There is no doubt that prevention is the best strategy for a healthy lifestyle. Health workers should regard the onset of menopause as a signal for the start of the next stage of life, and not as a decrease in the quality of life of a woman. This phase is an opportunity to help a woman choose the right diet and lifestyle, optimize her physical, social, mental and sexual capabilities. This may be for a woman the beginning of a new bright stage in life.
One of the key elements in preventing osteoporosis is maintaining a good calcium balance. During menopause, this task becomes difficult because calcium absorption decreases with age. A decrease in the amount of estrogen during menopause leads to a decrease in the concentration of 1,25-dihydroxyvitamin D, which leads to a decrease in calcium absorption.
Nordin et al. recorded the absorption of radioactive calcium in 262 menopausal women aged 40-87 years and showed a steady decrease (only after 75 years) of calcium absorption with age. They determined that this decrease in calcium absorption could occur either due to a decrease in the active transport of calcium, or due to a change in the components of its absorption system.
According to the conference “Consensus building of the National Institutes of Health on the issue of optimal calcium intake” held on June 6-8, 1994, women are recommended the following calcium intake: • 1200-1500 mg per day for adolescents and young people (age 11-24 years ) • 1000 mg per day for women aged 25-50 years. • 1200-1500 mg per day for pregnant or lactating women. • 1000 mg per day for postmenopausal women receiving estrogen treatment. • 1,500 mg per day for postmenopausal women not receiving estrogen treatment.
• For all women over 65, a daily intake of calcium of 1,500 mg per day, although further studies are needed.
• The presence of a sufficient amount of vitamin D is a significant factor in the optimal absorption of calcium. Nutritional supplements, hormones, medications, age, insolation, and genetic factors influence the amount of calcium needed to maintain a healthy skeletal system. • Calcium intake of up to 2000 mg per day is considered safe for most people • The preferred source of calcium is rich foods such as dairy. However, products containing calcium do not always provide the optimal intake of this microelement, therefore, the body needs additional calcium intake in the form of medications.
These guidelines are based on dietary calcium intake plus any additional sources of calcium. The most preferred way to achieve optimal calcium intake is through food. High-calcium foods include dairy, green vegetables (such as broccoli, cabbage, turnip, Chinese cabbage), calcium-containing bean curd, some beans, canned fish, seeds, nuts, bread, and cereals. There is a good rule of thumb for calculating daily calcium intake: multiply the number of servings of milk (8 ounces = 240 ml = 1 cup) by 300 mg. There are tables available to all to evaluate their daily calcium intake with food.
Due to the difficulty of achieving adequate calcium intake with food, doctors recommend the additional use of its preparations. There are two main types of calcium preparations available in the market: calcium carbonate and calcium citrate. Some authors prefer the use of calcium citrate (citracal) rather than calcium carbonate (OS-Cal ”), arguing that calcium citrate is better absorbed, especially on an empty stomach.
On the other hand, calcium carbonate is usually cheaper and, according to one study of absorption, accumulation in the body and cost-effectiveness, is the best choice for additional calcium intake by the population to reduce the risk of spinal and hip fractures.
Vitamin D is usually not found in food. It forms in the skin in response to exposure to light. There are controversies regarding adequate doses of vitamin D taken orally. The recommended dietary intake of vitamin D for women 51 years of age or older is 400 IU (10 mcg / day) and corresponds to a dose that prevents rickets. A dose of 800 ME is recommended for those who live in countries with a cold climate.