Calcium, Vitamin D & Weight?


You probably know that calcium and vitamin D3 are essential nutrients for bone health, but did you know they may also aid in managing your weight?


Research published in the FASEB Journal in June 2000, and in the January 2003 issue of Nutrition, plus many newer studies have shown:


Calcium intake actually lowers calcium levels within fat cells which happens to accelerate the breakdown of fat.  


Several studies have linked low vitamin D levels with increased risk of being overweight.  This may be because vitamin D is stored in the fat cells and is not then circulating in your body, or because obesity also causes less absorption of the vitamin.


One study found that women on a reduced-calorie diet with higher blood levels of vitamin D ended up losing more weight than those on the same diet with lower vitamin D levels. 


While dieting or just eating a low calorie diet, it may be hard to get enough calcium and vitamin D from food.  To get 1000 mg of calcium each day, you would need to drink 3 full-sized glasses of milk!  This can be especially difficult for those who are lactose intolerant or allergic to dairy products.  Smart and Easy Ways to Get More Calcium


Getting enough vitamin D from food is even more difficult.  You would need to drink 10 glasses of milk to get 1000 IU of vitamin D and there are not very many food choices that contain high levels of vitamin D naturally.  You can get vitamin D from the sun, but only if the UV index is 3 or higher and if you are not wearing sunscreen.  Not an easy thing to do in the chilly winter months, especially in the northern states.


First things first…get a bone density test and get your vitamin D levels measured, then supplement according to your doctors instructions.The best way to insure adequate intake of calcium and vitamin D each day is by taking a quality calcium and vitamin D supplement.  Try a liquid formula that uses vitamin D3.  It will be easy to swallow and absorb quickly into the body.    Make this a part of your overall plan to Get Healthy in 2014!!


Do you currently take a calcium and vitamin D3 supplement?  Why or why not? 



Are You Keeping Your Bones Strong As You Age?



Though you may think your bones are just a hard and dormant support structure for your body, they are actually  dynamic, growing tissue with new bone constantly replacing old bone. How can you keep your bones strong over time?   Feed them the right nutrients and engage in regular weight bearing physical activity.  Strong bones help protect your organs from injury, allow your body to move and support good posture.


 Several vitamins and minerals are important for bone health. However, the top two that provide the most impact  are calcium and vitamin D. Calcium, the primary mineral found in bone, contributes to the strength and hardness of bone tissue. Over time, inadequate calcium intake can lead to weak, porous bones.


National survey data shows that many Americans are not getting enough calcium in their diet.  In women ages 19-30 and 31-50 only 28% and 33% are getting above the Recommended Dietary Intake (RDI) set for calcium. The best dietary sources of calcium are dairy foods and fortified nutritional foods such as protein shakes. Green leafy veggies also contain calcium but in very small quantities. For instance, 1 cup of broccoli contains only one-sixteenth of the recommended intake for the average adult aged 19-50!   So eat broccoli too, but be aware of the proportion of calcium coming from it versus other foods and take a calcium and vitamin D supplement if your doctor recommends it.


 Vitamin D helps your body absorb the calcium you consume. Most of us aren’t getting enough vitamin D either, which has set the stage for a vitamin D insufficiency and deficiency epidemic in this country. Few foods contain vitamin D. Most milk is fortified with it and it is also fortified in some brands of orange juice, yogurt and breakfast cereal. Egg yolks, liver and some types of fish naturally contain vitamin D.


 In addition to eating a nutritious diet packed with calcium and vitamin D, everyone needs regular physical activity including resistance training (strength training) and weight bearing exercise. Lifting weights, rock climbing, gymnastics, running and walking are examples of activities that help build bone strength. If you choose to run or walk, be sure to lift weights for your upper body too so you build those bones as well.



Calcium and Bones. NIH.

What We Eat in America, NHANES 2005-2006.


Finally Updated Guidelines for Weight Loss Surgery – Important Takeaways

Recently the updated clinical practice guidelines for bariatric surgery were released, cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery (ASMBS).  


For us practitioners it was a welcomed document since the last guidelines were published in 2008. In those five years, we have learned a lot more through research and we are always looking for the best practices and recommendations to treat weight loss surgery patients. There has been a lack of standards as you may know since recommendations vary between surgeons and practices. If you talk to friends or family who have had weight loss surgery at a different location than yourself, you know what I mean.


Bariatric surgery food pyramid


The new guidelines are somewhat lengthy and technical. I would like to point out the postoperative items of interest that I have shared with my patients. Many of these are not new, but have new research to substantiate the recommendation. (My comments follow.)


  • Patients should adhere with principles of healthy eating, including 5 daily servings of fresh fruits and vegetables. (Eat your fruits and veggies before eating starchy carb foods.)
  • Minimum protein intake should be 60 grams/day and up to 1.5 grams/kilogram ideal body weight per day. (Your RD can individualize your protein needs based on your age, weight, and gender.)
  • Take your supplements daily. Your supplement needs depend on the type of surgery you had and your individual lab values. (Get your blood work done as ordered by your bariatric provider. Just because you feel good doesn’t mean you don’t have to take supplements. Supplements are not optional.)
  • Fluids should be consumed slowly, preferably 30 minutes after a meal to prevent gastrointestinal symptoms and in sufficient amounts to maintain adequate hydration, more than 48 fluid ounces. (Water is always a good choice. Flavor it with slices of lemon, lime, or cucumber.)
  • Exercise should include moderate aerobic activity of a minimum of 150 minutes per week and a goal of 300 minutes per week including strength training 2 to 3 times per week. (Do what you can, just get started. Any physical activity is better than no physical activity. You have got to do something and stick with it to maintain weight loss.) Read more on exercise after surgery
  • All patients should be encouraged to join and attend support groups. Patients who regularly attend support group have better weight loss.  (Better yet, be a support group leader. Then you have made a commitment to attend group.)
  • Regular postoperative dietary counseling with an RD means greater improvement in eating behaviors. (Your RD is important in your long-term success.  Stay in contact with her/him.)
  • If you have an adjustable gastric band, adherence with follow up visits is associated with greater weight loss. (The band doesn’t work by itself. In order to keep it properly adjusted and stay in the “green zone” you need to attend your follow up appointments for tune- ups.)
  • Out of control eating and grazing are associated with lower weight loss and weight regain. (Your pouch may not hold a lot of food at one time but if you eat every hour you can eat a lot of food over the course of a day. Ask yourself if you have physical signs of hunger or do you just want to eat.)
  • Drinking alcohol after gastric bypass and gastric sleeve surgery results in accelerated alcohol absorption, higher blood alcohol levels, and longer times to eliminate the alcohol from your body. (If you decide to drink alcohol, be very cautious. These two surgeries are not good mixers with alcohol. NEVER DRINK AND DRIVE.)


Please keep in mind that these are guidelines and recommendations, not absolutes. Follow the guidelines provided by your bariatric team since they know you and are best suited to meet your individual needs.


Eat Smart…


Vicki Bovee, MS, RDN, LD, Vicki Bovee, MS, RD, is a registered dietitian with over 25 years experience in weight management with specialization in bariatrics since 2003.


*Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient- 2013 Update: Cosponsored by American Association of Clinical Endrocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery.