NAP Challenge #10: Take on the Calcium Balance Challenge

This week I will eat or drink three servings daily of calcium rich foods.

Background:

This week’s challenge features Calcium Balance. Why is calcium balance pertinent to the New American Plate Challenge? For prevention of osteoporosis, cancer, cardiovascular disease, hypertension, and type 2 diabetes as well as optimal nutrition while losing weight. One important part of your New American Plate… and your New American Plate cereal bowls, glasses, and mugs is calcium-rich foods.

The National Academy of Science’s Institute of Medicine recently updated recommendations for calcium for bone health. The amount of calcium recommended is 1,000 milligrams (mg) per day for adults ages 19-50 years and increases to 1,200 mg per day for adults over age 51. According the US Dietary Guidelines for Americans, calcium is considered a “nutrient of concern” because most of us do not consume adequate calcium. Most Americans are at risk for osteoporosis because of having low bone mass due to inadequate calcium intake.

Adequate calcium intake from diet and supplements also is associated with lower incidence of colorectal cancer; yet, too much calcium from diet and supplements is associated with increased risk for prostate cancer. Thus, “calcium balance” is necessary for bone health and cancer prevention. AICR advises consuming no more than 1500 mg of calcium from diet and supplements daily. The recommended 1000 – 1200 mg calcium translates to consuming 2 1/2 to 3 servings of dairy foods daily as part of a balanced diet. It’s critical to eat a healthy diet including calcium-rich foods even when trying to lose weight to protect your bones and prevent cancer.

With the mostly plant-based eating style of the New American Plate, you can achieve calcium balance. While two-thirds or more of your plate (… and cereal bowl… and glass… and mug…) is plant based, the remaining one-third or less is animal protein based and that includes dairy products. You get concentrated calcium, in a well-absorbed form, from non-fat and low-fat dairy products such as milk, yogurt and cheese.

You also can choose some high calcium plant-based foods such as collard greens, tofu, edamame, and calcium and vitamin D fortified soymilk. Sardines are also high in calcium. Calcium fortified cereals, breads and 100% fruit juices are good choices too. Striking your calcium balance with a combination of calcium-rich dairy and plant-based foods is easy. Look at the suggestions below for meal and snack ideas.

If you don’t consume dairy products or enough calcium and vitamin D fortified soymilk or other milk alternative beverages and calcium fortified foods such as cereals, breads and juices, calcium supplementation may be advised. Again, do not exceed 1500 mg daily of dietary and supplemental calcium.

Time to take on the Calcium Balance Challenge!

Data Source: USDA National Nutrient Database for Standard Reference, Release 22.
Table (from Dietary Guidelines for Americans 2010, www.dietaryguidelines.gov)

Steps and Tips:

• Estimate your calcium intake one day this week. Go to www.mypyramid.gov
• Read labels to select milk alternative beverages like soy, rice or almond milk that are calcium and vitamins D and A fortified
• Choose non-fat or low-fat lattes and cappuccinos
• If lactose intolerant, try drinking no more than 1/2 cup non-fat or low-fat milk at a time. Try low-lactose or lactose-free milk, yogurt and cheeses and calcium and vitamin D and A fortified soymilk or other fortified milk alternative beverages
• Choose non-fat and low-fat yogurts with minimal added sugar. Look for active cultures for probiotic advantage
• Get Greek-style yogurts for a heartier snack, these are often lower in sugar and richer in protein, keeping you satiated longer. Calcium content may be less than regular yogurt, yet it still provides calcium
• Substitute some non-fat or low-fat yogurt for sour cream or mayonnaise in dips, sauces and casseroles
• Buy hard cheeses made with reduced fat milk more often and cheeses made with whole milk less often. The 1 1/2-ounce portion size fits nicely into the 2/3 – 1/3 rule. Eat in smaller amounts shaved or grated whole milk aged cheeses like Parmesan, Romano, and Asiago
• Top soups, stews, casseroles, salads, and vegetables with reduced fat cheeses. Use low-fat ricotta, cottage cheese, shredded mozzarella and assorted cheeses in dishes
• Dress baked sweet potatoes and other potatoes with non-fat or low-fat yogurt and cheeses
• Make, buy or order pizza with low-fat cheeses preferably on whole-wheat crust with lots of veggies. Let vendors know that’s what you would like them to offer!
• Buy tofu processed with calcium sulfate for higher calcium content

