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" Over the past several years, research has pointed to possible heart risks from calcium pills. &amp;quot;When you take a supplement, you get a spike in your blood calcium for three to five hours, and that may lead to deterioration in the health of blood vessels,&amp;quot; says Ian Reid, M.D., a New Zealand osteoporosis expert involved in this research. Save your heart\u2014or protect your bones? Just as it seemed we were being asked to make an impossible choice, along came a startling announcement in February from the U.S. government group that develops health recommendations for all Americans. Calcium supplements\u2014or at least the commonly prescribed combo of 1,000 mg of calcium plus 400 IU of vitamin D\u2014didn&amp;#039;t prevent fractures in healthy women with adequate D levels, a new research review showed. Would a different dose\u2014maybe one with higher D\u2014work? &amp;quot;We can&amp;#039;t say,&amp;quot; says panel member and public health expert Jessica Herzstein, M.D. &amp;quot;All we know is, this amount of calcium and D isn&amp;#039;t helping reduce fractures.&amp;quot; Which leaves us\u2026confused. While the experts duke it out in their scientific journals\u2014not everyone&amp;#039;s convinced the heart risk is real or that supplements don&amp;#039;t help\u2014what are women supposed to do to make sure their bones stay strong? We asked top experts for their best advice. Surprisingly, the answer is really rather simple. Don&amp;#039;t pop pills\u2014eat. &amp;quot;Calcium is a nutrient, not a pharmaceutical. The right way to get it is through food, where it&amp;#039;s packaged with protein and other nutrients,&amp;quot; says Robert Heaney, M.D., an osteoporosis expert at Creighton University in Omaha. When the government recommends 1,000 mg of calcium a day (1,200 if you&amp;#039;re 51 or older), that means total calcium\u2014not a level of supplementation on top of the calcium you&amp;#039;re getting from food. So if your doctor automatically advises a hefty dose of supplements, speak up. Tell her how calcium-rich your diet is\u2014or will be, now that you know the score. Can you overdo it with what you eat? One of the heart studies did find that women whose calcium intake from food and supplements was really high\u20142,100 mg a day\u2014were more likely to die of heart disease. But the lead author is reassuring. &amp;quot;I think the [trouble] comes when you combine high calcium intake with supplements,&amp;quot; says Karl Micha\u00EBlsson, M.D., of Uppsala University in Sweden. &amp;quot;If you consider just diet, the increased risk of heart attacks is quite modest.&amp;quot; Next:   Overall, it&amp;#039;s easy to follow a bone-building plan. But don&amp;#039;t just visit the dairy case; strong bones require more than chugalugging milk. These steps are critical as well: Don&amp;#039;t skimp on protein: In volume, bones are about 50% protein and only 20% calcium. &amp;quot;Calcium can&amp;#039;t help rebuild your bones without enough protein,&amp;quot; says Dr. Heaney. And dietary protein boosts production of a growth factor that increases bone mass. Go green: Fruits and vegetables supply potassium, another bone essential. Produce also helps counter excess acidity in your body, which has been linked to bone loss. And, if you&amp;#039;re limiting dairy in your diet, you&amp;#039;ll need lots of calcium-rich veggies to compensate. Take D seriously: It&amp;#039;s essential to bone health and, by boosting muscle strength, it helps prevent bone-breaking falls in older people. So eat plenty of vitamin D\u2013containing foods: fatty fish, egg yolks, and fortified foods like milk and cereal. Supplement if you need to. The official recommendation is 600 IU of D per day, though many health experts advise 1,000. Shake the salt habit: Your body has no way to get rid of sodium without stealing a little calcium along with it. &amp;quot;The same molecule in the kidneys that controls how much salt you excrete also controls calcium excretion,&amp;quot; says Todd Alexander, M.D., Ph.D., of the University of Alberta. The current government recommendations: no more than 2,300 mg of sodium (one teaspoon of table salt) per day. Make that 1,500 mg if you are African American, have diabetes or high blood pressure, or are 51 or older. Put a cap on soda: In a Norwegian study, researchers found drinking lots of soft drinks (diet or regular, cola or non-cola) while skimping on produce was a good way to wreck bone density. The reasons aren&amp;#039;t clear, but the takeaway is: Make soda an occasional treat &amp;quot;and counteract its negative effect with salads, other vegetables, and fruits,&amp;quot; says Arne H\u00F8stmark, M.D., Ph.D., of the University of Oslo. Move: What goes in your mouth is just one part of maintaining strong bones. Exercise, especially weight-bearing movement like walking, is key. (So is not smoking.) Know your risks: Even if you do everything right, you could still develop osteoporosis\u2014your chances also depend on your build, medical history, and genetics. Whatever your age, talk to your doctor about your calcium needs and the best ways to meet them. &amp;quot;Some women are afraid to take any supplements, which can be bad,&amp;quot; says osteoporosis expert Susan Ott, M.D., of the University of Washington. And all women need to start bone-density screening at age 65\u2014or even earlier if risk factors make their fracture odds as high as those for someone that age. You need these, too: Strong bones require other nutrients besides calcium. The trouble is, many of us get too little of them in our diets, so eat up. And don&amp;#039;t just pop a megadose supplement: Overloading on some nutrients\u2014zinc, manganese, copper, and the retinol form of vitamin A, for example\u2014can be risky. - Vitamin D: On average, women get 27%; you&amp;#039;ll find it in fatty fish, egg yolks, fortified foods like milk and cereal - Magnesium: On average, women get 78%; you&amp;#039;ll find it in green veggies, whole grains, legumes, nuts - Vitamin K: On average, women get 109%; you&amp;#039;ll find it in green veggies, vegetable oils - Potassium: On average, women get 52%; you&amp;#039;ll find it in fruits and vegetables Doing it by the clock: Only if you really can&amp;#039;t get enough calcium from your diet should you make it up with supplements, says Nieca Goldberg, M.D., cardiologist at NYU Langone Medical Center. Then, to get the most from them: - Take calcium carbonate at meals or within a few hours of eating\u2014it needs stomach acid to be absorbed. (Calcium citrate can be taken at any time.) - Space your doses: You can absorb only about 500 mg at a time\u2014plus, questions about heart risks make it sensible to avoid taking too much at once. If you need more than that on top of your dietary calcium, take it in separate doses. "^^<http://www.w3.org/2001/XMLSchema#string>
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