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Childhood is an important time for building strong, healthy bones into adulthood.
As adults get older, bones become thinner and weaker and can sometimes be more likely to fracture. In cystic fibrosis, bones are at risk of becoming weaker at an earlier age. This is called cystic fibrosis related low bone mineral density (BMD).
The following can increase the risk of low BMD:
A few things can be done to reduce the risk of cystic fibrosis related low BMD including:
Calcium is needed for keeping bones healthy. The body cannot make calcium so it is important that enough calcium rich foods are included in the diet to reduce the risk of developing cystic fibrosis related low BMD.
How much calcium do children with cystic fibrosis need?
Age | Amount of calcium per day |
1 to 3 years | 500mg |
4 to 8 years | 800mg |
9 to 18years | 1300mg |
Calcium is in dairy products for example, milk, cheese and yogurts. They are also found in baked beans, green leafy vegetables, white bread and fortified cereals. These foods are not as rich in calcium as dairy foods, so you would need a large amount of these to meet the calcium requirements.
Here is an example of a meal plan so you can see how easy it is to consume enough calcium each day:
Fortified cereal with full fat milk has 290mg of calcium
Orange juice has 72mg of calcium
Slice of white toast with 10g of butter has 45mg of calcium
50g chocolate bar has 48mg of calcium
Ham sandwich has 107mg of calcium
Mini roll has 20mg of calcium
Crisps has 10mg calcium
Grapes
Cereal and milk bar has 140mg of calcium
2 cheese and tomato pizza slices has 400mg of calcium
Salad
2 potato waffles has 29mg of calcium
1 tablespoon of baked beans has 23mg of calcium
Twin pot yogurt has 228mg calcium
Mug of hot chocolate made with whole milk has 225mg of calcium
Total = 1637mg
Food (per serving) | Amount of calcium |
Dairy products | |
Thick milkshake (250mls) | 340mg |
Gold top milk (200mls) | 268mg |
Full cream milk (200mls) | 243mg |
Pot of yogurt (150g) | 183mg |
Pot of Greek style yogurt (150g) | 212mg |
2 infant yogurts (90g) | 108mg |
Twin pot yogurt (175g) | 228mg |
Fromage frais (100g) | 86mg |
ot chocolate (200mls) | 225mg |
Matchbox size piece of cheese (30g) | 222mg |
Cheese triangle | 123mg |
Cheese slice | 186mg |
Cheese strip | 140 to 190mg |
Cheese sandwich | 300mg |
Custard pot (150g) | 159mg |
Rice pudding (200g) | 152mg |
Fortified cereal with milk | 290mg |
Macaroni cheese (small tin) | 340mg |
Milk shake powder and 200mls of milk | 250mg |
Non-dairy foods | |
Children’s cereal and milk bar | 140 to 170mg |
Chocolate nut spread on 1 slice of bread | 61mg |
Bar of chocolate | 60 to 120mg |
1 slice of white bread | 53mg |
Prawns (60g) | 65mg |
Small piece of fish in batter | 80mg |
Small portion of scampi (90g) | 190mg |
Orange juice | 72mg |
Cheese and tomato pizza slice | 200mg |
Spinach (90g) | 144mg |
Broccoli (85g) | 34mg |
Small tin of chick peas | 92mg |
Small tin of kidney beans | 200mg |
Small can of baked beans | 106mg |
Oral nutritional supplements | |
Fortisip | 180mg |
Fortijuce | 60mg |
Scandishake made with 240ml of full cream milk | 369mg |
Milk alternatives | |
Calcium enriched soya milk (100mls) | 120mg |
Soya yogurt (125g pot) | 150mg |
Soya custard (100ml) | 120mg |
Vitamin D helps to make sure calcium is absorbed properly. This helps promote healthy bones.
Our bodies make their own vitamin D from sunlight. In cystic fibrosis, the vitamin supplements also contain vitamin D and it is important to take these at the same time as a meal and enzymes to aid their absorption.
Vitamin D can also be found in some of the foods we eat. These include:
At your annual review, your vitamin D level in your blood will be checked. If it is too low, the doctor will advise on how to increase this.
If you have any concerns that your child is not getting enough calcium, contact your cystic fibrosis dietitian on 0114 271 7212
If you have any questions or concerns you can call the dietetic department on 0114 271 7212.
Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.
Resource number: CF9
Resource Type: Article
Western Bank
Sheffield
S10 2TH
United Kingdom
Switchboard: 0114 271 7000
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