Healthy Lifestyle Month | How can the elderly supplement calcium scientifically?

1. Elderly people are generally calcium deficient

Calcium is one of the important constant elements that our human body cannot do without. Once calcium is deficient, it is easy to cause osteoporosis and other diseases. In my country, the incidence of osteoporosis caused by calcium deficiency is close to 40% among the elderly over 60 years old, among which the incidence rate is higher in women, about 49%; and slightly lower in men, about 23%.
Relevant surveys show that the calcium intake of Chinese residents is generally low, with the average intake reaching only about 50% of the recommended intake. In addition, due to the physiological characteristics of the elderly, calcium loss is accelerated and calcium absorption capacity decreases, resulting in a relatively increased calcium requirement and insufficient actual calcium intake. "Calcium deficiency" has become an unavoidable health problem for most elderly people.

2. Calcium supplementation goals for the elderly

The recommended calcium intake for adults is 800 mg/day, while the calcium requirement for the elderly is higher than this standard. According to the "Chinese Residents' Dietary Nutrient Reference Intake", the recommended daily calcium intake for people aged 50 and above is 1000 mg/day, but should not exceed 2000 mg.

3. Ways to supplement calcium for the elderly

There are two main ways for the elderly to supplement calcium: one is dietary intake, and the other is taking calcium supplements.

1. Dietary intake

Taking in an appropriate amount of calcium through a balanced diet is the most economical, safe and reasonable way to supplement calcium.

Foods rich in calcium in daily life include the following:

(1) Milk and dairy products

Milk is the best source of calcium for the human body, and the calcium-phosphorus ratio is appropriate, which is conducive to calcium absorption. Milk should be the main food for daily calcium supplementation. Other dairy products such as yogurt and cheese are also good sources of calcium.

The calcium content in milk can generally reach 100mg/100ml. Drinking a cup of milk (250ml) + a cup of yogurt (125ml) every day can basically meet nearly half of the calcium needs.

(2) Beans and their products

Soybeans are high-protein food and also high in calcium.

Especially fermented soy products, which are more nutritious, the elderly may wish to eat more soy products.

(3) Seafood such as fish, shrimp and shellfish

Shrimp skin, fish, kelp, and small fish and shrimp that can be eaten with their shells and bones are also high-calcium seafood.

(4) Green leafy vegetables

Most green leafy vegetables are moderate sources of calcium, such as Chinese cabbage, rapeseed, fennel, coriander, celery, and snow vegetable, which are all calcium-supplementing vegetables that cannot be ignored.

2. Take calcium supplements

When it is difficult to get enough calcium from a normal diet, appropriate amounts of calcium preparations should be supplemented.

(1) Calcium supplement selection

According to solubility, we often divide it into:

Organic calcium: such as calcium gluconate, calcium lactate, calcium citrate, calcium acetate, calcium fructose, etc. have high solubility, do not require the participation of gastric acid during the dissolution process, and are less irritating to the gastrointestinal tract.

Inorganic calcium: such as calcium carbonate, calcium phosphate, calcium chloride, calcium phosphate, etc. have low solubility and are more irritating to the gastrointestinal tract.

(2) Time of use

It is best to take calcium tablets after meals to minimize the impact on the digestive tract and reduce the risk of stomach discomfort or constipation.

Try not to drink strong tea, alcohol, or eat raw vegetables before and after taking calcium tablets. These foods contain substances that cause calcium loss and can form calcium oxalate crystals, which not only make calcium absorption difficult but also easily form stones.

(3) Supplement dosage: Take small amounts and multiple times to supplement calcium appropriately

The calcium intake at one time should not exceed 500 mg. Taking too much will reduce the utilization rate.

It is best to choose 100 mg ~ 300 mg calcium tablets and take them two or three times a day, such as 200 mg in the morning and 200 mg in the evening. Do not take too much at one time.

(4) Dosage form selection

The elderly can choose calcium supplements that are easy to swallow, such as long and thin calcium tablets, small chewable tablets, powdered calcium supplements, etc.

4. Other precautions for calcium supplementation

1. Exercise more

Physical exercise can deposit calcium into the bones and prevent osteoporosis.

Physical exercise can also get sunlight exposure. The ultraviolet rays in the sunlight can convert dehydrocholesterol in the skin into vitamin D, which helps the absorption and utilization of calcium.

If the elderly do not do some exercise that slightly stimulates the bones, it is difficult for the calcium supplement to work. Walking, square dancing and Tai Chi are good ways to exercise.

2. Get rid of bad habits

Smoking and drinking, irregular lifestyle, long-term fatigue or mental stress, endocrine diseases and gastrointestinal diseases are also not conducive to the absorption and utilization of calcium.

3. Drink less coffee and tea

Caffeine antagonizes calcium absorption; tea contains tannic acid, which reacts with calcium to form water-insoluble calcium salts, affecting calcium absorption.

4. Get enough sleep

Sufficient sleep is an effective measure to increase the body's calcium absorption rate. Therefore, the elderly who want to effectively supplement calcium should ensure adequate sleep time.

5. Take Vitamin D at the same time

The most important thing is left for last!

Calcium requires vitamin D to be well absorbed by the body.

Since the ability of the elderly to synthesize vitamin D is only one-third of that of young people, it is very necessary to supplement vitamin D when supplementing calcium.

You can choose calcium supplements that also contain vitamin D, or take additional vitamin D preparations, 400IU-600IU per day.

Author: Liu Fang | Registered Dietitian Intermediate Dietitian, Nutrition Department, Heping Hospital, Changzhi Medical College

Reviewer: Shi Rengfei | Professor at Shanghai Institute of Physical Education