Many of my patients believe that drinking milk is an important part of the diet to stay healthy. Milk contains calcium, an essential mineral for strong bones and teeth. It can also help with the proper functioning of the heart, muscles and nerves. Calcium, along with vitamin D, may help with high blood pressure, diabetes and cancer.

Not getting enough calcium during childhood and the growing years can lead to health problems related to weak bones. Children may not be able to reach their full potential for bone strength and adult height. And with weak bones as a child, this can lead to adults with low bone mass, increasing the risk for osteoporosis and fractures later in life.

But what if don’t like milk or if you are watching your calories? Does this mean that you cannot get the calcium you need?

The best way to get enough calcium is through diet. It is true that dairy products such as fresh milk (about 250-300mg of calcium per cup), yogurt, cheese and even condensed milk, evaporated milk and powdered milk have the highest concentrations of calcium. But some people may not be able to tolerate dairy products, however, and develop an upset stomach and diarrhea — a condition called lactose intolerance.

Fortunately, calcium can be found in a variety of other non-dairy foods:

•Almonds

•Calcium-fortified foods and beverages (cereal, fruit juices, milk substitutes)

•Chia seeds

•Dark green leafy vegetables (bok choy, spinach, mustasa, malunggay)

•fish with edible soft bones (sardines, dilis, canned salmon)

•okra

•oranges

•soy bean curd/tofu/tokwa

The recommended calcium intake per day depends on age, with infants and young children needing about 200-700mg/day to about 1,000 mg/day in older children and adults, and a little more in pregnant and breastfeeding women. The upper limit is about 2,000-2,500 mg/day.

If your diet is insufficient to meet your calcium needs then you may need to take a calcium supplement. The two main forms of calcium supplements are calcium carbonate, which needs to be taken after meals, and calcium citrate, which can be taken with or without food. If you experience bloating or constipation with calcium carbonate, switching to calcium citrate might help. Splitting the daily dose into 500-600 mg at a time can also lessen these symptoms.

Calcium is also often found in multivitamins and can be combined with other vitamins and minerals. Check the ingredients of any combination supplements you may be taking to see if you may be exceeding the recommended daily dose.

There are some controversies when it comes to taking calcium supplements in high doses, being linked to heart disease and prostate cancer. Until we know more about these possible risks, be careful to avoid excessive amounts of calcium. As with any health issue, talk to your doctor to find out what dose is right for you.

Ask your doctor about taking calcium at the same time as your other medications, such as steroids, blood pressure and thyroid medications, as these might interfere with calcium absorption. Other dietary factors can also affect calcium absorption in the body, such as an excess of sodium (salt) caffeine, phosphoric acid (found in dark cola sodas) and alcoholic beverages.

Remember, it is better to get calcium from your diet if possible. If you are taking enough calcium-rich foods in your diet, you may not need any calcium supplements at all. Always ask your doctor first before taking any unprescribed vitamins and supplements to make sure these are safe for you.