Children and young people lay down new bone until they are in their early twenties. If you have inflammatory bowel disease you are at risk of poor bone development during childhood and osteoporosis as an adult (thin bones that are more likely to fracture) due to:
- Poor absorption of nutrition
- Poor appetite and poor nutritional intake
- Certain medications
It is important to make sure that you look after your bones so that they can grow and achieve their full potential.
Calcium
Calcium is the main nutrient in the development of strong healthy bones. The best source of calcium in the UK diet is dairy products such as milk, cheese and yogurt and fortified plant based products. You should aim to eat three to four portions of these per day. A portion is 200ml milk, 30g cheese or 100g yogurt.
Calcium is also found in smaller quantities in a variety of other foods, for example green leafy vegetables and pulses.
Calcium requirements are calculated as an amount per day and change according to age and gender.
| Daily Calcium Requirements | Amount of calcium recommended per day |
|---|---|
| Daily Calcium Requirements 0-12 months | Amount of calcium recommended per day 525mg |
| Daily Calcium Requirements 1–3 years | Amount of calcium recommended per day 350mg |
| Daily Calcium Requirements 4-6 years | Amount of calcium recommended per day 450mg |
| Daily Calcium Requirements 7-10 years | Amount of calcium recommended per day 550mg |
| Daily Calcium Requirements 11-18 years female | Amount of calcium recommended per day 800mg |
| Daily Calcium Requirements 11–18 years male | Amount of calcium recommended per day 1000mg |
| Daily Calcium Requirements 19 + years with IBD | Amount of calcium recommended per day 700mg |
Individuals on a cow’s milk or lactose free diet are at higher risk of calcium deficiency.
The following tables list good sources of dietary calcium (dairy and non-dairy) and the amount of calcium a typical portion contains. Please note this information is correct at time of publication but sometimes ingredients and nutrition change. Food labels can contain more information.
Dairy Sources of Calcium
| Food type | Portion size | Average amount per portion (mg) |
|---|---|---|
| Food type Milk | Portion size | Average amount per portion (mg) |
| Food type Whole/Semi-skimmed/Skimmed | Portion size 200ml glass | Average amount per portion (mg) 250 |
| Food type Dried/Skimmed milk powder | Portion size 1 tsp | Average amount per portion (mg) 60 |
| Food type Evaporated/Condensed milk | Portion size 50g | Average amount per portion (mg) 135 |
| Food type | Portion size | Average amount per portion (mg) |
| Food type Cream | Portion size | Average amount per portion (mg) |
| Food type Single | Portion size 1 tbsp=15g | Average amount per portion (mg) 15 |
| Food type Double | Portion size 1 tbsp=15g | Average amount per portion (mg) 10 |
| Food type | Portion size | Average amount per portion (mg) |
| Food type Yoghurt | Portion size | Average amount per portion (mg) |
| Food type Whole milk/Low fat | Portion size | Average amount per portion (mg) |
| Food type - Plain | Portion size 1 pot=150g | Average amount per portion (mg) 240 |
| Food type - Fruit | Portion size 1 pot=150g | Average amount per portion (mg) 210 |
| Food type Fat free | Portion size 1 pot=150g | Average amount per portion (mg) 210 |
| Food type Greek | Portion size 1 pot=150g | Average amount per portion (mg) 270 |
| Food type Drinking Yoghurt | Portion size 1 carton= 200ml | Average amount per portion (mg) 200 |
| Food type Fromage Frais | Portion size 1 small pot=45g | Average amount per portion (mg) 50 |
| Food type Calcium Enriched Fromage Frais | Portion size 1 pot=85g | Average amount per portion (mg) 125 |
| Food type | Portion size | Average amount per portion (mg) |
| Food type Cheese | Portion size | Average amount per portion (mg) |
| Food type Cheddar | Portion size 30g | Average amount per portion (mg) 220 |
| Food type Edam | Portion size 30g | Average amount per portion (mg) 240 |
| Food type Brie | Portion size 30g | Average amount per portion (mg) 80 |
| Food type Camembert | Portion size 30g | Average amount per portion (mg) 100 |
| Food type Stilton | Portion size 30g | Average amount per portion (mg) 90 |
| Food type Parmesan | Portion size 30g | Average amount per portion (mg) 220 |
| Food type Cottage Cheese | Portion size 100g | Average amount per portion (mg) 140 |
| Food type Cheese triangle | Portion size 1 triangle=15g | Average amount per portion (mg) 60 |
| Food type Cheesestring | Portion size 1 cheesestring=20g | Average amount per portion (mg) 156 |
| Food type | Portion size | Average amount per portion (mg) |
| Food type Desserts | Portion size | Average amount per portion (mg) |
| Food type Ice Cream | Portion size 1 scoop=60g | Average amount per portion (mg) 80 |
| Food type Custard | Portion size 1 serving=120ml | Average amount per portion (mg) 120 |
| Food type Creme Caramel | Portion size 1 pot =100g | Average amount per portion (mg) 95 |
| Food type Rice pudding | Portion size 1 pot=180g | Average amount per portion (mg) 170 |
| Food type Mousse | Portion size 1 pot=60g | Average amount per portion (mg) 65 |
Note: Lactose free products contain the same amount of calcium as the standard versions.
