Healthy Bones for Neuromuscular Conditions

Having strong bones is important for people with neuromuscular disorders. Reduced bone mineral density means that your bones become thinner and can break more easily. Calcium and Vitamin D are important to build and maintain strong bones and teeth.

To build strong bones growing children need

  • A diet rich in calcium.
  • Vitamin D to help the body absorb calcium. 
  • Physical activity or weight-bearing exercise.

Reduced bone mineral density means that your bones become thinner and can break more easily. 

Children with neuromuscular disorders have an increased risk of reduced bone mineral density. This is due to:

  • Reduced physical activity
  • Side effects of steroid medications used to treat some neuromuscular disorders.

To keep bones healthy it is important to:

  • Eat a well-balanced diet that includes enough calcium
  • Maintain a healthy body weight
  • Be as active as you can

Frequently Asked Questions

How much calcium is needed each day?

The amount of calcium needed increases with age. It is highest in adolescents. The amount needed is shown in the table below.

What foods are high in calcium?

Dairy foods such as milk, yoghurt and cheese are the richest sources of calcium. Calcium from these foods is easily absorbed.

Small amounts of calcium are found in a variety of other foods but without including dairy foods or calcium-fortified alternatives it is hard to get the amount of calcium that your body needs.

The number of serves of dairy food needed for each age group is shown in the table below.

 

Age

Amount of Calcium (mg)

Number of serves of dairy foods

2-3 years

500 mg

4-8 years

700 mg

2

 9-11 years

1000 mg

3

12-18 years

1300 mg

 

A serve of dairy food is equal to:

1 cup of milk

200 g tub yoghurt

40 g cheese (2 slices)

 

What type of dairy products are best?

Low fat and full-fat dairy products are both high in calcium. If your child is above their healthiest weight choose low or non-fat dairy products. If your child is below their healthiest weight choose full fat or regular dairy products.

What if my child doesn’t eat dairy foods?

If your child doesn’t eat dairy foods, try offering:

  • calcium-fortified soy drinks or yoghurt
  • high calcium non-dairy sources more often e.g. salmon with bones or sardines

If intake remains inadequate a calcium supplement may be needed.

Calcium supplements

These are available over the counter at chemists and in supermarkets. They can be used to supplement the diet if calcium intake is low.

  • Nature's Way Kids Calcium – 200mg Calcium (chewable, flavoured ‘burstlets’)
  • Andrew’s Tums Antacid Tablets - 200mg Calcium (orange flavoured, chewable tablet)
  • Caltrate – 600mg Calcium (chalky tablet that can be crushed and added to food or swallowed whole)
  • Cal-sup – 500mg Calcium (spearmint flavoured, chewable tablet)
  • Calsource – 1000mg Calcium (effervescent tablet that dissolves in water)
  • OsteoVit-D – 600mg Calcium and 500IU Vitamin D (chewable, vanilla flavour)
  • Calvid – 1000mg Calcium and 880IU Vitamin D (an orange flavoured, effervescent powder that dissolves in water)

Your dietitian can advise you on a suitable dose for your child.

What about Vitamin D?

Vitamin D is important for the absorption of calcium and maintaining strong bones. Only small amounts of Vitamin D are obtained from food. Most Vitamin D is obtained from the action of sunlight on the skin. For most people, a few minutes of sun exposure on the face arms and hands each day will be adequate. It is important to be Sunsmart and avoid excessive sun exposure. Your doctor may order a blood test to check your child’s Vitamin D levels. If the level is low, a supplement will be needed.

 

Calcium content of food 

 

Food

Amount of Calcium (mg)

Drinks – 1 cup (250 mls)

 

Regular milk

300

Reduced fat milk

350

Skim or non fat milk

320

Physical low or non-fat milk

440

Soy drink with added calcium

300

So Good Essentials (Soy milk)

400

Up & Go   (250 ml Tetra pack)

400

Sustagen

400

Powders

 

Sustagen powder, 1 tablespoon 20g

180

Dried milk powder no fat, 1 tablespoon

100

Desserts

 

Yoghurt - reduced fat (100g tub)

155

CalciYum Squeezie yoghurt (70g)

160

CalciYum – Disney tub (95g)

200

Soy Yoghurt – 175g tub

210

Custard  (½ cup

140

Fruche  (150 g tub)

240

Ice-cream (1 scoop 25g)

25

Cream 1 tablespoon

15

Cheese

 

Cheese (cheddar)  1 slice 20g 

155

Processed cheese 1 slice 20g

130

Other foods

 

Almonds, 1 tablespoon 8g 

30

Baked beans ½ cup

50

Broccoli, 1 cup

33

Canned sardines (75g)

320

Orange – 1 medium

30

Salmon with bones (50g)

100

Wholemeal bread 1 slice 30 g

30

 

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