journal, points out that there is enough evidence from numerous published studies to recommend a dairy- and
calcium-restricted diet for people who suffer with atherosclerosis, or clogging of the arteries. (2)

Of course, atherosclesoris is calcification – or calcium buildup – that blocks the arteries, and I have always thought it strange that conventional medicine decided to only focus on cholesterol and never even consider that calcium could also be a culprit.

Aside from these articles, researchers are seeing atherosclerosis increasingly as the end result of a chronic inflammatory process in the artery walls. This process eventually leads to
abrasion and damage of the artery itself, which the body patches up by laying down calcium with cholesterol acting as glue.

Osteoporosis itself has been described as the result of chronic inflammation, since the inflammatory process needs calcium to perpetuate itself and ends up leaching it out of the
bones. A classic example of this is gingivitis, or inflammation of the gums, which is known to eventually lead to osteoporosis in the jawbone and loss of teeth.

In this context, calcium is at least a two-edged sword. The calcium you might take to protect your bones could be instead fueling an inflammatory process that will eventually result in
both heart disease and osteoporosis!

My advice is not quite to throw all calcium out of the window, but to take moderate amounts of it with enough magnesium and other minerals as well as trace minerals that actually
have counter-balancing effects and help reduce inflammatory processes in the body.

1. “Lifetime high calcium intake increases osteoporotic fracture risk in old age.” Med Hypotheses, 2005; 65 (3): 552-8

2. “The case for dietary calcium restriction in patients with atherosclerosis” Med Hypotheses, 2005; 65 (3): 521-4

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Making sure there is enough calcium in your child’s diet can be a daunting task, especially when they are on a casein-free diet. The option of calcium supplementation is always available, but the body’s ability to absorb these nutrients from supplements is not nearly as good as when the calcium is contained in the food you eat.

So in my quest to add natural food sources of calcium, I turned to a very wise doctor we all know. He informed me that the sesame seed is an excellent source of calcium. So off I went to Whole Foods Market in search of sesame seeds, and it is there that I discovered a very important piece of information about sesame seeds. All of the bottled tahini (sesame seed paste), the sesame seeds in the spice aisle, and even the shiny white ones in the bulk bins, contained very little calcium.

I was a bit confused, had I been led astray? Surely not, so after further inspection I discovered another bulk bin that contained tan or mottled brown sesame seeds. Certainly not the sesame seeds you would choose to eat, let alone take home to your kids. But I felt fairly confident that Whole Foods was not peddling rancid sesame seeds, so I checked the label.

The difference was that this bin contained unhulled sesame seeds, and the majority of calcium is contained in the hull. In fact, just 1/2 cup of these seeds contains 350 mg, 35% of the recommended daily allowance for calcium. By comparison, 1/2 cup of whole milk provides about 75 mg.

The key to unlocking the nutrients for use in the body is grinding them before consumption; otherwise they will just take the quick tour through the body. You should store them in the freezer and grind only the amount you need to prevent rancidity.

Not only are these seeds full of calcium, they are also powerhouses of other nutrients. They are packed with B vitamins in the form of riboflavin, thiamine, niacin, folic acid and vitamin b6. They also contain the minerals iron, zinc, magnesium, and potassium. To top it all off, the sesame seed makeup is 25% protein.

So pick up a bag of not-so-shiny sesame seeds the next time you are at a health food store, and grind them up to use in cookie and bread recipes, as a crispy coating on your chicken or fish, as a spread for crackers, or as a boost to your smoothie.

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Most women past the age of menopause have probably been offered one of several drugs to treat or prevent osteoporosis. These drugs work primarily by inhibiting hormones like parathyroid, although in most cases these hormones are at healthy levels and are not what causes bone loss. The drugs may well lead to stronger bones, but toxicity and side effects are a real concern.

All of us know about the importance of calcium for bone growth in children and healthy bones in adults. However taking calcium alone has not been shown to help reduce bone loss and osteoporosis. One reason is that the body needs vitamin D to absorb calcium and deposit it in bones.

A recent study showed that taking 800 to 900 IU of vitamin D in addition to 1,200-1,300 mg of calcium resulted in increased bone density in both younger and older postmenopausal women. The study also revealed that vitamin D deficiency was widespread among aging individuals. Ensuring adequate intake of vitamin D and calcium would seem to be a reasonable first step in manag ing osteoporosis before even considering drugs that cause undesirable hormone disruption (J Women’s Health (Larchmnt) 2003 Mar; 12:2: 151-6).

Unlike other vitamins, our bodies can make Vitamin D. The skin has enzymes that, when exposed to the ultraviolet rays of the sun, convert cholesterol into Vitamin D. We also obtain some Vitamin D from food, but since the amount we get from the sun can vary a great deal, it is a challenge to determine exactly how much Vitamin D we need from our food or supplements.

