"People are like stained-glass windows.
They sparkle and shine when the sun is out,
but when the darkness sets in, their true beauty is revealed
only if there is a light from within."
~ Elizabeth Kübler-Ross
The Importance of Calcium and Vitamin D in Women’s Health
Calcium
A diet rich in calcium is important throughout your life. Calcium is essential, yet the majority of Americans do not get enough. About 99% of the calcium in our bodies is found in our bones and teeth. In addition to building and maintaining healthy bones, calcium allows blood to clot, nerves to send messages, muscles to contract, etc…
Our bodies lose calcium daily through skin, nails, hair, sweat, urine, etc… yet we cannot produce our own calcium. That’s why it’s important to get enough calcium through food and supplementary vitamins. When the diet does not have enough calcium for our body’s needs, calcium is taken from the bones.
Fracture among children has increased by one-half in girls compared to a generation ago. A diet high in calcium, especially during the adolescent years, helps build bone mass to prevent osteoporosis later in life, as well as reducing fracture risk.
Falling can cause fractures in the elderly. Breaking a hip can dramatically reduce a woman’s future quality of life and overall life span, it is paramount to avoid this complication if at all possible.
A lifetime of calcium and vitamin D supplementation cannot always prevent fracture, but used in addition to fall-prevention measures can go a long way.
Incidentally, vitamin D supplementation has been shown in some trials (with opposite results in others), to decrease the incidence of falls.
Fall prevention in our parents, our grandparents, and soon enough, in ourselves, is critical to avoiding fractures that can disable our elderly population. Please click on and read "at risk" for specific recommendations on preventing falls, and see site: stopfalls.org, for more information.
Measures such as: keeping eyesight optimized with annual eye exams, non-slip rugs, addition of "handicap" bars in the shower, and by the toilet for safe use in the dark, rubber-soled shoes are obvious ways to start.
Walking is always healthy, but in winter months, shoes with cleats for unseen ice has been a recent additional safety measure my patients have taught me.
Good sources of calcium:
Plain yogurt, nonfat 1 cup 450 m
Ricotta cheese, part skim ½ cup 340 mg
Skim or 1% milk 1 cup 300 mg
Fortified cereals 1 oz. 250-1000 mg
Fortified soy milk 1 cup 370 mg
Fortified orange juice 1 cup 350 mg
Tofu, fortified (nigari) ½ cup 250 mg
Swiss, provolone, cheddar 1 oz. 220 mg
Mozzarella, part skim 1 oz. 210 mg
Pink salmon, canned 3 oz. 180 mg
Soybeans ½ cup 130 mgI
ice cream, frozen yogurt 1 cup 300 mg
Vitamin D
Vitamin D: Exciting Vitamin???
Breakthrough science has played a significant role in broadening our understanding of vitamin D and its importance in the maintenance of health.
Recent research suggests vitamin D may provide protection from osteoporosis, high blood pressure, cancer, stroke, depression, cardiac and several autoimmune diseases. Hormones of the endocrine system, such as vitamin D, help the immune and nervous systems defend the body, with defects in this intricate system leading to autoimmune disorders.
Sources of Vitamin D
The best source of vitamin D is the sun. For those of us in the Northeast however, we do not absorb any vitamin D on even the sunniest days from October to April. This is why supplementation is so important. Not just for bone health, but for your overall health.
As part of the diet, vitamin D is found in fortified milk, fatty fish, cod-liver oil, and (to a lesser extent) eggs. In the United States, milk is fortified with vitamin D2 (a plant steroid) or vitamin D3 and is the principal source of dietary vitamin D.
At risk for D deficiency
- Exclusively Breast-fed infants
- Teens
- Obese
- Elderly
- Patients with GI Malabsorption
Function of Vitamin D
The major biologic function of vitamin D is to maintain normal blood levels of calcium and phosphorus. Vitamin D aids in the absorption of calcium, helping to form and maintain strong bones. Vitamin D insufficiency and deficiency, as measured by low levels of 25-OH vitamin D, are common particularly among adolescents and the elderly.
Access Problems: Winter, Sunscreen, Overdressing
Vitamin D deficiency is common in young children and adolescents worldwide. In a US study, the prevalence was highest in African American teenagers and during winter, although the problem seemed to be common across sex, season, and ethnicity.
In the Northeast U.S., the skin virtually ceases to produce vitamin D between October and April. In the summer months, the use of sunscreen blocks vitamin D synthesis. Subclinical vitamin D deficiency may also be more common in Asian Indian immigrants to the United States, even with adequate sun exposure, possibly because of clothing customs.
Cancer prevention
Research suggests that synthetic vitamin D analogs may play a role in the treatment of human cancers. Women with low levels of vitamin D have a 222% increased risk for developing breast cancer. Ecologic studies have shown an inverse correlation between breast cancer mortality and sun exposure and dietary vitamin D intake.
