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The calcium- Dairy myth

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A commonly asked question is “Can I just drink milk to get enough calcium?”

Let’s take a quick look at the daily recommendations for calcium requirements.

The recommended daily allowance (RDA) for calcium varies by age. The RDA for Singapore is considerably lower as compared to standard calcium requirements in United States or Canada. (Use this table only as a general information guide. However, the requirements change based on ethnicity and on individual basis).

Age Male Female

Pregnant

Lactating

0–6 months

200 mg

200 mg

7–12 months

400mg

400 mg

1–3 years

500 mg

500 mg

4–6 years

600 mg

600 mg

7-9 years

700mg

700 mg

10–18 years

1000 mg

1,000 mg

1000 mg

1,000 mg

19–50 years

800 mg

800 mg

1,000 mg

1,000 mg

51–70 years

1,000 mg

1,200 mg

71+ years

1000 mg

1000 mg

 

Doctors have recommended dairy as a good source of calcium since decades for people who tend towards osteoporosis. Dairy is no doubt a great source of calcium but also provide adequate sources of other minerals like magnesium and potassium that is essential for bone building and metabolism. If you are not intolerant or allergic to dairy, it is far by the easiest way to get calcium especially with children. Pastured dairy products in particular, are also a good source of fat soluble vitamins like A,D, E, K2 which can be difficult to obtain elsewhere in the diet. However, one would have to take very high amounts of these foods to achieve the required daily amounts of calcium especially in adults which make it less practicable.

Milk, 1% low fat – (8oz 1 cup) – 300 mg calcium

Yogurt, plain low fat (8 oz, 1cup) – 400 mg calcium

American cheese (1 oz)-. 150mg calcium

Cheddar Cheese (1 oz).-204 mg calcium

Gouda/Muenster/Provolone (1 oz.) -200mg calcium

Lactose intolerance and dairy sensitivities are a common concern these days. Lactose intolerance is the lack of enzyme to digest lactose, the naturally occurring milk sugar. It is estimated that 90% of Asians and Africans are lactose intolerant, 70% of Hispanics and Jewish persons, 65% of Southern Indians, 30% of Central Europeans, and 5% of Northern Europeans. Persons who are not lactose intolerant may still have allergies or food sensitivities to the proteins casein or whey in dairy products. Cow’s milk has also been associated with potential problems like autoimmune conditions, asthma, allergies, autism and others.

So considering the rise of potential problems associated with dairy, other dairy forms like fermented dairy for lactose intolerant people should be considered.

Foods Quantity (serving) Calcium content (mg)
Yogurt, plain (low fat) 8 oz 400 mg calcium
Yogurt, flavored (low fat) 8 oz. 300-400 mg calcium (depends on different brands)
Kefir 100gms 120mg
Firm tofu 1/2 cup 253 mg

 

Excessive intake of dairy in children has also shown to be associated with deficiency of iron and anemia as calcium competes with iron for absorption. Intake of processed foods like cheese creates an acidic environment which can cause calcium to leach out of bones. Therefore a alkaline environment with plenty of greens would be ideal for bone building than relying completely on dairy.

Other nondairy sources of calcium:

Foods Quantity (serving) Calcium content (mg)
Sardines, 3 ounces 324 mg
Collard greens, 1 cup 357 mg
Calcium-fortified orange juice 1 cup 300 mg
Soy or rice milk, fortified, 1 cup 200-300 mg
Canned salmon 3 ounces 205 mg
Turnip greens 1 cup 215 mg
Kale 1 cup 179 mg
Soybeans 1 cup 175 mg
Okra 1 cup 172 mg
Bok choy 1 cup 158 mg
Mustard greens 1 cup 152 mg
Tahini 2 tbsp 128 mg
Broccoli 1 cup 94 mg
Almonds 1/4 cup 89 mg
Almond butter 2 tbsp 86 mg
Ikan bilis 2tbsp 200mg
Lentils 1 cup 230mg
Kailan 1 cup 116mg
Spinach 1 cup 84mg

If you take iron or other minerals, it is advisable to space calcium supplements. Calcium competes with iron for absorption in the gut.

Remember that calcium is not just the only player in the osteoporosis prevention game. Magnesium, vitamin D, Vitamin K, Boron are equally essential for bone building. Vitamin D is essential to use the calcium appropriately and preventing deposition elsewhere in the body. Therefore it is essential to use a balanced nutrient composition if you plan to take a calcium supplement on a long term basis.