The US recommended daily allowance (RDA) is 400 international units (10mcg) daily from infancy to adulthood, and it was long thought that intakes exceeding 2,000 IU daily posed a risk of toxicity. However, expert opinion is shifting on this point since it has become apparent that the body can make many times more Vitamin D from even brief exposure to the sun.

Deficiency of Vitamin D is probably becoming more common in part because of widespread use of sunblocks that interfere with the skin’s ability to synthesize this vitamin. Large doses of Vitamin A, while beneficial in certain cases, can also induce a deficiency of Vitamin D if the levels of the two vitamins are not monitored and maintained in proper balance.

Studies have also shown that Vitamin D plays a central role in regulating the immune system. People with low blood levels of Vitamin D have been shown to have a higher occurrence of numerous cancers, including prostate, breast, colon, and others. The rate of autoimmune disease is higher in those who are deficient in this important vitamin.

Regular but sensible exposure to the sun may be the best way to ensure adequate stores of Vitamin D. Individuals at risk for osteoporosis, those who take Vitamin A supplements, or those with immune system disorders should ask their healthcare professional to order a simple test called 25-hydroxy-vitamin D to help determine their level of this important vitamin.

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More and more of us are finding that eliminating dairy from our diet can help solve chronic health problems. Children stop having ear infections, digestive problems or constipation suddenly improve, and asthma, headaches and even depression may finally come to an end with just this simple step.

I am not suggesting that milk is always bad, or that everyone should avoid it, but those who are sensitive to it are better off without it. This is not an indictment of milk itself, but of the
modern production techniques that have altered an otherwise perfectly healthy food.

The next question on many people’s minds is: how can I get enough calcium without milk? The calcium story is a bit more complicated than just counting the number of milligrams consumed per day, but the good news is that there are many excellent sources of calcium aside from milk.

The first point to keep in mind is that the body cannot use calcium by itself. Without enough Vitamin D, for example, we cannot adequately absorb and utilize calcium. Bones also need other important minerals, and taking too much calcium alone can be actually damage our health by causing acidity in blood and contributing to plaque buildup in arteries.

To promote ideal calcium absorption, a majority of our calcium should come from natural food sources, whether we consume dairy products or not. Calcium-rich foods don’t just contain calcium; they also contain many associated nutrients including minerals and proteins that promote optimal calcium utilization. This complex food synergy cannot be easily achieved by just taking supplements. Supplements are man-made and can never quite match the optimal balance of nutrients found in nature.

Most foods contain at least some calcium as this mineral is found everywhere in nature. Certain grains, seeds and green vegetables are very rich in calcium, with sesame seeds containing four times more calcium than milk. The seeds can be digested properly only if finely ground – it’s easy to grind them in an inexpensive coffee grinder at home and sprinkle them over salads or other foods, add them to drinks like smoothies, use in baking, etc. If you are concerned about your ability to fully digest these foods and absorb the calcium and other nutrients they contain, having them with a digestive enzyme might help.

One strategy to obtain enough calcium is to select several combinations of high-calcium foods you can include in your or your child’s diet on a rotating basis. Calculate the calcium content of each combination using the table at the end of this section. You may also take a well-balanc ed, high-quality calcium supplement every day to fulfill any residual need.

For example, on Day One you can have one cup of amaranth flour and a quarter of a cup of ground sesame seeds in your meals for a total of 750 mg of calcium. Add 250 mg of calcium from a supplement if you need to reach 1,000 mg.

On Day Two, have half a cup each of almonds, tofu and ground flaxseeds and reach roughly the same 750 mg of calcium. You will not be able to match exactly every day’s calcium intake, so just average it and remember: variety is the key to obtain not only calcium but also a wide range of synergistic nutrients!

The next question is how much calcium do we really need on a daily basis? Unfortunately there is no general consensus on this point. Although the US recommended daily allowances (RDA) are often very low and have been nicknamed “recommended deficiency allowances,” they are unusually high when it comes to calcium.

The U.S. RDA for calcium in children aged 1 to 10 is 800 mg per day, whereas in the United Kingdom the recommended intake is 350-550mg. In addition, other dietary factors affect

calcium balance. Sugar and caffeine cause excretion of calcium and other minerals from the body, so if the diet is high in these products you will need extra calcium to make up for the loss.

In my opinion, an intake in the range of 500 mg in children under the age of 11, roughly double that for children over 11 and 700 mg in adults is adequate as long as the diet is “clean”
and low in sugar, stimulants and other junk foods. Higher intakes of calcium should be considered in special cases, including osteoporosis. I have included both the U.S. and U.K.

