The doctor at Central Indiana Orthopedic diagnosed the persistent, aching cramp in the arch of junior Stacy Lods' foot as a stress fracture. Because it took more than a year to heal, however, she was referred to Ball State Nutritionist Kathy Beals, who recommended she get a bone scan at the campus lab.
The test showed she had 17 percent bone loss. Her condition was labeled osteopenia, borderline osteoporosis.
Lods, who will be on her feet for long hours during the golf season, said she now feels as if she is walking on fragile eggshells. She said she never thought of herself as the type of woman who would have bone loss.
She had always considered herself big-boned, she said.
Lods is not alone. The average college-aged woman gets the daily calcium intake recommended for a toddler, less than 500 milligrams a day. Women ages 19 to 50 should get at least 1,000 milligrams of calcium daily, the National Institute of Health reported.
Because calcium absorption is highest during the college years, women need to recognize the risk factors and take immediate action to prevent bone loss, according to a report by Healthy People 2010, a national set of health objectives created by the government.
After about age 20, the average woman has acquired 98 percent of her skeletal mass. Peak bone mass is then reached at about age 25. Then resorption begins, and bone loss occurs at a rate of 1 to 5 percent a year, according to the American Medical Association.
"This is the time to be putting calcium into the bone bank," said Denise Amschler, a professor in the physiology and health science department. "It isn't hard. It really isn't."
Osteoporosis literally means "porous bones," a condition that develops when bone breakdown exceeds buildup, resulting in low-bone density. It is often called the silent disease because it occurs with no early, recognizable symptoms.
In the United States, more than 8 million women and 2 million men have the disease. One in every two women and one in eight men over 50 will suffer an osteoporotic fracture, according to the NIH. Hip, spine and wrist fractures are the most common.
"It is eye-opening to keep track of how much calcium you're getting compared to the recommended amount," Amschler said.
"The students in my women's health classes every year do an assignment where they keep a calcium-intake journal for a week," Amschler said. "I'd say 450 to 500 milligrams a day is common. They usually get half the adequate amount if they're lucky. The lowest I've seen during the years is 27 milligrams for one day, I think."
Many young women, however, subscribe to the myth that all dairy products are fattening, but woman can substitute calcium-rich foods in place of other snacks and soft drinks.
One 8-ounce glass of milk or calcium-enriched orange juice contains 300 milligrams, or 30 percent, of the daily calcium recommendation. Also, cup for cup, non-fat skim milk exceeds the calcium content of 2 percent reduced-fat or vitamin D whole milk.
Without the fat, Amschler said, there is more room for calcium.
Dairy products also contain Vitamin D, which is necessary for calcium absorption. The vitamin can also be obtained from as little as 15 minutes in direct sunlight.
There are also non-dairy alternatives to acquire adequate calcium, but even those who are lactose intolerant or have a perceived milk allergy can often handle half to one cup of skim milk twice a day.
It was Amschler's sufficient calcium intake that saved her from a more severe amount of bone loss.
Amschler said she was shocked and angry when, in 1997, she learned from a bone scan that she showed signs of pre-menopausal bone loss, despite her "clean living" and ample calcium intake.
She said she believes she would have had significantly more bone loss if it wasn't for her calcium-conscious lifestyle as a teen and young adult.
"My doctor asked, 'Who are you going to be mad at, God or your ancestors?'" Amschler said.
About 80 percent of the risk for osteoporosis is genetic, but you can manipulate the other 20 percent, according to Amschler.
Strong bones require more than calcium, though. Cigarette smoking increases the production of the destructive bone cells, osteoclasts. Excessive alcohol use both impedes essential absorption and interferes with excretion of calcium.
Also, a steady regimen of weight-bearing exercise - including walking, jogging and full-body aerobics - is necessary for optimal bone health.
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