Non-Dairy Sources of Calcium
| Food type | Portion Size | Average amount per portion (mg) |
|---|---|---|
| Food type Milk substitute products Fortified with calcium - | Portion Size 200ml glass | Average amount per portion (mg) 240 |
| Food type Soya milk e.g. Alpro Soya Growing up Drink for 1-3+ years, Provamel Soya calcium + vitamins, Alpro Soya Original | Portion Size | Average amount per portion (mg) |
| Food type Coconut milk e.g. Alpro Coconut Original, KoKo dairy free, Coconut Dream + calcium | Portion Size | Average amount per portion (mg) |
| Food type Oat milk e.g. Oatly oat drink enriched, Oat Dream + calcium, Alpro Oat Original, Oatly Foam-able Barista Oat Drink | Portion Size | Average amount per portion (mg) |
| Food type Almond milk e.g. Ecomil almond calcium drink, Alpro Almond, Almond Dream + calcium, Almond Breeze, Alpro Alm Soya milk e.g. Alpro Soya Growing up Drink for 1-3+ years, Provamel Soya calcium + vitamins, Alpro Soya Original ond Original | Portion Size | Average amount per portion (mg) |
| Food type Hazelnut milk e.g. Alpro Hazlenut Original | Portion Size | Average amount per portion (mg) |
| Food type Cashew milk e.g. Alpro Cashew Original | Portion Size | Average amount per portion (mg) |
| Food type Rice milk | Portion Size | Average amount per portion (mg) |
| Food type Only suitable for children over 4 ½ years | Portion Size | Average amount per portion (mg) |
| Food type e.g. Rice Dream original + calcium, Provamel Rice calcium + vitamins, Alpro Rice Original | Portion Size | Average amount per portion (mg) |
| Food type Note: please always check the label of the chosen milk substitute to ensure it has been fortified with calcium. | Portion Size | Average amount per portion (mg) |
| Food type | Portion Size | Average amount per portion (mg) |
| Food type Desserts | Portion Size | Average amount per portion (mg) |
| Food type Soya dessert (calcium enriched) e.g. Alpro | Portion Size 125g | Average amount per portion (mg) 150 |
| Food type Soya yoghurt e.g. Alpro | Portion Size 125g | Average amount per portion (mg) 150 |
| Food type | Portion Size | Average amount per portion (mg) |
| Food type Cheese | Portion Size | Average amount per portion (mg) |
| Food type Soya or coconut alternatives e.g. Violife, Koko, Supermarkets Own Brand dairy free cheese | Portion Size 30 | Average amount per portion (mg) 45 |
| Food type | Portion Size | Average amount per portion (mg) |
| Food type Seafood | Portion Size | Average amount per portion (mg) |
| Food type Tinned pilchards (with bones) | Portion Size Half tin=60g | Average amount per portion (mg) 260 |
| Food type Tinned sardines (with bones) | Portion Size Half tin=60g | Average amount per portion (mg) 150 |
| Food type Tinned salmon (with bones) | Portion Size Half tin=60g | Average amount per portion (mg) 260 |
| Food type Tinned crab | Portion Size 1 tin=100g | Average amount per portion (mg) 90 |
| Food type Fish paste | Portion Size 1 tbsp=15g | Average amount per portion (mg) 40 |
| Food type Whitebait (rolled in flour and fried) | Portion Size small portion=50g | Average amount per portion (mg) 430 |
| Food type Prawns (boiled) | Portion Size 4 fish=16g | Average amount per portion (mg) 140 |
| Food type Mussels (boiled) | Portion Size 60g | Average amount per portion (mg) 30 |
| Food type | Portion Size | Average amount per portion (mg) |
| Food type Meat alternatives | Portion Size | Average amount per portion (mg) |
| Food type Tofu (if set with calcium, not nigari) | Portion Size 60g | Average amount per portion (mg) 200 |
| Food type Baked beans | Portion Size Quarter tin=100g | Average amount per portion (mg) 50 |
| Food type Red kidney beans | Portion Size Quarter tin=50g | Average amount per portion (mg) 40 |
| Food type | Portion Size | Average amount per portion (mg) |
| Food type Nuts and seeds | Portion Size | Average amount per portion (mg) |
| Food type Sesame seeds | Portion Size 1 tbsp=12g | Average amount per portion (mg) 80 |
