Studies May Hinder Fight Against Osteoporosis : Diet: Doctors and dietitians fear that Americans will stop counting their milligrams of calcium and doom themselves to living with humps and bone fractures.

Just as we were getting used to counting calcium the way we count calories, along came a pair of studies to make us question whether stuffing ourselves with milk and cheese is really worth all the hassle.

In April, a 20-year study at the University of Michigan School of Public Health reported that consuming more calcium in the diet does not appear to prevent bones from thinning.

In early May, a Chinese study concluded that dairy calcium is not needed to prevent osteoporosis, a deterioration of the bones due to the excessive loss of bone tissue. The Chinese, who get all of their calcium from vegetables and consume half the calcium we do, rarely get osteoporosis, according to the study.

The publication of these two studies has caused medical doctors and dietitians to fear that Americans will stop counting their milligrams of calcium and doom themselves to an old age living with dowagers’ humps and bone fractures.

An estimated 24 million Americans, including as many as half of all menopausal women, have osteoporosis. And, as the baby-boom generation ages, the number of victims is expected to double by the year 2020.

Sandra Raymond, executive director of the National Osteoporosis Foundation, says that the foundation is continuing to recommend a diet high in calcium to prevent osteoporosis despite the latest studies. The foundation is a nonprofit health agency dedicated to the prevention of osteoporosis.

“Already there are people who are saying, ‘I am going to stop calcium because it doesn’t help,’ ” says Dr. Andrew Klipper, a Baltimore physician who treats patients suffering from osteoporosis.

“Patients have heard about the Michigan study and are confused. The bottom line is you need adequate calcium throughout life. This is only one study.”

Caroline Buchanan, a registered dietitian and nutrition consultant with Chesapeake Nutrition Services in Abingdon, Md., says that these new studies provide no solid reason to forget calcium awareness in the diet.

“You have to take all studies with a grain of salt,” she says. “And you have to compare what they say to what all the top researchers are saying.”

Buchanan sees two faults with the latest studies. She points out that the Michigan study was based on self-reported eating habits, not a scientifically controlled diet. And what the Chinese study may be telling us is that Americans eat too much protein. The Chinese may absorb more calcium than we do because protein interferes with calcium absorption.

She recommends complying with the new Recommended Dietary Allowances for calcium set by the National Academy of Sciences last fall. The calcium requirements were raised from 800 to 1,200 milligrams a day for males and females between the ages of 11 and 25. The RDA remains at 800 milligrams for older adults.

The National Institutes of Health recommends 1,000 mg. of calcium for men and women, 1,500 mg. a day for women after menopause who are not on estrogen and 1,000 mg. a day for those on estrogen. The National Institutes of Health gives no recommendations for calcium from birth to age 18.

Unfortunately, no matter which recommendation we use, most of us don’t consume enough calcium to keep bones healthy. Typically, Americans consume only 450 to 500 milligrams of calcium a day, according to national surveys of dietary intake.

Young women, who often opt for fad or low-fat and low-calorie diets, may be getting only 300 milligrams of calcium a day. And those years from 18 to 25 are crucial for development of bone mass, according to the experts. We reach top bone mass by age 30. After that, the damage is done. We can maintain the mass we have, but we can’t build any more.

“Osteoporosis occurs because all of us lose bone as we age,” Klipper says. “Everyone should have the greatest density possible so that when we age we have more bone to lose.”

But how do we increase the calcium in our diet without increasing the size of our waistlines? Learn to drink skim milk. Skim milk has more calcium and fewer calories than whole milk. An 8-ounce glass of skim milk contains 302 mg. of calcium and 85 calories compared to 291 mg. of calcium and 150 calories in whole milk.

Look for low-fat cheeses. Read the label and select a cheese with 5 grams of fat or less per ounce.

Those who cannot digest the lactose in milk without suffering gastric discomfort should drink calcium-fortified orange juice or milk fermented by bacteria sold as acidophilus milk. LactAid, a product that can be added to regular milk to make it easier to digest, is another good option. Some of the best sources of calcium include collards (357 mg. per cup and only 65 calories) and sardines (372 mg. of calcium in 3 ounces and 175 calories).

To enhance the absorption of calcium, eat a diet that does not contain too much protein (not more than 30% of total calories) or too much caffeine.

Vitamin D also helps absorption of calcium, but avoid high-potency supplements because excessive Vitamin D can cause bone density loss. Make sure to get at least 400 International Units of Vitamin D daily through egg yolks, salt-water fish, liver and Vitamin-D fortified milk.

And be sure to get exercise. A minimum of at least three hours a week of physical exercise helps absorption of calcium.

Try to get as much calcium as you can through food, but if you need to take a calcium supplement, make sure it is bio-available. To test, drop a tablet in a glass of vinegar. Wait a half hour and see if it has dissolved. If so, it will dissolve in your body in sufficient time.

Buchanan also warns that you can get too much of a good thing, and she suggests not trying to overload with calcium-fortified products unless you are lactose-intolerant. The recommended upper limit for calcium consumption is 2,500 mg. a day. Higher levels may induce constipation and kidney stones, she says.

“People have to realize that dietary calcium is only one of the factors in preventing osteoporosis,” Buchanan says. “You should also exercise, stop smoking and avoid excessive alcohol.”