Print    Email
Decrease (-) Restore Default Increase (+)

Calcium & Supplements

No matter what your age, calcium plays a bone-saving role.

Calcium Isn't Just for Kids

Children need calcium for building bones, but did you know that bone growth doesn’t stop in childhood? The older we get, the more we need calcium to help build and maintain bones. Lack of calcium can lead to osteoporosis, a condition in which bones become fragile and break easily. Twenty-five million Americans suffer from osteoporosis. Eighty percent of them are women.

Luckily, there is much you can do to prevent osteoporosis. Eating foods rich in calcium throughout your life can help prevent this disease. Adequate calcium, vitamin D, magnesium, other vitamins and minerals, and regular exercise are essential for building and maintaining bone mass. It’s never too late to increase your intake of these nutrients and start an exercise habit.

Learn How to Protect Your Bones

Saint Joseph Mercy Health System wants to help you build strong bones and lower your risk of osteoporosis. The information provided below will help you:

  • Understand the role that calcium, vitamin D and exercise play in keeping your bones healthy
  • Learn how much calcium each member of your family needs
  • Keep track of the nutrients you are getting in your diet
  • Determine whether calcium supplements are appropriate for you
  • Tell you where to find more information

Why is Calcium so Important?

Calcium and vitamin D are essential to support bone growth and teeth formation early in life, and to reduce bone loss later in life. Vitamin D helps your bones absorb calcium.

Calcium helps prevent bone loss during pregnancy and after age 35, when bones naturally begin to thin. Everyone naturally loses bone mass as they age, but women – particularly after menopause – are at much higher risk.

When your estrogen levels begin to decline during menopause, you may need extra calcium. Consuming too little of this nutrient is a risk factor for osteoporosis – a condition in which loss of tissue in the bones causes them to become fragile and break more easily.

Most American adults aren’t getting enough calcium to help prevent osteoporosis. The average adult consumes only 500 to 700 milligrams of calcium per day; that's about half of the necessary daily amount for adults (1,000 to 1,200 milligrams), according to the Institute of Medicine.

How much calcium does your body need? Please see Table 1 for calcium and vitamin D recommendations.

Who Needs Calcium?

We all do! Many people believe that once calcium goes to the bone, it's there forever. The truth is that the minerals in your bones are in a constant state of buildup and breakdown throughout each day of your life.

As caregivers and providers of nutrition, women have an opportunity to influence their families’ health and eating habits. Here are some reasons why you should be concerned about the calcium intake of every member of your family.

  • Children and teens need extra levels to support growth of bones and tissues.
  • With enough calcium in their diet, young adults continue to accumulate bone mass until age 30 to 35.
  • Women who are pregnant or breastfeeding need higher amounts of calcium.
  • As you approach, or are going through menopause, your bone building cells slow down; and you need extra calcium to keep your bones healthy.
  • Men are also at risk for osteoporosis, especially after age 65.

How Do I Get Calcium?

There are a number of good sources of calcium, including:

  • Low-fat dairy products
  • Dark, leafy vegetables such as broccoli, kale and collards
  • Tofu
  • Canned salmon or sardines with bones
  • Calcium-fortified juice, bread and cereal

Vitamin D is important because it helps your body absorb calcium. Good sources of vitamin D include sunlight, low-fat dairy products and fortified cereals.

Choose three to four servings of dairy or other high calcium foods every day (see Table 2). Be sure to read nutrition labels. More and more foods are being fortified with calcium.

Will Eating Dairy Raise My Fat Intake?

Although it’s true that dairy foods do contain fat, there are now low-fat and fat-free alternatives that also provide the necessary calcium. Since many fat-free brands don’t taste exactly like the higher fat items, don’t be disappointed by the first one you try. Continue to experiment with different brands. Try adding other ingredients to your recipes to improve the flavor, and use a small amount of the fat-free item until you get accustomed to the taste.

What If I Can't Eat Dairy Products?

Because calcium – a key nutrient in everyone’s diet – is best consumed in food, it’s important to get as much as you can from your diet. If you have trouble tolerating dairy products, you have several options.

