Fat-free is clearly preferred. Why waste calories on putting 2 percent milk in your coffee? Soy milk is not an ideal choice, either, because it is not a complete protein, as milk is, has extra calories, and does not give you as much calcium.

Keep milk cold at the back of the refrigerator, at 35-40F, not on a door shelf. Each 5F rise in temperature shortens milk's shelf life because of bacterial growth.

The sad fact is that teens are drinking half as much milk as they did thirty years ago. Milk has been replaced with newfangled drinks including designer bottled waters, exotic juices, iced teas, and soy beverages. But the saddest fact of all is the replacement of milk with carbonated sweetened beverages. When milk is replaced with carbonated beverages, the result is a loss from the diet of protein, calcium, magnesium, and vitamins A and D. There is an almost linear relationship between the rise in consumption of carbonated drinks and obesity in teens. Teenagers need to build bone mass that will last for a lifetime. Because of this, we have to look for new and creative ways to get the calcium we need every day. Space your intake of calcium during the day and also take a calcium supplement as an insurance policy.

Which Calcium Supplement Is Best?

Supplemental calcium comes in two forms: calcium carbonate and calcium citrate. Calcium carbonate must be taken with meals. This is also the type of calcium found in TUMS. By consuming this indigestion remedy, you are giving your bone density a boost. Calcium citrate may be taken any time -- with or without food. I recommend that my patients take at bedtime a supplement of calcium citrate containing vitamin D.

Even if you receive your calcium requirement from food, I recommend adding a calcium supplement just to insure adequate intake. If you have trouble swallowing calcium tablets, as many people do, try another form of calcium. TUMS and calcium chews are popular, and easy for most people to consume. They contain calcium carbonate and must be taken with food for the calcium to be digested. Calcium citrate can be taken with or without food. Make sure that your calcium supplement also contains vitamin D, for optimal absorption.

You need to be aware of the amount of elemental calcium any supplement contains. The term "elemental calcium" refers to the amount of calcium in a supplement that is available for your body to absorb. Most calcium supplements list on the label the amount of elemental calcium. Some brands list only the total weight -- in milligrams (mg) -- of each tablet. This is the weight of the calcium, plus whatever may be bound to it -- such as carbonate, citrate, lactate, or gluconate. For calcium, the % Daily Value (DV) is based on 1,000 mg of elemental calcium, so every 10 percent in the Daily Value column represents 100 mg of elemental calcium (0.10 x 1,000 mg = 100 mg). For example, if a calcium supplement has 60 percent Daily Value, it contains 600 mg of elemental calcium (0.60 x 1,000 mg = 600 mg). It is also important to note the serving size -- the number of tablets you must take to get the % DV listed on the label.

When choosing a calcium supplement, check the label for the abbreviation USP. The best supplements meet the voluntary standards of the U.S. Pharmacopeia (USP) for quality, purity, and tablet disintegration or dissolution. Generic brands of calcium supplements are often cheaper than name brands. However, they may not meet voluntary standards for tablet disintegration. In other words, they may dissolve more slowly, which decreases their effectiveness. Avoid calcium supplements that contain bone meal or dolomite, as these may also contain toxic substances, such as lead, mercury, and arsenic. Check the label for "no added sugar." Chelated calcium tablets tend to be more expensive and really do not have any advantage over other types of calcium. Coral calcium is also marketed as superior calcium, which has not been proven.

Many of my patients love Viactiv Calcium Soft Chews -- chewy little squares that taste like Kraft caramels and come in several dessertlike flavors. Although they are very sweet, two squares contain 100 percent of the Daily Value of calcium and include vitamins D and K. Each VIACTIV Calcium Soft Chew contains 500 mg of elemental calcium from 1,250 mg of calcium carbonate. (www.viactiv.com)

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