While patients tend to associate sodium with high blood pressure, its effect on calcium is equally important. People who reduce their sodium intake to 1-2 grams per day cut their calcium requirement by an average of 160 milligrams per day. It helps to encourage your patients to avoid salty snacks and canned foods with added sodium, and to minimize salt use in the kitchen and at the table. Caffeine's diuretic effect causes the loss of both water and calcium, and appears to be significant at consumption levels equivalent to two or more cups of coffee per day. 6 Smoking is also a contributor to calcium loss.
Active people keep calcium in their bones, while sedentary people tend to lose calcium.
Physical activity may be part of the reason why people in the nonindustrialized world have fewer fractures. Simple weight-bearing exercises can be recommended for patients at virtually any age. Vitamin D is also important, as it controls how efficiently the body absorbs and retains calcium. A few minutes of sunlight on the skin each day normally produces all the vitamin D the body needs. However, people who get little or no sun exposure, who live in areas with less direct sunlight, who have darker skin, or who are older, may need a vitamin D supplement.