Teens Can Get the Jump on Osteoporosis

Of all the questions we get about calcium, most come from women in their 40s and 50s who are rightfully worried about getting enough calcium to ward off osteoporosis later in life.

But nobody can afford to skimp on calcium. Not women, not men and especially not children.

Osteoporosis is a very expensive problem not just for the individuals who develop it, but for society at large. The annual medical costs of osteoporotic hip fractures alone exceed those of congestive heart failure and asthma combined, according to the National Institutes of Health. Preventing osteoporosis could knock billions off the U.S. health-care bill.

Although osteoporosis typically strikes older women (and men) at a time of life when all that can be done is to slow bone loss, the most important and practical time to take preventive measures is during the adolescent years, when children, especially girls, are building maximum bone density and strength. If calcium is “banked” during these early years, the body can draw on the reserves for other needs later in life, and there will still be enough left to prevent osteoporosis.

Girls 12 to 14 store about five times more calcium as bone than they will do just a few years later. In fact, half of all adult bone mass is developed during the teen years. So, if girls’ calcium consumption is highest when maximum bone is being stored, they will be way ahead of the game. This works the same way for boys, but boys generally consume more calories and nutrients, which lead to denser, stronger bones.

So what’s the problem with girls? Well, according to studies, girls 11 to 13 get less than 70% of the calcium they need. They are often overly concerned about weight gain and body image, and are more likely to reach for a diet soda than a glass of milk (even the low- and nonfat varieties). Their diets also tend to be lower in calories and other key nutrients, and of course all kids at that age feel immortal and don’t think any of these “old folks’ diseases” will ever hit them.

A few weeks ago, the American Academy of Pediatrics published a policy statement in which they encouraged pediatricians to recommend milk, cheese, yogurt and other calcium-rich foods as part of the daily diet of all children. The recommendation was intended to prevent bone deformity diseases like rickets and to build bone mass for the future.

The current recommended daily allowance for calcium is 1,200 milligrams a day for people 11 to 24. Some experts think this is even a little low. The pediatrics academy recommends 1,200 to 1,500 milligrams of calcium a day for preteens and adolescents, and it further recommends that this come from food and not supplements. That may seem like a lot, but with some effort, it is possible to incorporate these requirements into a low-fat diet. For example, three 8-ounce glasses of low-fat or nonfat milk alone will supply about 900 milligrams of calcium.

The following list of calcium food sources was prepared by the National Institutes of Health using data from the U.S. Department of Agriculture.

400 milligrams:

3 1/2 ounces of sardines with the bones.

8 ounces plain, low-fat yogurt with added milk solids.

8 ounces plain, nonfat yogurt.

4 ounces tofu processed with calcium salts (note that the calcium content of tofu varies widely, so consult the label for the amount).

300 milligrams:

1 cup skim, low-fat or whole milk, or low-fat chocolate milk.

1 cup buttermilk.

8 ounces plain, whole-milk yogurt.

8 ounces fruit-flavored, low-fat yogurt.

1/2 cup part-skim ricotta cheese.

1/4 cup instant, nonfat dried milk (can be added to many foods).

1 cup cooked, drained collard greens, from frozen.

200 milligrams:

1 ounce cheese (cheddar, part-skim mozzarella, Muenster, provolone, pasteurized processed American or Swiss).

1 cup ice cream or ice milk.

3 1/2 ounces canned pink salmon with the bones.

1 cup cooked, drained kale, from frozen.

1 cup cooked, drained turnip greens (from raw or frozen).

100 milligrams:

3/4 cup low-fat (2%) or creamed cottage cheese.

1 cup cooked, drained broccoli, from frozen.

1 1/3 cups cooked, drained broccoli, from raw.

3/4 cup cooked, drained collard greens, from raw.

1 cup cooked, drained kale, from raw.

1 cup cooked, drained Great Northern, navy or pinto beans.

50 milligrams:

2 ounces canned, drained clams.

3 ounces canned shrimp or 4 1/2 ounces steamed, fresh shrimp.

Two-thirds cup oyster meat, raw (9 to 13 medium).

1 cup cooked, drained lima or black beans.

Because many high-calcium foods probably are not among the average teenager’s favorite treats, it might be wise to concentrate on the more familiar dairy products and vegetables.

Adding dried milk solids to foods like meatloaf, muffin batter and the like sneaks in some extra calcium without anyone being the wiser. You can also beef up your mashed potatoes by adding some plain yogurt, or add milk to soups, oatmeal and chowders. Putting cheese on broccoli usually delivers a double dose. Even the lower-fat cheeses have significant amounts of calcium.

If you can get your kids to sit down for breakfast, you can add milk to their cereal. And never underestimate the power of chocolate milk and hot chocolate.

Obviously, the Dairy Council has a vested interest in having people get their calcium from dairy products, and they have a couple of good Web sites that might help if you’re searching for ways to include your kids in meal planning or looking for helpful suggestions and recipes: https://www.whymilk.com and https://www.familyfoodzone.com.

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To submit questions, send e-mail to daogar@uclink4.berkeley.edu, fax (510) 642-2857, or write Dale Ogar, School of Public Health, UC Berkeley, Berkeley, CA 94720-7360. We regret that we cannot answer questions personally.