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Did you know only 10% of teen girls in the USA get enough calcium? That’s an astonishingly depressing stat from the American Academy of Pediatric’s fascinating position paper on calcium (available here for free). Let’s show that graph right now:
This graph clearly shows a couple points:
- Most infants are doing great with their calcium, thanks to breast and formula milks.
- The second, much more depressing point, is that calcium intake drops dramatically after the toddler years.
- Girls, especially teens, drink much less dairy than boys, putting them at enormous long term risk for osteoporosis
I always knew that teen girls hated dairy mostly due to taste and fears of getting fat, but I never realized they were this much at risk of osteoporosis and other diseases. What about your teenage children — or what about yourself? Are you getting enough calcium in your diet? (Even here in China, the average calcium intake is less than half the recommended amounts.) To answer this question, we need some data. First, we need to know how much calcium we need per day to stay healthy. Here’s the data, from the US NIH review article on calcium:
| Life Stage | Recommended Amount |
|---|---|
| Birth to 6 months | 200 mg |
| Infants 7–12 months | 260 mg |
| Children 1–3 years | 700 mg |
| Children 4–8 years | 1,000 mg |
| Children 9–13 years | 1,300 mg |
| Teens 14–18 years | 1,300 mg |
| Adults 19–50 years | 1,000 mg |
| Adult men 51–70 years | 1,000 mg |
| Adult women 51–70 years | 1,200 mg |
| Adults 71 years and older | 1,200 mg |
| Pregnant and breastfeeding teens | 1,300 mg |
| Pregnant and breastfeeding adults | 1,000 mg |
What about your daily routine — how much calcium do you get? To find out, you can start with a list below, listing the calcium content of the most common foods. For all other foods, you can look at the nutrition label or use the wonderful online Nutrient Data Laboratory database from the USDA. (For Chinese readers, you can find an excellent handout about calcium here from the Chinese Community Health Resource Center in San Francisco.)
| Food | Serving Size | Calcium Content, mg | No. of Servings to Equal Calcium Content in 1 Cup of Low-Fat Milk |
|---|---|---|---|
| Dairy foods | |||
| Whole milk | 1 cup (244 g) | 246 | 1.0 |
| Low-fat (1%) milk | 1 cup (244 g) | 264 | — |
| Nonfat milk | 1 cup (245 g) | 223 | 1.2 |
| Yogurt, nonfat, fruit variety | 6 oz (170 g) | 258 | 1.0 |
| Frozen yogurt, vanilla, soft serve | 1/2 cup (72 g) | 103 | 2.6 |
| Cheese | 1 1-oz slice (28 g) | 202 | 1.3 |
| Cheese, pasteurized, processed | 1 3/4-oz slice (21 g) | 144 | 1.8 |
| Cheese, ricotta, part skim milk | 1/2 cup (124 g) | 337 | 0.7 |
| Nondairy foods | |||
| Salmon, sockeye canned, drained, with bones | 3 oz (85 g) | 203 | 1.3 |
| Tofu, firm, prepared with calcium sulfate and magnesium chloride | 1/2 cup (126 g) | 204 | 1.3 |
| White beans, cooked, boiled | 1 cup (179 g) | 161 | 1.6 |
| Broccoli, cooked | 1 cup, chopped (156 g) | 62 | 4.3 |
| Collards, cooked, boiled, drained | 1 cup, chopped (190 g) | 266 | 1.0 |
| Baked beans, canned | 1 cup (253 g) | 127 | 2.1 |
| Tomatoes, canned, stewed | 1 cup (255 g) | 87 | 3.0 |
| Foods fortified with calcium | |||
| Calcium-fortified orange juice | 1 cup (240 mL) | 300 | 0.9 |
| Selected fortified breakfast cereals | 3/4–1 cup (30 g) | 100 | 2.6 |
| Instant oatmeal, fortified, plain, prepared with water | 1/2 cup (117 g) | 65 | 4.1 |
| English muffin, plain, enriched, with calcium propionate | 1 muffin (57 g) | 99 | 2.7 |
| Calcium-fortified soy milka | 1 cup (240 mL) | 200–500 | 0.5–1.3 |
Source: US Department of Agriculture, Agriculture Research Service.
What If Your Child Isn’t Getting Enough?
I strongly advise all parents to do a bit of math and see how your kids are faring with calcium, especially your girls. Because as we mentioned, it’s overwhelmingly likely that they’re not getting enough, and it’s our job as parents to guide them with proper choices. One easy task is to completely eliminate all sodas. I know you don’t have control over your kids at the mall or a friend’s house, but you certainly can be a role model at home and never even buy sodas. Ever. Really! I’ve blogged about soda dangers, as it is by far the #1 most unhealthy choice in America now, at all ages. There’s actually some data showing soda drinkers have lower bone density, but it’s still controversial why that is. Most likely the soda is just replacing healthy calcium drinks such as milk. But there still remain a host of reasons never to drink soda, especially due to its risk of obesity and diabetes. I would much prefer any child drink a calcium fortified orange or apple juice instead of any soda.
The best choice for calcium remains milk, but let’s just assume you’ll never convince your 13 year old daughter of this (likely scenario!). The best other sources are the same for any age, as I previously discussed with toddler formulas: yogurt and hard cheese, fortified soy or rice milk, leafy green vegetables, and canned salmon or sardines. As a last resort, a daily multivitamin may be reasonable for some. For further kid-specific advice, here’s some again from the AAP:
For kids who aren’t getting enough calcium, make use of calcium-fortified milk, orange juice, cereals and granola bars. Some of these products contain so much calcium that a single serving takes a youngster halfway to her recommended daily value.
Your teen isn’t a milk drinker? There are other ways to obtain calcium through the diet. “Many adolescents don’t like milk, especially girls,” says dietitian Mary Story. Try tempting your son or daughter with chocolate-flavored skim milk. You can also disguise milk by adding it to soups, puddings, baked products, sauces and stews. Alternatives to milk include cheese and yogurt. Eight ounces of yogurt and two ounces of cheese contains about the same amount of calcium as eight ounces of milk and therefore each would equal one serving. Half a cup of cottage cheese, however, is lower in the mineral and counts as half a serving.
Discover more from Richard Saint Cyr MD
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The reason so many people have poor diet is because it’s extremely hard to achieve that “perfect” diet, due to economic reasons and other reasons, indeed some is lack of education. A practical approach to resolving calcium defficiency in teens and adults is obviously a pill. Theoretically it might not be as good as food, in practice it is far, far better.
As a side note, could you provide some numbers the actual net absorption of calcium from milk?
Thanks.
Thanks.,