I know that calcium is related to bone health, but what should I eat, which supplements should I take, and how much do I need? And is vitamin D also important for healthy bones?

Calcium is essential for maintaining and building your bones. It’s a good idea to get as much calcium in your diet as you can, and then take supplements if you need additional calcium.

Dairy products can be a significant part of your bone-building diet – but not if you’re allergic to dairy, or have lactose intolerance. Not only are they loaded with calcium, but researchers have discovered that they contain specific proteins, especially concentrated in whey, that can enhance bone density. In addition, a sugar found in dairy products, lactulose, enhances calcium absorption. If you don’t tolerate dairy products, there are other food sources rich in calcium.

According to the National Institutes of Health, the recommended daily amounts of calcium ingestion by age group are: 210 mg at under 6 months; 270 mg at 7 to 12 months; 500 mg at 1 to 3 years; 800 mg at 4 to 8 years; 1,300 mg at 9 to 18 years; 1,000 mg at 19 to 50 years; and 1,200 mg at over 51 years. Those with osteoporosis should take at least 1,500 mg a day.

If you take calcium supplements, use calcium citrate for maximum absorption. (Note: some people experience diarrhea if they ingest too much calcium citrate.)

Calcium needs vitamin D in order to be absorbed in your intestinal tract, so it’s important to look at your vitamin D intake as well. You get one type of vitamin D, known as D3 (cholecalciferol), from exposure to sunlight and from eating fish oils and eggs; another type, D2 (ergocalciferol), is made in plants and used to fortify dairy products.

According to a study published in the Journal of Clinical Endocrinology & Metabolism in 2004, vitamin D2 is less effective than vitamin D3; the researchers found that D2 has less than one third the potency. Another study, published in the American Journal of Clinical Nutrition in 2006, reported that “vitamin D2 should not be regarded as a nutrient suitable for supplementation or fortification.”

Be sure you’re ingesting vitamin D3 for maximum effectiveness. To know if you have enough D3, ask your doctor to run a blood test. The recommended daily intake is 200 international units (i.u.) for people from birth to 50 years old, 400 i.u. for those aged 51 to 70, and 600 i.u. for those 71 or older. Most bone-building formulas contain 200 to 800 i.u. of vitamin D.

Examples of Dietary Sources of Calcium and vitamin D3:

Source: USDA

Calcium

Dairy sources:

Plain yogurt, non-fat: 8 oz. = 452 milligrams (mg)
!% low-fat milk: 1 cup = 290 mg
2% reduced fat milk: 1 cup = 285 mg
Whole milk: 1 cup = 276 mg
Romano cheese: 1.5 oz = 452 mg

Non-dairy sources:

Soy milk, fortified: 1cup = 368 mg
Tofu (firm) prepared with nigari: � cup = 253 mg
Sardines with bones: 3 oz. = 325 mg
Blackstrap molasses: 1 Tbsp = 172 mg
Collard greens, cooked from frozen: � cup = 178 mg
Spinach, cooked from frozen: � cup = 146 mg
Kale, cooked from frozen: � cup = 90 mg
Pak-choi (Chinese cabbage), cooked from fresh: � cup = 79 mg

Vitamin D3

Cod liver oil: 1 Tbsp = 1,360 mg
Salmon, cooked: 3.5 oz = 360 mg
Mackerel, cooked: 3.5 oz. = 345 mg
Tuna fish, canned in oil: 3 oz. = 200 mg
Sardines, canned in oil, drained: 1.75 oz. = 250 mg
Egg: 1 whole = 15 mg

Dr. Laurie Steelsmith is a naturopathic physician and licensed acupuncturist in Honolulu, as well as author of the new #1 best-selling book Natural Choices for Women’s Health, published by Random House. You can reach her and read her past columns at www.drsteelsmith.com This column is for information only. Consult your health provider for medical advice.