| Food type Tahini paste | Portion Size 1 heaped tsp=30g | Average amount per portion (mg) 40 |
| Food type Almonds | Portion Size 20g | Average amount per portion (mg) 50 |
| Food type Brazil nuts | Portion Size 30g | Average amount per portion (mg) 30 |
| Food type Hazelnuts | Portion Size 30g | Average amount per portion (mg) 55 |
| Food type | Portion Size | Average amount per portion (mg) |
| Food type Fruit | Portion Size | Average amount per portion (mg) |
| Food type Oranges | Portion Size 1 medium=120g | Average amount per portion (mg) 75 |
| Food type Tangerines | Portion Size 2 small=100g | Average amount per portion (mg) 40 |
| Food type Apricots | Portion Size 4 dried=32g | Average amount per portion (mg) 25 |
| Food type Raisins | Portion Size 1 pot = 30g | Average amount per portion (mg) 15 |
| Food type Figs | Portion Size 2 dried=40g | Average amount per portion (mg) 100 |
| Food type Blackcurrants | Portion Size 140g | Average amount per portion (mg) 85 |
| Food type | Portion Size | Average amount per portion (mg) |
| Food type Vegetables | Portion Size | Average amount per portion (mg) |
| Food type Broad beans (boiled) | Portion Size 2 tbsp=120g | Average amount per portion (mg) 70 |
| Food type Broccoli (boiled) | Portion Size 2 spears = 85g | Average amount per portion (mg) 35 |
| Food type Cabbage (boiled) | Portion Size 95g | Average amount per portion (mg) 30 |
| Food type Curly kale (boiled) | Portion Size 60g | Average amount per portion (mg) 90 |
| Food type Spinach* (boiled) | Portion Size 40g | Average amount per portion (mg) 65 |
| Food type *Absorption poor due to oxalic acid binding with calcium | Portion Size | Average amount per portion (mg) |
| Food type Spring greens | Portion Size small portion=60g | Average amount per portion (mg) 45 |
| Food type Watercress | Portion Size ¼ bunch=20g | Average amount per portion (mg) 35 |
| Food type | Portion Size | Average amount per portion (mg) |
| Food type Cereals | Portion Size | Average amount per portion (mg) |
| Food type Breakfast Cereals | Portion Size 30g | Average amount per portion (mg) 140 |
| Food type Bread | Portion Size | Average amount per portion (mg) |
| Food type - White Bread | Portion Size 2 medium slices=80g | Average amount per portion (mg) 105 |
| Food type - Wholemeal | Portion Size 2 medium slices=80g | Average amount per portion (mg) 85 |
| Food type - “Best of both”, ”50/50” | Portion Size 2 medium slices=80g | Average amount per portion (mg) 325 |
| Food type Pitta bread / chapatti | Portion Size 1 small=65g | Average amount per portion (mg) 60 |
Other factors that affect your bones
Vitamin D
Vitamin D is made in your body following exposure to the sun. If you use a lot of sunscreen this process can be reduced, therefore it is important to get good sources from your diet. The main sources of vitamin D are dairy products, oily fish and butter/margarine. All children over the age of one should be taking a daily supplement containing 10 micrograms of Vitamin D, especially during autumn and winter.
Exercise
Weight bearing exercise can help build bones. This can be exercise such as running, football, rugby, hockey, athletics, trampolining and many more.
Steroids
Steroids used to treat inflammatory bowel disease can thin your bones if used for a long time. To minimise these affects you can also be given a calcium supplement while you are taking them. Calcium is best absorbed overnight, so supplements are best taken in the afternoon and before going to bed.
If you have any other questions about bone health ask your doctor or nurse to refer you to a dietitian for more advice. Additional information sheets are available for those following a dairy free diet upon request.
We are smoke-free
Smoking is not allowed anywhere on the hospital campus. For advice and support in quitting, contact your GP or the free NHS stop smoking helpline on 0800 169 0 169.
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