It is imperative to build strong and healthy bones in our childhood to avoid osteoporosis and other bone-related problems as we grow older.

Osteoporosis, or “porous bone", is a condition which make bones fragile, because of low bone mass and deterioration of bone tissue, and can lead to fractures, typically in the hip, spine and wrist.

How much calcium we need, though, depends on our “peak bone mass". Peak bone mass can be defined as the amount of bony tissue present at the end of the skeletal maturation and is an important determinant of osteoporotic fracture risk. By our mid-20s, we have acquired most of our skeletal mass. A high bone mass as a young adult results in high bone mass later in life, and thus lesser chances of bone-related problems. Calcium is a mineral needed by the body for healthy bones, teeth, and proper functioning of the heart, muscles, and nerves. Since the body cannot produce calcium, it must be absorbed through food. It is important to eat calcium-rich foods, exercise, and get enough sunlight as children to build peak bone mass; stronger your bones are to begin with, lesser are the consequences of bone loss in adult life.

Green goodness: Add dark leafy vegetables to your diet as they are a good source of calcium.

The sources of calcium

• Dairy products like milk, cheese or yogurt. Full-fat, skimmed or toned milk, all are a good source of calcium.

• Dark leafy vegetables such as pak choi, kale, Chinese cabbage, turnip greens; sweet potato; and foods like makhana (fox nut), and singhada (water chestnuts).

• Calcium-fortified foods like fortified breakfast cereals and fortified orange juice. Avoid the ones with added sugars.

• Nuts and seeds like watermelon seeds, pumpkin seeds, sesame seeds, and almonds.

• Fruits like custard apple, banana, jackfruit, and chikoo.

• Soy foods—these contain isoflavones, which are plant-based chemicals that strengthen bone density. Soy also has an oestrogen-like effect, which can ward off bone disease in postmenopausal women.

• Fatty fish like salmon. These have bone-boosting nutrients like vitamin D and calcium, and also omega 3 fatty acids. Fish oil supplements have been shown to reduce bone loss, specially in elderly women.

Beside food, there are some lifestyle choices that affect bone health.

Smoking: One packet of cigarettes a day through your adult life can lead to as much as 5-10% bone mass loss.

Alcohol: More than two drinks a day can cause the bones to weaken.

Carbonated drinks: Colas, like alcohol, can lynch calcium from the bones.

Tea and coffee: They prevent calcium absorption in the intestine and prevent calcium from getting deposited in the bones. Excessive tea also causes excretion of calcium.

Sunshine: Vitamin D is required by the body to absorb calcium. Our body produces Vitamin D in response to sunlight, so the lack of sunshine alone can lead to calcium-depleted bones (osteomalacia). Because we spend much of our urban life being inside a house or an office, an alarming number of people develop Vitamin D deficiency. The required intake of vitamin D is 600 IU a day, which you can get as a supplement. An excess of vitamin D, though, can lead to its toxicity, resulting in an increase in calcium levels in the blood and urine, and development of kidney stones. So, do a blood test to check your Vitamin D levels before taking any supplements.

Weight exercises: Bones are living tissues. Exercising with weights causes new bone tissues to form, making the bones stronger.

Salt and protein: An excess of either or both in the diet causes our body to excrete calcium. The NIH (National Institutes of Health) Consensus Conference, US, recommends 1,000mg a day of calcium for adults between the ages of 19 and 70; 1,200mg a day for pregnant and lactating mothers and adults above the age of 71.

Since it is not always possible to get adequate calcium in our diet, calcium supplements are the easy way out. It is advised that you take only 500mg of calcium at a time for better absorption. Calcium carbonate tablets are best when taken with foods. Calcium citrate, on the other hand, can be taken any time. Consult your doctor about supplements with Vitamin K and magnesium, as they help regulate calcium.

Vishakha Shivdasani is a Mumbai-based medical doctor with a fellowship in nutrition. She specializes in controlling diabetes, cholesterol and obesity.

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