Often people who have trouble digesting foods with lactose can tolerate yogurt, cheeses and a small amount of milk as part of a meal or snack. Your doctor may recommend that you take lactose tablets or drops that break down lactose and can help you digest dairy products. There are also lactose-reduced and lactose-free products that still offer the benefits of calcium.

There are many non-dairy foods that are excellent sources of calcium such as green vegetables, fish with edible bones and tofu (see Table 2). And many foods, such as orange juice, soy milk and breakfast cereal, are fortified with calcium.

Easy Tips for Increasing Calcium in Your Diet

  • Add nonfat dry milk powder to recipes that include a creamy base or mix it into a batter (1/3 cup dry powder equals the calcium in eight ounces of milk.) Try adding milk powder to creamy soups, casseroles, sauces, mashed potatoes, meatloaf, pancakes, muffins, breads, hot cereals, dips and sandwich fillings.
  • Substitute nonfat yogurt for sour cream or mayonnaise, or for butter on baked potatoes.
  • Cook rice, noodles, hot cereals and other grains in nonfat milk.
  • Sprinkle low-fat grated cheese on salad, soups, vegetables, chili and casseroles or on tortillas, pita bread toast or English muffins.
  • Do not remove the tiny calcium-rich bones in canned salmon, tuna, and sardines.
  • When cooking, substitute ricotta cheese for cottage cheese (you get 268 mg. more calcium per 1/2 cup).
  • Use evaporated skim milk, instead of cream, for sauces, gravies, soup bases and desserts.
  • Include yogurt, low-fat string cheese, pudding or other nonfat dairy foods in your snack choices.
  • Make milk part of your meal. Get in the habit of ordering low-fat milk instead of a soft drink when you eat out.

Is Vitamin D Necessary?

You need vitamin D to help absorb calcium from the food you eat. Vitamin D is formed in your skin when it is exposed to sunlight or obtained from dietary sources (such as dairy or other fortified foods). Later in life, you may be exposed to less sun due to your location (homebound) or season (winter). You need about 15 minutes of sun exposure three times per week without sunscreen. As you age, you must rely more on sources other than sunlight (such as food and supplements). Food sources that contain vitamin D are fatty fish such as salmon or halibut, milk (fluid, dried or evaporated) and other fortified foods such as breakfast cereals.

Because vitamin D can be toxic, experts recommend that you do not to take more than 2,000 IU (International Units) or 50 micrograms per day. The RDI (recommended daily intake) for vitamin D is 400 IU (see Table 1). One cup of milk contains 100 IU. Most cereals have about 40 IU per serving. Multivitamins often have 100 to 400 IU.

What are the Benefits of Soy?

Many soy products contain a nutrient that helps strengthen bones. Some soy foods are also a good source of calcium. The most common soy foods are tofu and soy milk, which are usually found in the produce aisle of your grocery store. To get more calcium from tofu, choose tofu made with calcium chloride or calcium sulfate. Check the label for soy milk to determine if it has been fortified with calcium.

How to Calculate Your Daily Calcium Intake

It’s difficult to get too much calcium from food sources, but supplements and calcium-fortified foods can make it possible to overdo it. To meet your daily need of calcium, you may need to keep track of your intake from food sources and supplements.

Consider adding up your calcium from foods for several days to determine your average intake of calcium. To figure the milligrams of calcium in a product, check the label. For example, if it states the calcium content is 35 percent, just add a zero, which means each serving size provides 350 milligrams of calcium.

Remember, calcium helps prevent bone loss during pregnancy and after age 35, when bones naturally begin to thin. Everyone naturally loses bone mass as they age, but women – particularly after menopause – are at much higher risk.

What Can I Do To Increase the Amount of Calcium My Body Absorbs?

  • Don’t smoke. Cigarettes may damage bone directly or prevent your body from absorbing calcium or other nutrients.
  • Limit your intake of caffeine, salt and alcohol.
  • Eat reasonable portions of meat, poultry and fish (six to eight ounces per day).
  • Work out regularly. Include weight-bearing activities in your exercise routine such as walking (at least seven miles a week), gentle jogging or aerobics to help maintain bone density.
  • If you don’t get out in the sun much or don’t eat vitamin D fortified foods, take a calcium supplement fortified with vitamin D.
  • If you are taking calcium supplements, take them at a different time of day than other supplements for optimum absorption.

