Ask the Huisvrouw: DIY calcium intake boost

Dear Huisvrouw,

I've been reading your blog for a while now. I love the mix you have going on here--crafty stuff like writing and knitting, culture and the arts, and especially all your fantastic food content.

The question I'm writing to you about today has to do with that last, food, and I'm afraid it's a two-parter. It's recently come to my attention that I really need to increase my intake of calcium. Per my doctor's recommendation, I'm taking some very sciency, organic supplement, but she's been really stern with me about needing to incorporate more calcium-rich foods into my regular diet. So, part one of my question is, what should I be eating?

Part two: Here's the deal: I have a partner and a cat, but no kids, yet. I'm in my early thirties, and of modest, modest means. And I'm a bit of a food moron. I'm an awesome waitress, but my back-of-house knowledge set and self-efficacy is nill. I do, however, reallllllllly want to learn. I'm passionate about living healthier for myself and for my partner and the kids we might get lucky enough to have someday. So, and dumb it down for me, Huisvrouw, how do I eat the calcium-rich foods, once I get them home from the store?

Signed,

Waitress Lost in the Kitchen

Dear WLitK,

I'm so flattered you asked. I've had calcium-boosting behavior drilled into me since birth, almost, given how many risk factors for osteoporosis (the brittle bone end game for insufficient calcium intake) I happen to embody: I'm female, white, thin, and have a family history of low bone density (dad, not mom). But I enjoyed doing a little research on the subject, primarily at the National Osteoporosis Foundation and the totally excellent, interactive, customizable new government food pyramid site (It's so nice to feel positively about something the feds have done in the past 5 years).

Let's talk first about the role of calcium in the body and what's behind your doctor's concern.

Calcium is an important structural component of healthy bones and teeth. In addition, calcium ions play a messenger role in all kinds of other cellular business, from the firing of muscles to the firing of synapses. A small amount is also excreted each day, mainly through the kidneys, and when women are breastfeeding, they secrete enough to meet the considerable needs of the little bone-growing machines that depend on them. If there doesn't happen to be enough calcium in circulation at the time that it is needed, your bones dispense it like an ATM. It just gets harder and harder to make compensatory deposits once bone growth has ended, so over time the bones can get porous and weak. A person with osteoporosis not only might fall down and break a hip, but she might spontaneously break a hip and fall down.

Women suffer from osteoporosis at higher rates than do men (20% of white and Asian women over the age of 50, vs. 7% of the corresponding demographic of men; for non-Hispanic blacks, 5% of women vs. 4% of men; and for Hispanics, 10% of women vs. 3% of men) not only because of the potential breastfeeding component, but because we generally have smaller, finer bones, which are the effective equivalents of smaller starting bank accounts. (The same thing goes for us skinny folks.) Also, estrogen levels drop precipitously with menopause, while testosterone production in men declines more gradually, and it turns out that these sex hormones help the body to retain calcium. It is possible for women to lose 20% of their bone mass in the first 5-7 years after menopause.

Smoking further leeches calcium out of your bones at whatever age you do it, as does an inactive lifestyle. On the positive side of the equation, stretching and weight-bearing exercise helps to build bone strength, as does an ample supply of vitamin D, which has to be present for bones to absorb and store calcium. Your skin actually makes vitamin D out of sunlight (which might have something to do with why pale whiteys like me who have to stay out of strong sun are at greater risk for osteoporosis than people of color are), so more and more doctors are starting to recommend that we allow ourselves 10-15 minutes of sunscreen-free exposure to the sun 3 or 4 times a week.

Now I know that you didn't really ask me for a whole science lesson, but I always find it easier to figure out the kinds of changes I'm willing and able to make when I also know the hows and whys involved. If you look in the paragraphs above, you can already see a number of things you can do to make maximum use of the calcium you're already taking in: stretch, exercise, spend a little time outside each day, and try to give up cigarettes if you smoke. The next step is to consider what kinds of foods you can eat to average about 1000 mg of dietary calcium a day.

We'll start with the easy stuff: dairy products. Everyone knows that milk has a lot of calcium, and now you know why; nature intended that milk for calves, which also need to build bone as they grow. One cup of milk provides about 300 mg, or 30% of your recommended daily allowance. You can get the equivalent amount of calcium from 1 1/2 ounces of hard cheese, 1/3 c. shredded cheese, 1/2 c. ricotta cheese, or 2 c. cottage cheese; or you could enjoy a single 8-ounce serving of yogurt. And here's another sneaky thing: there are about 52 mg of calcium per tablespoon of nonfat powdered milk, and you can add it into homemade baked goods at the rate of 2T per cup of flour.

