3 International comparisons show a strong positive relationship between animal protein intake and fracture rates. Such comparisons generally do not take other lifestyle factors, such as exercise, into account. Nonetheless, their findings are supported by clinical studies showing that high protein intakes aggravate calcium losses. A 1994 report in the American Journal of Clinical Nutrition showed that when animal proteins were eliminated from the diet, calcium losses were cut in half. Patients can easily get adequate protein from grains, beans, vegetables, and fruits.
Sodium also encourages calcium to pass through the kidneys.
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.