Sources :

Calcium content of foods, Harvard University of Medical Sciences

RDA derived from: Health promotion board, Singapore

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Heartburn/GERD- What everyone needs to know about it?

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We often hear several ads on Antacids to help with heart burn or GERD. You probably have someone in the family with heartburn who is probably on some form of acid lowering medications.

How are these meds supposed to decrease the heartburn? They tend to lower the levels of stomach acid either by neutralizing the stomach acid or by shutting down the body’s ability to produce the acid. The mainstream medical approach is to keep taking these till the symptoms persist. Read further to see if they really cure the heartburn and you do not need them anymore?

Heartburn is caused by the acid moving upwards into the esophagus causing a burning sensation in the lining of the mucosa. Antacids help to block it or reduce the acidity, thereby giving the relief. But, is this a cure or symptomatic relief? Is there really an excess of acid in the stomach? Most importantly, is it healthy to reduce the stomach acids?

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Do antacids/ PPI’s are really the solution for heartburn/GERD cure?

Antacids do reduce the acidity, but they do not stop the acid going from where it should not belong. There is a valve called LES (lower esophageal sphincter) at the end of the esophagus which prevents the food from re entering the esophagus from the stomach. So the valve is shut tight in presence of food in the stomach except during burping-when it opens. The LES tends to relax in situations like food sensitivities, alcohol, caffeine and nicotine. A major cause not accepted widely, but theorized by experienced integrative practitioners is the presence of low acid in the stomach causing the LES to relax leading to the reflux of acid. Thus, would antacids really help with the heartburn?

Numerous studies have shown that stomach acid secretion declines with age. In one study researchers found that over 30 percent of men and women past the age of 60 su?er from atrophic gastritis, a condition marked by little to no acid secretion. Another study found that 40% of women over the age of 80 produce no stomach acid at all.

Just as studies show acid secretion declines with age, it is also well established in the scienti?c literature that the risk of GERD increases with age. If heartburn were caused by too much stomach acid, we’d have a bunch of teenagers popping tums and not the elderly.

Yet, when one goes to a doctor, Antacids and PPI’s are often prescribed without testing for the stomach acid. When tested, it often reveals a low stomach acid than excess acid. So the theory holds true that low stomach acid relaxes LES.

Stomach acid is essential for absorption of minerals, proteins and key nutrients like iron, zinc and vitamin B12, folate and calcium. One of Stomach acid’s major role is carbohydrate digestion and to inhibit bacterial overgrowth. People who have low stomach acids are prone to carbohydrate mal digestion and bacterial overgrowth causing gas. The resulting gas in turn causes the intra-abdominal pressure to rise and becomes a driving force for the LES to stay open. Thereby, the whole cycle perpetrates to more heartburn and GERD.

What are better alternatives in curing heartburn?

Since low stomach acid is a major concern in people with heartburn, some doctors have found that acid supplements often cure the problem. The supplements also help restore the digestive system, which enables better absorption of nutrients. Of course, do not take acid except with the advice and under the care of a licensed doctor. If acid is normal in a person suffering from heartburn, his or her physician will often recommend testing for food allergies that could be causing the LES to malfunction. In addition there are other natural supplements and herbs and time tested traditional remedies that have been proven to help strengthen LES function and improve stomach acid. So if you are suffering from heartburn, especially with any frequency, look for an integrative doctor (one who combines the use of supplements and natural remedies with more conventional approaches as needed) who is familiar with stomach acid level testing, and can get to the real cause of your heartburn.

Refrences:

Dyspeptic symptom development after discontinuation of a proton pump inhibitor: a double-blind placebo-controlled trial. Am J Gastroenterol. 2010 Jul;105(7):1531-

Proton-Pump Inhibitor Therapy Induces Acid-Related Symptoms in Healthy Volunteers After Withdrawal of Therapy ,Christina R, Bo Sondergaard, Linda Hilsted, Peter Bytzer, GastroenterologyJuly 2009 (Vol. 137, Issue 1, Pages 80-87.e1)

Krasinski SD, Russell RM, Samloff IM, Jacob RA, Dallal GE, McGandy RB, Hartz SC. Fundic atrophic gastritis in an elderly population. Effect on hemoglobin and several serum nutritional indicators. J Am Geriatr Soc. 1986 Nov;34(11):800-6.

Altzman JR, Kemp JA, Golner BB, et al. Effect of hypochlorhydria due to omeprazole treatment or atrophic gastritis on protein bound vitamin B12 absorption. J Amer Coll Nutr 1994;13:584-591.