- Blood levels of vitamin D at the time of diagnosis of breast cancer accurately predict a woman's survival!
- The cancer is much more aggressive in those with low serum vitamin D levels: they are 94% more likely to have the cancer metastasize and 73% more likely to die within 10 years of diagnosis.
- However, it remains unclear if vitamin D deficiency raises cancer risk, or if an increased intake of vitamin D is protective against some cancers. More studies are needed, over a period of years.
Other Medical Conditions Found in Patients with Vitamin D Deficiency Currently Under Investigation:
- Cancers: colon, pancreatic, ovarian, brain, endometrial, prostate, bladder, eye and skin.
- Chronic Pain: chronic low back pain as well as persistent, nonspecific musculoskeletal pain.
- Poor Cognitive Function: low mood and cognitive impairment in the elderly seen in vit D deficiency.
- Stroke: Low levels of 25(OH)D and 1,25(OH)2D are independently predictive for fatal strokes, suggesting that vitamin D supplementation is a promising approach in the prevention of strokes. Data also indicate that vitamin D3 reduces ischemia-induced brain damage.
- Depression & SAD: have been shown to be significantly associated with decreased vit D levels. In one study, depression patients had D levels14% lower than in those who did not suffer from depression. In one study, vitamin D was found to be better than light therapy in the treatment of SAD (Seasonal Affective Disorder.)
- Parkinson's and MS: A study recently published in Arch Neuro 2010, based on more than 3000 men and women in Finland, followed almost 30 years showed that high levels of vitamin D appear to confer “chemoprotection” against Parkinson’s disease. Longitudinal studies needed to confirm this.
Recommendations: [from the vitamin D council]:
Although the FDA recommends not going over 2000 IU of vit D/day, some research indicates that well adults and adolescents should receive at least 5,000 IU vit D3 per day, either from sunlight or supplementation.
For adults, the 200 IU vitamin D recommended dietary allowance may prevent osteomalacia (severe problems with your bones.) In the absence of sunlight dailty, much more is needed to help prevent osteoporosis, secondary hyperparathyroidism, and the many other vitamin D deficiency-related diseases, discussed above.
Toxicity is extremely unlikely:
One of the least toxic substances to humans, overdose of D3 doesn't occur until more than 100 times (approximately one bottle of vitamin D3 tablets) the daily RDA has been taken daily for several months. Acute, one-time overdoses require over 50 mg (10,000 times the RDA).
Humans make thousands of units of vitamin D within minutes of whole body exposure to sunlight. From what we know of nature, it is unlikely such a system evolved by chance. ~ Dr. John Cannell, Vitamin D Council.
Calcium and Vitamin D Supplements (they come together)
Supplement Calcium (mg) Type Vitamin D (IU)
Caltrate 600 + max D 600 Carbonate 400
Caltrate 600 chewables 600 Carbonate 400
OsCal 500 500 Carbonate 200
Oscal 500 + Extra D 500 Carbonate 400
Oscal Ultra 600 Carbonate 200
Citracal Ultradense Petites 200 Citrate 200
Citracal caplets + D 315 Citrate 200
Citracal 250 + D 250 Citrate 200
Posture-D 600 Phosphate 125
Cal-100 with vit D 1000 Carbonate 400
Calcium gummy bears 600 Phosphate 500
Viactiv Chews, plus D + K 500 Carbonate 200
Adora chocolates 500 Carbonate 250
In Summary: Calcium
- Osteoporosis causes bones to become abnormally thin (“osteopenic”), weakened, easily broken. This can be prevented & treated with diet, exercise, smoking cessation, calcium & vitamin D, & bone-building meds.
- The main dietary sources of calcium include milk and other dairy products, and green vegetables. Milk is the primary source of dietary, containing approximately 100 IU/cup.
- Exercise can help to prevent & treat thinning bones. Exercise should be done for at least 30 min, 3x/wk. Any weight-bearing exercise regimen is appropriate (e.g. walking).
- Some medications cause bone thinning, including steroids, heparin, vitamin A, and some anti-seizure drugs.
In Summary: Vitamin D
- Vitamin D supplementation is being widely recommended by most medical groups.
- The main source of vitamin D is the sun. In Northeast, we don’t get any vitamin D from Oct – April.
- Deficiency of vitamin D has very recently been shown to be associated with many serious medical illnesses. In terms of getting more bang for your health care buck, daily vitamin D supplementation (cheap) has the potential of improving long-term quality of life and even, saving lives from disease.
- Sunscreen is vitamin D block: in summer months, consider benefits of 10 min sun before applying sunblock.
“Vitamin D testing and supplementation for the population is one solution which is guaranteed to improve overall health of the population at a ridiculously low cost.” ~ Jeffrey Dach MD.
[edited from national vitamin D council, uptodate.com, mayoclinic.com, nof.org, etc...]
