Grace Schmidt, MS, RD, LD
Clinical Dietitian at Texas Children’s Hospital MDA Clinic
Why is calcium important for individuals with neuromuscular disease? “Calcium builds strong bones” is a conditioned response you might have learned as a child. While NMD is associated with an increased risk for osteoporosis (literally “porous bone”), it is important to remember that calcium is also an essential nutrient for nerve function, muscle contraction, blood clotting, and cellular signaling.
How do you know if you are getting enough calcium? A total calcium lab value is not indicative of true calcium stores, as 99% of the body’s calcium is stored in teeth and bones. A bone density scan or DEXA scan can reveal if these stores are depleted, however assessment of dietary calcium intake via foods and supplements is the best indicator of a potential deficiency.
Unfortunately, many Americans are not receiving enough calcium in their diets. Calcium-rich foods include dairy products, leafy green vegetables, nuts and seeds, and fish with bones. Calcium is also fortified in foods such as orange juice, grains, and milk alternatives. It is best to meet calcium needs from foods, however a calcium supplement should be taken when diet calcium is insufficient. The table below details calcium needs for all age groups.
It is important to note that calcium intake in excess of the above needs is not beneficial. Individuals with osteoporosis may be advised by their doctor to exceed recommended intakes, however such high intakes require close monitoring of blood and urine values as excessive calcium intake can result in the development of kidney stones and calcification of organs and blood vessels. Given the adverse the effects of both under and over supplementation, work with your doctor or dietitian to determine appropriate calcium supplement dosing if necessary.
Calcium food lists and other helpful information: