RX for readers: Calcium confusion

Since I – at 62 years old – have osteoporosis, I am very concerned about calcium intake and absorption. Recently I have heard lots of new information, some contradicting my long-held beliefs.

For example, I have been told that it is best to eat dairy foods (yogurt, milk, cottage cheese and so on) with higher fat content. Another friend told me she has improved her bone density by avoiding dairy foods altogether, since they leach calcium from the bones. And what about drinking soda water and soft drinks? Do they prevent calcium absorption? Some time ago, I had a 24-hour urine sample analyzed and it showed that calcium was not leaving my body; So should I assume that the foods I am eating are adequate?

M.S., Jerusalem

Dorit Adler, chief clinical dietitian at the Hadassah University Medical Centers in Jerusalem, replies: Bone health is influenced by the diet as a whole and not only by calcium consumption.

This is the reason for different information.

The DASH diet, which was proven to lower hypertension, has been found to have protective influence on the bones as well. This diet is based on seven to nine daily portions of vegetables and fruits, plus whole grains and pulses; low-fat milk products; nuts; fish and poultry. I recommend this as the basis of your diet and to consult a physician and or dietitian before taking any supplement, as their benefit is questionable and they should should be considered on an individual basis.

Dr. Olga Raz, director of the department of nutrition and dietetics at Tel Aviv Sourasky Medical Center and head of the nutrition science department at the Ariel University Center, adds: If a patient has been diagnosed with osteoporosis, he must get medication. It’s important to understand that calcium is not a drug but a nutritional supplement given if a person is not getting enough from his food alone. For calcium to be effective, it’s important to have a steady, adequate level of vitamin D3. A lack of this vitamin boosts osteoporosis and can cause secondary hyperparathyroidism.

Another factor that is even more important than calcium is magnesium; Most of us do not get enough of it. So it’s worth taking 300 to 400 milligrams a day, even if your level is normal. With a shortage of magnesium, calcium is not absorbed properly in the body by the digestive system or by the bones.

As for calcium itself, you can eat one or two dairy products a day – a container of yogurt or 100 grams of white cheese of any kind, whatever the fat content, equals one serving. Absorption of calcium from water is excellent, even if the water has no fat at all.

You can also get calcium from vegetables, tehina, nuts and sardines; not only from dairy products. It is apparently true that cheeses may cause some of the calcium to exit the bone. It is possible to eat too much of them.

What does one do in an emergency over the weekend or another time when one’s dentist is not available and a crown or a filling falls off, a child’s baby tooth breaks in a fall, a cavity causes pain or the gums are hurt from eating a foreign object by mistake?
T.V., Rehovot

Recently retired Jerusalem dentist Dr. Steve Sattler and Tel Aviv dentist Dr. Ronen Bordovski reply: Some pharmacies sell an emergency dental kit for the home. It has some oral glue in it, oil of cloves for toothache and other materials for emergencies. It is usually possible to stick a crown back in place with chewing gum, toothpaste or even some flour and water mixed into a paste.

A broken tooth should be stored in a glass of milk or sterile water. Hold ice over the area in the mouth if there is any bleeding and quickly seek first aid. If a whole tooth falls out, quickly wash it in water without wiping it, and put it in milk or sterile water. If it’s an adult, hold it inside the cheek, but do not do this for a child as he may swallow it. One must reach a dental practitioner within an hour. If the tooth can be returned to its socket, do so immediately but do not use force.

If a filling has fallen out, don’t bite on the tooth or put any pressure on it until you reach a dentist.

The Israel Dental Association has a roster of emergency dental clinics that are open on Shabbat, holidays and at night in every city. See the IDA website or call the IDA office in Tel Aviv.

For serious dental emergencies, all major hospitals have a maxillofacial department with a duty surgeon.

Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000; fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to jsiegel@jpost.com, giving your initials, age and place of residence.