Ideas for dairy foods and calcium rich foods and portion sizes:

• Breakfast: 1 cup skim or 1% milk with cereal, 1 cup hot cocoa, 1 cup non-fat or low-fat yogurt with whole grain granola and mixed fruit, 1 1/2 ounce of reduced fat cheese with sliced fruit and whole grain bagel, 1/2 cup fortified orange juice, 1 cup fortified cereal; make oatmeal with skim or 1% milk, not water; make whole wheat pancakes and muffins with fat-free buttermilk; AICR NAP Smoothie.
• Lunch: 1 1/2 oz reduced fat cheese preferably more often in sandwiches or entrée salad, 1/2 cup tofu in vegetable salad medley, 1/2 cup non-fat or low-fat cottage cheese preferably, 1 cup non-fat or low-fat yogurt, 1 cup skim or non-fat milk, 1 cup nonfat or low-fat pudding, 1/2 - 1 cup cooked kale and white beans in soup.
• Dinner: 1 1/2 ounce reduced fat cheese in pizza or pasta dishes, 1/2 cup reduced fat ricotta cheese, 1/2 cup tofu vegetable stir fry, 1/2 cup non-fat or reduced fat cottage cheese, 1 cup skim or 1% milk, 1 cup non-fat or low-fat yogurt, 1/2 cup or more calcium rich vegetables.
• Snacks: 1 cup skim or 1% milk or soy milk latte, cappuccino or chai latte, 1 cup hot cocoa, 1 cup non-fat or low-fat yogurt with whole grain flake or granola cereal and dried or fresh fruit, 1 1/2 ounce reduced fat cheese, 1/2 cup edamame, AICR NAP Smoothie.
• Desserts: puddings, parfaits made with skim or 1% milk and topped with lots of fruit, ice milk or non-fat or low-fat frozen yogurt.
• Remember:
  • When eating out, try to include calcium rich foods – cheese and tofu from salad bar, 1 1/2 ounces cheese on sandwich, veggie and/or grain salads with tofu and cheese.
  • Reward yourself with non-food treats when feeling like a "pick-me-up" or when meeting your steps or minutes activity goal or for losing weight. For example, instead of a coffee shop beverage treat, grab your water bottle and take a walk in the park or read a magazine standing up, buy and plant some new annuals or container pot herbs.
  • For osteoporosis prevention, in addition to adequate calcium intake make sure to enjoy weight bearing physical activities such as walking, hiking, running, dancing, and playing sports like tennis. Another reason to stay moderately to vigorously active daily!

Further Information:

• AICR online articles and information:
  • Q & A: Sugar in Yogurt
  • What You Need to Know About Preventing Prostate Cancer
• AICR online recipes:
  • Breakfast Banana Smoothie
  • Grilled Fruit with Strawberry Dip
  • Turkish Yogurt Soup Good Hot or Cold
  • Baked Tofu Kabobs
  • Bean and Vegetable Enchilada Casserole
  • Apricot Pecan Cereal Bars (made with tofu)
• More information:
  • Calcium and Bone Health – US Centers for Disease Control and Prevention
  • Dairy: Tips for Making Good Choices – USDA My Pyramid
  • Meeting Calcium Recommendations on a Vegan Diet by Vegetarian Nutrition Practice Group of the American Dietetic Association – more information on calcium rich plant sources
  • Calcium in the Vegan Diet by Vegetarian Resource Group