RDAs for calcium to give you more information about target intakes.

Food/Calcium content (mg) per cup unless otherwise indicated.

Dairy:
Milk, whole/291
Milk, 2%/297
Milk, nonfat/302
Cottage cheese/150
Yogurt, plain/274

Fruits:
Currants, zante, dried/124
Figs, dried/269 per 10 figs

Grains:
Amaranth grain, boiled/276
Amaranth flour/407
Carob flour/359
Cassava flour/193
Cottonseed flour (low fat)/1,080
Garbanzo flour/324
Quinoa flour/324
Rice bran/128
Soybean flour (low fat)/165
Sweet potato flour/115
Teff, grain or flour/407 (note: contains gluten)

Vegetables:
Hummus spread/124
Black-eyed peas, boiled/212
Navy beans, boiled/128
White beans, boiled/161
Wax beans, cut, canned/174
Beet greens, boiled/165
Chard, Swiss, boiled/102
Dandelion greens, boiled/146
Kale, boiled/180
Mustard greens, frozen, boiled/150
Okra, boiled/100
Parsley, dried/912
Taro, Tahitian, cooked/202

Soybean products:
Miso/184
Tempeh/154
Tofu/260
Firm tofu/516

Nuts, seeds and nut butters:
Almonds/600
Almond butter/688
Brazil nuts/400
Cashews/104
Cashew butter/96
Cottonseed flour, low-fat/1,080
Filberts (hazelnuts)/424
Flaxseeds/616
Macadamia nuts/160
Peanuts/136
Pistachios, shelled/304
Pumpkin seeds, dried/96
Safflower seeds, dried/176
Sesame seeds, whole/1,408
Soybean nuts, dry roasted/464
Sunflower seeds/272
Walnuts/216

Sea Vegetables:
Agar agar, dried/1,438
Arame, dried/2691
Carragheen, dried/2,036
Dulse, dried/681
Hijiki, dried/3,220
Kelp, raw/386
Kelp, dried/1,840
Wakame, dried/2,990

Fish and shellfish:
Salmon (canned)/167 per 3oz serving (includes bones)
Sardines (canned)/371 per 3oz serving (includes bones)
Oysters (raw)/226

Sources: mostly from “Calcium without the Cow” by Sally Rockwell, PhD, CCN. Other books by Dr. Rockwell include “Allergy-Free Baking Tips for Special Flours,” “Allergy Recipes” and “The Rotation Game,” all available from www.amazon.com.

Recommended daily allowances for Calcium

Category/Age (years)/US RDA (mg)/UK nutrient intakes (mg)
Infants/7-12 mo/400/535
Children/1-10/800/350-550
Males/11-19/1,200/1,000
Males/Adult/800/700
Females/11-19/1,200/800
Females/Adult/800/700
Females/Pregnant/1,200/700
Females/Lactating/1,200/1,250

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Question: I have been hearing many good things about coral calcium. What is your opinion about this supplement and do you recommend that I take it and give it to my child?

Answer: the truth is that I have been reading the same reports and, although I was skeptical all along, I knew very little about coral calcium until I decided to do some research on this topic.

If you want to sell a calcium supplement and really make some money, you’d better find a catchy name and make some bold claims even if you can’t substantiate them. In a nutshell,
this was my original thought and I must say I haven’t seen anything to change my mind.

Coral calcium is extracted from coral reefs near Okinawa, Japan and the health claims stem from the fact that Okinawans enjoy long healthy lives and apparently consume some of these coral extracts. The fact is that we have seen this type of marketing many times before and in all likelihood the Okinawans’ good health has more to do with their active lifestyle and traditional diet than coral calcium.

A closer look reveals that coral calcium is made primarily of calcium carbonate. This is the same type of calcium found in limestone and the antacid Tums. Although there is nothing specifically wrong with calcium carbonate, it is known to be very poorly absorbed, with absorption rates as low as 5%, especially in aging individuals. Other forms of calcium, including calcium citrate, far outperform the absorption of calcium carbonate.

One claim that is made for coral calcium is that it can raise blood pH making the body more alkaline. However, pH is determined by a complex set of factors and we can’t state either that raising pH is always desirable, or that calcium will predictably raise pH. In fact, within different ranges calcium can either increase or decrease alkalinity. One good place to start to assess pH balance of the body is to obtain a comprehensive blood chemistry, something that can be done with minimal expense.

The most outrageous claim I read was that coral calcium can extend life. I’ll let you be the judge of that one. To read all about these claims you can visit www.coral-calcium-supplement.com or www.coral-calcium-supplement.net.

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