Despite a major push by health authorities, most American women still aren’t getting enough bone-building calcium even when they are being treated for osteoporosis.

“Calcium is important,” says Robert P. Heaney, MD, of the Osteoporosis Research Center at Creighton University Medical Center in Omaha, Neb. “You want to tell American women to go to the chalkboard and write 1,000 times, ‘I will take my calcium.’”

Heaney reported his findings at the American Society of Bone and Mineral Research 27 Annual meeting here.

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Falling Short

Osteoporosis affects 9 million women, primarily postmenopausal women, making the bones weak and more likely to fracture. An additional 34 million women are estimated to have bone loss that puts them at risk for osteoporosis. Adequate daily calcium is essential in maintaining bone strength.

Creighton researchers looked at more than 11,000 women and evaluated how much calcium they got.

The results revealed that 85 percent of postmenopausal women only got on average 727 milligrams of calcium per day, a full 500 milligrams below the recommended intake of 1,200 milligrams a day for women aged 50 years and older.

“The study showed that daily calcium intake has not improved since the landmark Study of Osteoporotic Fractures nearly 20 years ago,” says Heaney. “We wanted to see if health care was improving in this area. The answer is we are failing.”

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Osteoporosis Drugs Aren’t Enough

To make matters worse, the team also found that even many American women prescribed medication for osteoporosis still weren’t getting enough calcium and vitamin D. Calcium helps build stronger bones, and vitamin D helps the body better use calcium.

Of the more than 1,100 women taking medications for osteoporosis, only about one-third took the calcium supplementation necessary to achieve the full benefit of the medicine, the researchers reported.

One hundred percent of the women taking bisphosphonate need to be taking adequate levels of calcium, Heaney tells WebMD. “All the new osteoporosis drugs build bone – some more than others – but none without adequate calcium.”

Walking Your Way to Better Bones

Humans Are Bad

When women are asked if taking calcium is important, they will answer that it’s important, he says. “But they aren’t internalizing the information and taking action.”

This study has hit the mark, Robert Lindsay of the National Osteoporosis Foundation tells WebMD. “The human race isn’t very good about taking medicine. Americans aren’t getting enough calcium from their diets and that is why physicians advise them to take calcium supplements.”

It is especially important for women taking osteoporosis medication because without enough calcium, the medicine won’t be as effective, says Lindsay.

“All the clinical trials showing the effectiveness of [osteoporosis drugs] were done in combination with women taking calcium supplements. However, in the real world, patients are taking the medication without the supplements.”

Testing for Osteoporosis

A painless and accurate test can provide information about your bone health before problems begin. Bone mineral density (BMD) tests, or bone measurements, are X-rays that use very small amounts of radiation to determine bone strength.

To get an idea of what your osteoporosis risk may be, take the osteoporosis risk assessment quiz.

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Preventing Osteoporosis

There are a variety of ways you can protect yourself against osteoporosis, including:

Exercise. Weight-bearing exercises, done at least three to four times a week, are best for preventing osteoporosis. Walking, jogging, playing tennis, and dancing are all good weight-bearing exercises.

Eat foods high in calcium. Excellent sources of calcium are milk and dairy products (low-fat versions are recommended), canned fish with bones like salmon and sardines, dark green leafy vegetables such as kale, collards, and broccoli, calcium-fortified orange juice, and breads made with calcium-fortified flour.

Supplements. Calcium carbonate and calcium citrate are good forms of calcium supplements.

Vitamin D.Your body uses vitamin D to absorb calcium. Being out in the sun for 20 minutes every day helps most people's bodies make enough vitamin D. You can also get vitamin D from eggs, fatty fish like salmon, cereal and milk fortified with vitamin D, as well as from supplements. People aged 51 to 70 should get 400 IU each day, and those over age 70 should get 600 IU.

Other preventive steps: Limit alcohol consumption and do not smoke. Smoking causes your body to make less estrogen, which protects the bones. Too much alcohol can damage your bones and increase your risk of falling and breaking a bone.

By Linda Little, reviewed by Michael W. Smith, MD

SOURCES: American Society of Bone and Mineral Research 27th Annual meeting, Nashville, Tenn., Sept. 23-27, 2005. Robert P. Heaney, MD, S. Magowan and S. Zhous, Proctor & Gamble Pharmaceuticals, Mason, Ohio. S. Boonen, Leuven University, Leuven, Belgium. W.Y. Chow, Health Outcomes, Sanofi-Aventis, Bridgewater, N.J. Robert Lindsay, professor of medicine, Columbia University, New York.