More Thoughts on Calcium Absorption, Gastroesophageal Reflux and PPIs
Last week, I wrote about a recent research study that found a relationship between high doses of Proton Pump Inhibitors (PPIs) and hip fractures in elderly patients. As if we didn’t have enough to worry about, now reflux moms and dads have to worry that one of the main medications used to treat reflux may cause poor absorption of calcium. While more research is needed to determine if children with reflux are at risk, it is probably a good idea to increase your attention to providing a calcium rich diet now.
According to the American Academy of Pediatrics, the vast majority of children in the United States do not get their daily minimum requirement of calcium from foods and supplements under normal circumstances. The recommended daily requirement for infants is 500 mg per day, with children needing 800mg and teens 1300 mg per day. Of course it is best to eat a steady diet of foods rich in calcium and vitamin D, but it might be more realistic to use a multi vitamin or calcium supplement. Remember that most multi vitamins only provide a small amount of calcium. Read the label carefully. A calcium supplement made from calcium carbonate is more readily absorbed than calcium glutamate. Vitamins D and C increase calcium absorption along with acids in the stomach. One theory is that reflux medications such as PPIs (and perhaps even acid reducers) eliminate too much acid for calcium absorption while performing the main job of reducing reflux symptoms.
So how DOES a reflux mom get a refluxer to eat calcium-rich foods and use vitamin supplements? The same way a reflux mom gets a picky eater to eat and take necessary, and sometimes yucky-tasting, medication...with skill and hard work!
I am going to give you my best ideas for getting refluxers to increase calcium intake. But do me a favor and don’t tell my kids. They might catch on to my secret methods and ruin my plan for getting them to eat healthy foods and take vitamins without begging, nagging, and being accused of acting like the “healthy food police”.
My top secret ideas:
1. I go shopping WITHOUT my kids. This way I can carefully read labels and find out which baby formula, nutritional drink, breakfast cereal, juice, and nutritional bars contain calcium. Then, I buy massive quantities of these items and claim that the Oreos and Ho Ho’s that they placed on the shopping list were completely sold out.
2. I stock the refrigerator with every flavor and brand of yogurt and drinkable yogurt they like. Even my refluxers have found a few flavors and brands that they love. Again, I buy massive quantities of their favorites. Yogurt is a suitable food for every meal from early morning to late night.
3. Think outside the milk carton. While a big glass of cold milk at each meal would go a long way toward meeting the daily requirements for calcium, many children, and especially refluxers, cannot tolerate milk. If your child is lactose intolerant or rejects milk for other reasons, then hard cheeses, yogurt, and lactose-free milk may be a better option.
4. Get out the blender or smoothie machine and try some combinations of yogurt, ice cream, frozen yogurt, and fruit to make a smooth, easy-to-digest drink containing a full serving or more of calcium.
5. I have purchased every chewable, gummie, pill and soft-chew calcium supplement on the market. Vitamins and supplements generally burp up and leave a bad taste in their mouths, so I have had limited success with finding a supplement that they will tolerate. If you are lucky, your picky eater will tolerate one brand.
6. I use all of the rejected calcium supplements from the kids and increase my intake of calcium. Most adult women don’t get the minimum requirement of calcium either. I can role model taking my calcium supplement and get the calcium I need too. My back does have a noticeable slump -- not from osteoporosis but from holding and comforting my kids 24/7 during the reflux years! I need all of the yogurt shakes and calcium pills I can get!
Let me know if you have any other ideas for increasing calcium and other nutrients for refluxers.
Read more about the importance of calcium in treatment for acid reflux.