The best way to meet your calcium needs is to include calcium-rich foods like low-fat dairy products, beans, almonds and green leafy vegetables in your diet on a regular basis.  However, many Americans are not consuming enough calcium-rich foods to meet their estimated needs.  In fact, Studies have found that over 85% of girls ages 12-19 and nearly 80% of women over 20 years of age are not meeting their recommended calcium intakes.  While foods are the preferred calcium source, those who are not meeting the RDA with food should consider calcium supplements.  (See Calcium and Bone Health article to learn more about your calcium needs.) 

So what should you be looking for when choosing a supplement?

• It is important to recognize that the body has difficulty absorbing more than 300-400 mg of calcium at one time.  Therefore, it is best to take supplements that have 500 mg of calcium or less per serving, and take each dose at separate times.  For example, you would want to take one dose in the morning and one in the evening. 

• Look for a supplement that includes vitamin D, since vitamin D helps improve calcium absorption.  (Supplements that contain vitamin D₃ are preferable to those that include vitamin D_2.)

• You may want to avoid supplements that come from unrefined oyster shell, dolomite or bone meal as they can contain lead or other toxic materials.

• The amount of calcium you need from supplements, depends on how much calcium you get in the diet.  The chart below may be helpful to determine how much calcium is in many calcium-rich foods.  Nutrition labels can also help determine your calcium intakes. 

  • On nutrition labels, calcium is listed as a percentage.  This percentage is based on 1,000 mg per day.

• Be aware that you can get too much calcium which could lead to calcification of bones and soft tissues and kidney stones.  The safe upper limit for calcium is set at 2,000-2,500 mg per day.

This chart was adapted from the following website:  

http://www.niams.nih.gov/Health_Info/Bone/Bone_Health/Nutrition/calcium_intake.asp

As we all know, it can be very challenging to make good food choices when eating in a restaurant.  Not only are the portions frequently over 2 ½ times larger than what a serving should be, but the foods are often loaded with extra fat and calories.  Unfortunately, even when we are trying to make wise choices, they often end up being much higher in fat/calories than we think.  For example, you choose a Chicken Caesar Salad at Chili’s because salads are healthy, right?  Little did you know that this salad is packed with 76 grams of fat and 1,010 calories.  It is almost unfathomable that a serving of the Original Baby Back Ribs could have less fat and calories (66gm fat and 970 calories) than this salad with grilled chicken on it.

Because it is difficult to know exactly what you’re getting when you eat out, planning is essential.  Healthy Dining Finder is a great website that can make the planning process quicker and easier.  This website, designed by dietitians and health professionals, lists the “healthiest” food options at all types of restaurants.  You can search by restaurant name, city or zip code, price range, etc.  When you click on a restaurant, it will tell you all the menu options that meet the nutrition criteria set by the website.

Not only can this website help you to make the best choices at a restaurant, but it can also help you to choose a restaurant that you know has good choices.  After all, if you fail to plan, you plan to fail. 

Many athletes think about what they are eating before exercise to improve performance, but they don’t realize that what they eat afterwords affects recovery time and muscle development.  If carbohydrates are consumed immediately after a workout, they can enhance the rate that glycogen stores are made.  Use the following as a general guide if you exercise hard for 90 minutes or longer:

• Consume 0.68 grams carbohydrate/pound immediately after exercise
• Eat an additional 0.68 grams carbohydrate/pound 2 hours later

Including protein in the post workout meal can help to build and repair muscle after both endurance and resistive-type exercises.  The most effective way to build muscle after a workout is to eat small doses of protein repeatedly during the recovery period.  You can use the following as a guide:

• 0.45-0.9 grams protein/pound/hour

For fluid needs after exercise, refer to Hydration for Athletes.

If you are participating in endurance exercise that lasts longer than 1 hour, it can be helpful to include some carbohydrates during your exercise.  This has been found to help athletes run longer and harder during endurance activities and stop-and-go sports.  Eating carbohydrates during exercise is particularly helpful when you have low levels of muscle glycogen.

How Can I Meet My Carbohydrate Needs While I exercise?

To maximize performance, it is recommended to consume 30-60 grams of carbohydrate per hour.  Many people tolerate fluids better than solid foods when they exercise, but you must know what your body tolerates best.  Any of the following items would provide an adequate amount of carbohydrate:

• 24 oz sports drink containing 6-8% carbohydrate = 42-57 gm carbohydrate
• Banana = 30 gm carbohydrate
• Sport Bar = 47 gm carbohydrate
• 2 Gels = 50 gm carbohydrate
• 3 Large Graham Crackers = 66 gm carbohydrate

When choosing foods to eat during a competition, remember that protein and fat can delay gastric emptying, which might not be tolerated well by some athletes.

For fluid needs during exercise, refer to Hydration for Athletes.

Do you feel like your energy levels are low?  Next time you feel like you could use a pick-me-up, don’t reach for the “energy drinks” or sugary snack.  While these items may give you a “quick fix”, they will often leave you feeling even more tired about an hour or two later.  Instead, reach for your sneakers and go for a walk.  A new study found that even as little as a 20-minute walk may be enough to increase energy levels throughout the day. 

It has long been believed that a sedentary lifestyle can cause feelings of fatigue, and now there is research to support that.  Thirty-six sedentary young adults with chronic feelings of fatigue participated in a 6 week study.  During the 6 weeks they were broken up into three groups: those who did not exercise or those who participated in either low-intensity exercise or moderate-intensity exercise for 3 days per week.  Both exercise groups had reported nearly a 20% increase in energy levels, and the low-intensity group experienced a 65% improvement in fatigue scores (fatigue scores were intensity-dependent).

So, next time you feel that you don’t have the energy to exercise, you may want to rethink that and recognize that you don’t have the energy to not exercise.

Puetz, T.W., et al (2008) A Randomized Controlled Trial of the Effect of Aerobic Exercise Training on Feelings of Energy and Fatigue in Sedentary Young Adults with Persistent Fatigue. Psychother Psychosom 77:167-174 

One of the most important interventions in preventing bone loss is to ensure that your calcium intake is adequate.  The preferred method to meet your calcium needs is through food.  The following foods are good sources of calcium:

• All dairy foods such as milk, cheese and yogurt
• Some legumes such as soy, navy, pinto, garbanzo and red beans
• Some green, leafy vegetables and broccoli
• Calcium fortified orange juice, soy milk and tofu
• Canned salmon with bones
• Dried Figs and Almonds

Although all of these foods are rich in calcium, your body can best absorb the calcium from dairy foods.  In fact, your body can absorb 25-35% of the calcium in a cup of milk but only 5% from spinach.  Therefore, ounce-for-ounce dairy foods will provide you with the best sources of calcium.  Most dairy foods are also fortified with vitamin D, which is an important nutrient that helps to increase calcium absorption.  It has been found that without vitamin D less than 10% of dietary calcium may be absorbed.  (See Vitamin D and Bone Health for more information about how you can ensure that you are meeting your Vitamin D needs.)

Your calcium requirements change throughout the years.  The following is a list of the recommended dietary allowance (RDA) for calcium:

• Ages 9-18: 1,300mg
• Ages19-50: 1,000mg
• Ages 50 and up: 1,200mg

Although you can use the above information as a general rule, calcium intakes do differ for some groups.  For example, it is recommended that postmenopausal women not taking estrogen increase their calcium intakes to 1,500mg per day, while postmenopausal women taking estrogen can take 1,000mg per day.  In order to meet your calcium needs through dairy products you would need to have 3-4 servings of dairy per day.  (Low-fat or fat-free dairy products are best to help maintain a healthy weight!)