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. The Role of Calcium Getting enough calcium in the diet has been emphasized in the popular press. However, calcium intake alone does not protect against osteoporosis and fractures, nor do low calcium intakes predict fracture risk. A 1992 review of fracture rates in many different countries showed that populations with the lowest calcium intakes had far fewer fractures than those with much higher intakes.