Getting Enough Calcium In Your Crohn's Disease Diet

Dairy products are important sources of calcium and some of these products are fortified with vitamin D. Calcium and vitamin D are critical for good bone and tooth health (other important nutrients for bone health include phosphorus, magnesium, and fluoride). A diet that includes adequate amounts of these nutrients is one important factor to help prevent bone loss (osteopenia) and development of osteoporosis.

 

You may limit dairy because of lactose intolerance or avoid it entirely for other reasons, such as taste, ethics, allergy, or cultural or religious traditions. Regardless of the reason, the challenge is to get the key nutrients provided by this food group in other ways. Calcium from dairy products is better absorbed than calcium in many other foods.

 

 

Another strategy for consuming adequate calcium when you are lactose intolerant is to a commercial lactase enzyme product to break down lactose. These are available as tablets or as liquid drops in most pharmacies.

 

 

If you don't think you can improve your intake from food and beverages, consider calcium supplements with vitamin D and discuss this with your doctor. There may be times when your doctor recommends supplements in addition to foods. There are many forms of calcium supplements to choose from — pills, effervescent tablets, chewable tablets, and 'soft chews' in multiple flavors. Be sure to choose calcium supplements that also contain vitamin D.

 

 

On the label, look at the "elemental" calcium content — that is, the calcium available to your body. Split calcium dosages so that you are taking no more than 500 mg elemental calcium at any one time in order to get maximal absorption. For some forms of calcium, take the supplements with meals. Calcium carbonate, for example, requires stomach acid for absorption, whereas calcium citrate or gluconate do not.

 

Discuss the safest sources of calcium supplements with your pharmacist. Dolomite or bone meal, for example, are most contaminated by lead; oyster shell or shellfish sources may pass government standards; and calcium citrate and refined calcium carbonates are considered lowest in lead content.

 

 

Vitamin D helps your body absorb calcium. Interestingly, vitamin D is a hormone that our bodies make when sunlight shines on our skin (sunlight provides ultraviolet radiation for the body to convert vitamin D to an active form). In northern latitudes of North America and Europe, the reduced sunshine and angle of the sun in winter months results in less vitamin D manufactured by the skin. Similarly, if individuals have dark skin (more pigmentation), are housebound or institutionalized, or wear sunscreen at all times when outdoors, they are also at risk of not getting enough vitamin D. Generally speaking, if you have 10 to 15 minutes of sunlight exposure (face, arms, hands) twice a week, you are probably getting enough vitamin D (without sunscreen). What can influence this estimate is your geographic location, the time of year, your age, and your skin color.

 

 

Because of these factors that interfere with our ability to get enough vitamin D, selected items in our food supply are fortified with vitamin D. Scientific evidence is suggesting now that for some people (high-risk groups, such as the elderly), the optimal intake of vitamin D is higher than current daily recommended intake levels (200 IU). In fact, some scientists and North American osteoporosis societies are recommending increased vitamin D intakes of 800 to 1000 IU per day

 

Adults on prednisone may be advised to take 1500 mg of calcium a day and 800 IU of vitamin D. Vitamin D above these amounts can lead to significant health problems, so it is important to discuss any supplementation with your physician.