Healthcare Treatment Guidelines

Calcium is present in a wide range of foods. Dairy products, leafy green vegetables, nuts and seeds (almonds, brazils, sesame seeds), tofu, and dried fruit are all good sources of calcium for vegetarians. Most flour is fortified with calcium carbonate so cereals can also be a good source. Hard water may also provide calcium. Meat is a very poor source of calcium.

Calcium balance can be affected by a range of other factors. Vitamin D is essential for absorption of calcium from the gut. This is because calcium is transported into the body by a special carrier protein which requires vitamin D for its synthesis.

A number of substances can inhibit the absorption of calcium. Phytic acid, found in bran, whole cereals and raw vegetables is one of these. Uronic acid, a component of dietary fibre, and oxalic acid, found in certain fruits and vegetables can also bind calcium. However, diets habitually high in these acids are not thought to have a major effect on calcium absorption. Saturated fats can also lessen calcium absorption.

Calcium is lost in the faeces, urine and sweat. Calcium loss is roughly equal to dietary calcium in adults. Calcium loss is reduced if dietary calcium is low. Adaptation to both high and low calcium intakes occur. Reduced intake leads to increased efficiency of absorption. In infants and children calcium is retained for new bone growth. Calcium is also lost during lactation in breast milk.

Foods rich in calcium are :

• Ragi, a millet, is a rich source of calcium and known as poor man’s milk.

• Green leafy vegetables are very rich sources of Vitamin B, carotene, iron, calcium, Vitamin B complex and Vitamin C .

• Milk is a good source of protein, calcium and vitamins.

• Yogurt (Curds), paneer, fenugreek leaves, drumstick leaves, Almond, Dried Figs (Anjeer) are great source of protein, riboflavin and calcium.

• Pineapple is tropical fruit. It is a good source of Vitamin A and B and rich in Vitamin C and calcium. It also contains phosphorus and iron.

• Sea Food: Small fish like sprats and sardines can be a useful source of calcium when eaten whole together with bones and may supply up to 400 mg of calcium/ 100 gms. Fish also contains fair amount of copper.

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  • A calcium rich diet and weight bearing exercise play a critical role in helping to build and maintain strong bones.

    Calcium requirements should be met everyday: however the majority of women fall far short of this.

    On an average, women get only 500-700mg of calcium from their daily diets, while the National Institutes of Health’s Consenses Conference on Optimal Calcium Intakes recommends 1000-1500mg for women over 50 years. Based on these average levels most women require calcium supplementation.

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  • DIET

    • Throughout life, dietary intake of calcium is essential for bone formation and maintenance
    • Vitamin D, which aids in the absorption of calcium, is also essential

    • Maintaining a healthy diet which includes a sufficient amount of calcium and Vitamin D is very important

    A diet that includes an adequate amount of calcium, vitamin D and protein should be maintained. This will not completely stop bone loss, however it will guarantee that a supply of materials tha body uses for bone formation and maintenance is available.


    Regular exercises can reduce the likelihood of the bone fractures associated with osteoporosis. Exercises, requiring muscles to pull on bones, cause the bones to retain and perhaps even gain in density.

    Some of the recommended exercises include:

    • Weight bearing exercises
    • Riding stationary bicycles
    • Using rowing machines
    • Walking
    • Jogging

    It is important to remember that any exercise that presents a risk of falling should be avoided

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  • There are no symptoms associated with the onset of the disease

    Symptoms occuring late in the disease
    • Low back pain
    • Neck pain
    • Bone pain or tenderness
    • Loss of height over time
    • Stooped posture
    • Fractures of the spine, wrists or hips
    Investigations :Your doctor would make the diagnosis of Osteoporosis based on investigations such as Bone mineral density, Spine CT, X-ray, etc. among other findings.

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  • • Asian women
    • Menopause
    • Old age
    • Family history of osteoporosis
    • Smoking
    • Eating disorders
    • Diet deficient in calcium
    • Alcohol consumption
    • Use of certain medications such as steroids

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  • What causes Osteoporosis?

    There are a number of causes of osteoporosis, however hormone deficiency(oestrogen in women and androgen in men) is a leading cause.

    Other causes include
    • Low calcium in diet
    • Excess of corticosteroids (Cushing’s Syndrome)
    • Hyperthyroidism
    • Hyperparathyroidism
    • Immobilisation
    • Bone malignancies
    • Certain genetic disorders

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    Osteoporosis is a common type of bone disease. It occurs when the body fails to form enough new bone or when too much of the old bone is being re-absorbed by the body.

    Calcium is essential for normal bone formation. Throughout youth, the body uses calcium to produce bones. If calcium intake is not sufficient, or if the body cannot absorb enough calcium from the diet, bone formation and bone tissue may suffer. Calcium may be reabsorbed into the body from the bones in which case the tissue is made weaker. Both situations can result in brittle fragile bones that are prone to fractures.

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