Bariatric Bone Health & Calcium…
Consuming adequate calcium is essential for maintaining strong bones and teeth and for reducing the risk of osteoporosis.
It is recommended that patients who have had bariatric surgery consume a minimum of 1200 mg of calcium per day. This would mean having 4 serves of dairy products each day which unlikely to be possible in view of your small stomach capacity!
Bariatric patients should therefore aim for at least 2 serves of dairy products each day and take a calcium citrate supplement to make up the short fall. Your dietitian will advise you how much supplementary calcium you will need.
The following foods provide approximately 300 mg calcium:
- 1 cup (250 ml) reduced fat milk / calcium fortified soy milk
- ¾ cup (200 g) reduced fat natural / no added sugar yoghurt
- 2 slices (40 g) of hard cheese
- 100 g canned salmon / sardines with bones
Other Sources of Calcium
Small quantities of calcium are also found in fruit, vegetables, nuts, seeds, white fish, tofu and legumes, though these foods are unlikely to provide significant amounts of calcium in the bariatric patient due to the limited gastric capacity.
Dairy products are not only a good source of calcium, they are an excellent source of protein and a wide range of micronutrients including vitamin A, riboflavin, vitamin B12, potassium, magnesium and zinc.
Reduced fat dairy products are recommended as they have less saturated fat and calories but more protein and calcium than the full fat varieties. The natural sugar in milk, lactose is marginally higher in low fat dairy products, however lactose is low GI and has little effect on the blood glucose level.
People who are lactose intolerant can choose reduced fat lactose-free milk and yoghurt without compromising on nutrition. Cheese is very low in lactose and is usually well tolerated. Calcium fortified soy milk is a useful alternative to lactose-free milk, however, rice and almond milk are less desirable choices as the protein and calcium content is poor.
It is essential that blood vitamin D levels are kept in the desired range (50-150 nmol/L) as vitamin D plays an important role in calcium absorption and retention in the body.
Bone Density Test
Calcium levels in the blood are measured every 6 months however this level does not reflect the calcium stored in your bones. It is therefore recommended that all bariatric patients have a bone density test, two years post surgery to check your risk of osteoporosis. Contact us for details…