But what about the majority of the world's population that is more or less lactose intolerant? (As a group, only Northern European peoples seem to retain the ability to digest milk after childhood.) And what about a balanced diet? Well, consider these other options:

Fish (especially whole or canned ocean fish with bones): A 3-oz serving of salmon, which realistically speaking is about half of an entree-sized portion, contains 180 mg of calcium. The same 3-oz. serving of trout has 146; sardines, 325 mg; ocean perch, 116; and even shrimp have 102.

Pretty much any fruit or vegetable you pick up contains 40-60 mg of calcium. The real heavy lifters, though, are dark green veggies. Consider how much calcium there is in one cup of each of these foods, and load up your plate: Spinach, 291 mg; collard greens, 266 mg; turnip greens, 246 mg; okra, 176 mg; broccoli, 188 mg; bok choi, 158 mg; okra, 176 mg; rhubarb, 348 mg.

Beans: A lot of the sources I consulted specified dried or canned beans; I doubt the preparation method has anything to do with calcium content. More likely this is just a reflection on our overall impatience with foods that take a long time to cook. At any rate, you should feel free to crack open a nice convenient, easy can now and again--just make sure it didn't come from China, and it's not on the current botulism recall list. One cup white beans, 192 mg; cowpeas, 212 mg; kidney beans, 80 mg; refried beans, 90 mg.

Soybeans are beans too, you know: 1 cup edamame provides 176 mg calcium, and there's also good calcium in soy derivatives: 3 oz. tofu, 150 mg; tempeh, 82 mg.

Miscellaneous: Nuts (1/4 c. almonds, 89 mg); Blackstrap molasses (1 T, 172 mg); and a few other things you can look up yourself at the sources I cited above. (If I could sneak in one more plug for the MyPyramid site, it would be that you can use the Tracker function to get both a broad view of the quality of your diet over time, and the specific nutritional content of almost any food you can think of.)

Whew. This is getting really long, so I'm just going to wind it up with a baker's dozen or so of calcium-rich meals or snack ideas to get you going.

1. Spinach lasagna, made with tons of spinach, ricotta, and mozzarella cheese; you can really get a lot of servings out of a pan of lasagna, so this is a good, cheap meal
   
2. Salmon steaks with something dark green on the side; season the fish with salt, pepper, and a little dill if you want to get fancy, then stick it under the broiler for about 5 minutes
   
3. Raw broccoli dipped in a yogurt-based dip; add some instant onion soup mix to plain yogurt for an easy savory dip, or make a sweetened yogurt dip for fruit, which is always good, too
   
4. Stir fry with bok choi and tofu; there's a Dutch saying (or maybe something that I just always have said) that is central to my stir fry logic--hoe kleurrijker hoe gezonder. The more colorful, the healthier it is. Saute a bunch of seasonal veggies on high heat, starting with the hardest vegetables and working your way down to the tender ones. Just make sure you've got one or more dark green things in there
   
5. Plain yogurt on your baked potato (similar effect and much more calcium than sour cream)
6. Molasses cookies, made from scratch with blackstrap molasses and powdered milk sifted into the flour
7. Fruit parfaits made by layering yogurt, almond granola, and fresh fruit
8. Keep almonds and cheese around for grab-it-and-go snacks
   
9. Spinach salad
10. Steamed soy beans with coarse salt, aka edamame; you can buy these frozen and then all you have to do is heat them up, sprinkle salt on them, and sit back and look fabulously cosmopolitan
    
11. Soul food! Say yes to collard greens and baked beans, okra, and (yep) sneak some powdered milk into the flour you use to batter the chicken and/or green tomatoes
    
12. Haute bourgeois tapas with sardines, garlicky white beans, and a wedge of Manchego cheese; considering that you can get the beans canned and just jazz them up a minute with some garlic and whatever fresh herbs are plentiful in the moment, this is remarkably easy, and with the possible exception of the cheese, pretty cheap. Actually almost anything, even the fancy looking stuff, is cheap if you are willing to do all or part of the preparation
    
13. Caesar salad with fresh dressing: go heavy on the anchovies and parmesan cheese
    
14. Rhubarb cobbler with ice cream