Calcium and Teens: How to Prevent Osteoporosis

 Remember

• Calcium is a mineral that gives strength to your bones.
• It's important to get enough calcium during your teen years so you'll have strong bones now and when you're older.
• You may need a calcium supplement if you don't get enough calcium in your diet.

You have probably seen the “milk mustache” on some of your favorite stars, but are you sporting your own? Unfortunately, only 12% of teen girls actually get enough calcium in their diet.

What is calcium? Why do I need to be concerned about it now?

Calcium is a mineral that gives strength to your bones. Calcium is also necessary for many of your body's functions, such as blood clotting and nerve and muscle function. During the teenage years (particularly ages 11-15), your bones are developing quickly and are storing calcium so that your skeleton will be strong later in life. Nearly half of all bone is formed during these years. It is important that you get plenty of calcium in your diet because if your body does not get the calcium it needs, it takes calcium from the only source that it has: your bones. This can lead to brittle bones later in life and broken bones at any time.

What is osteoporosis?

Osteoporosis is a bone disease that develops slowly and is usually caused by a combination of genetics and too little calcium in the diet. Osteoporosis is a disease in which bones become fragile and more likely to break. Osteoporosis can also lead to shortened height because of collapsing spinal bones and can cause a hunched back.

How do I know if I'm at risk?

Several factors can put a young person at risk for developing osteoporosis. They include:

• Being white
• Being female
• Having irregular periods
• Doing little or no exercise
• Not getting enough calcium in your diet
• Being below a normal weight
• Having a family history of osteoporosis
• Smoking
• Drinking large amounts of alcohol

Osteoporosis can be prevented. There are some risk factors that you cannot change (like your race and the fact that you are female), but there are some you can! Eat a healthy diet, get some exercise, and don't smoke!

How much calcium do I need?

Children and teenagers between the ages of 9 and 18 should aim for 1,300 milligrams per day, which is about 4 servings of high-calcium food or drinks. Each 8-ounce glass of milk (whether skim, 1%, 2%, or whole) and each cup of yogurt has about 300 milligrams of calcium. Adults 19 to 50 years of age should aim for 1,000 milligrams per day.

How do I know how much calcium is in the foods I eat?

For foods that have a nutrition facts label, there will also be a % Daily Value (DV). To figure out how many milligrams of calcium a food has, take the % DV, drop the % sign, and add a zero. Can you use the label on the left to find out how much calcium is in one cup of skim milk? 30% means there is about 300mg of calcium per serving. The chart below shows how much calcium is in some calcium-rich foods from different food groups.

What foods contain calcium?

You probably know that dairy foods like milk and cheese are good sources of calcium, but do you know that tofu and beans contain calcium, too? Even if you don't drink milk or eat cheese, you can get the calcium you need from other foods. See the list of high-calcium foods at the end of this guide.

What if I'm lactose intolerant?

If you are lactose intolerant and can't drink milk, there are plenty of other ways to get your calcium. These include fortified soy milk, fortified juice, or Lactaid^TM milk (the lactase enzyme that you are missing has been added into the milk). You may also take lactase enzyme tablets before eating dairy products to help digest the lactose sugar in the milk. Some people who are lactose intolerant can tolerate having small amounts of milk or other dairy products at a time.

How can I get more calcium in my diet?

Breakfast

• Have a bowl of cereal with milk.
• Use milk instead of water when making oatmeal.
• Drink calcium-fortified orange juice.
• Make a healthy breakfast shake with a cup of milk or yogurt and a handful of frozen fruit.
• Add cheese to your bagel. Most cheeses, except for cream cheese, are high in calcium.
  

Lunch

• Choose milk instead of soda at school. If you don't like plain milk, try chocolate or strawberry milk.
• Pack a yogurt with your lunch.
• Add cheese to your sandwich.
  

Snacks

• If you like coffee-flavored drinks, try a milk-rich latte (decaf is best).
• Look for cereal bars or energy bars that contain calcium. Check the label to see if calcium is listed.
• Make hot cocoa with milk instead of water.
• Eat broccoli dipped in a veggie dip made with plain yogurt.
• Snack on cheese sticks or almonds.
• Have a yogurt as an after-school snack.
  

Dinner

• Have macaroni and cheese made with milk, or chowder-style soups.
• Prepare canned tomato soup with milk instead of water.
• Add tofu to stir fries.
• Include more beans (legumes) in your meals.
• Make lasagna or other pasta dishes with ricotta cheese.
• Eat pizza.
• Have pudding made with milk or frozen yogurt for dessert.
  

What if I just can't get enough calcium in my diet?

It is best to try to meet your calcium needs through by having calcium-rich foods and drinks, but some teens find it difficult to fit in 4 servings of high-calcium foods daily. If you don't like dairy foods or calcium fortified juice or soymilk, you may need a calcium supplement. Calcium carbonate (for example, Tums® or Viactiv®) and calcium citrate (for example, Citracal®) and are good choices. When choosing a supplement, keep the following things in mind:

• Most calcium supplements have between 200 and 500 milligrams of calcium. Remember, your goal is 1,300 milligrams of per day.
• If you have to take more than one supplement per day, it is best to take them at different times of the day because your body can only absorb about 500 milligrams of calcium at a time.
• Don't count on getting all of your calcium from your multivitamin. Most basic multivitamin/mineral tablets have very little calcium in them.
• Look for a calcium supplement that has vitamin D added. Vitamin D helps your body absorb calcium.
• Avoid “oyster shell” or “natural source” calcium supplements. These may have lead or aluminum in them and are not recommended.
• Know that your dietitian or health care provider will be able to support you with recommendations on what supplement will best suit your needs.

Food	Serving	Milligrams of Calcium
Dairy Products
Yogurt, low-fat (whole)	1 cup	350-420
Ricotta cheese, part-skim	1/2 cup	340
Milk (skim)	1 cup	310
Fortified soy and rice milks	1 cup	300
Milk (1%)	1 cup	290
Milk (whole)	1 cup	280
Ricotta cheese, whole	1/2 cup	260
Swiss cheese	1 ounce	220
Mozzarella cheese, part skim	1 ounce	210
Cheddar cheese	1 ounce	200
Muenster cheese	1 ounce	200
American cheese	1 ounce	160
Frozen yogurt	1/2 cup	100
Ice cream	1/2 cup	80
Pudding	1/2 cup	100
Protein Foods
Canned sardines (with bones)	3 ounces	330
Soybeans, cooked	1 cup	260
Canned salmon (with bones)	3 ounces	180
Tofu, firm (prepared with calcium sulfate or calcium lactate)	1/4 block	160
Beans, cooked	1 cup	50-130
Crab	3 ounces	90
Clams	3 ounces	80
Almonds	1 oz (24 nuts)	70
Hummus	1/2 cup	50
Vegetables
Collard greens, cooked	1/2 cup	130
Spinach, cooked	1/2 cup	120
Kale, cooked	1/2 cup	50
Broccoli, cooked	1/2 cup	30
Fruits
Calcium-fortified orange juice	1 cup	300
Rhubarb	1/2 cup	130
Dried figs	2 figs	30
Orange	1	50
Cereals
Total Raisin Bran® Cereal	1 cup	1000
Golden Grahams® Cereal	3/4 cup	350
Basic Four® Cereal	1 cup	200
Kix® Cereal	1 1/4 cup	170
U.S. Department of Agriculture, Agricultural Research Service. 2010. USDA National Nutrient Database for Standard Reference, Release 23.