Should I Supplement my Diet with Other Minerals?

Most experts agree:

  • Your diet probably contains sufficient phosphorous, so you don’t need to supplement this nutrient.
  • You can supplement magnesium at about half of the recommended calcium level. Check the label; a 500 milligram calcium supplement may also contain 250 milligrams of magnesium.
  • Vitamin K and other vitamins and minerals may be important, but you can get them through a varied diet or a general vitamin-mineral supplement.

What About Supplements?

If you are concerned about your calcium intake, ask your doctor whether calcium supplements are appropriate for you. Supplements can help you get the minerals your body needs, but it's important to monitor the amount you take. Too much calcium may interfere with your body’s ability to absorb other minerals, cause constipation or increase your risk of kidney stones.

Experts recommend that you do not consume over 2,500 milligrams of calcium a day. If you take calcium supplements and eat calcium-fortified foods like juice, cereal and bread, be careful not to exceed this guideline.

Some food sources of calcium are also rich sources of magnesium and phosphorous, which are important in bone formation. It can be a difficult to balance all of these minerals in a supplement, so getting calcium from food sources is the best choice. Some good sources of magnesium are beans, whole grains and leafy greens (such as kale and swiss chard).

Remember, even if you rely on supplements to get the healthy minerals your bones need, exercise is still very important to help hold on to those minerals.

Are Some Kinds of Calcium Better Than Others?

Calcium supplements contain different forms of calcium in different amounts. Make sure you read the label to find the amount of elemental calcium in each tablet; this is the actual amount of calcium you're getting in each tablet.

Calcium must be combined with other compounds such as carbonate or citrate. Calcium carbonate is generally less expensive, but it requires stomach acid for breakdown. Calcium citrate may be a better choice for older adults who may not have enough stomach acid to absorb carbonate well. Because calcium citrate supplements contain half the amount of calcium as calcium carbonate, you may need a higher dose.

Does it Matter When I Take the Supplement? Are There Differences Between Brands?

Calcium supplements should be taken with a large glass of water, with or following meals. To improve absorption, consider taking a low-dose supplement several times a day rather than taking a large-dose supplement all at once. To test if your supplement is really getting absorbed after ingestion, drop it into a six-ounce cup of vinegar, and stir occasionally. A high-quality supplement will dissolve within 30 minutes.

Calculating Calcium for a Day

Here is a summary of one person’s calcium intake for a day:

BREAKFAST
• Cereal, 1 cup, 250 mg
• Milk, 1 cup, 298 mg
• Calcium-fortified orange juice, 1 cup, 350 mg
• English muffin, wheat, 100 mg

LUNCH
• Tomato soup (with milk), 1 cup, 200 mg
• Grilled cheese sandwich, 250 mg
• Fruit yogurt, 1 cup, 345 mg

DINNER
• Macaroni and cheese, 2 cups, 480 mg
• Broccoli, frozen, 1 cup, 96 mg
• Salad, mixed greens, 1 cup, 70 mg

SNACKS
• Calcium-fortified breakfast bar, 330 mg

This daily total is 2,769 mg calcium, which is over the maximum for a day. If you eat foods fortified with calcium and get several servings of dairy products each day, you may not need a calcium supplement.

Where Can I Get More Information?

St. Joseph Mercy NutriCare Nutrition Services
The St. Joseph Mercy NutriCare program offers outpatient nutrition education and counseling services to individual and community groups.
734-827-3777

St. Joseph Mercy HealthLine
This easy-to-use phone resource offers information on classes and events, answers to medical questions, and referrals to Saint Joseph Mercy Health System doctors.
734-712-5400 or 800-231-2211

St. Joseph Mercy Health Information Library
This library, located in the St. Joseph Mercy Reichert Health Center, offers a variety of resources for patients, their families and the community, including books, journals, videos, pamphlets and electronic sources of health and wellness information.
734-712-5177

Consumer Nutrition Referral Network
This nutrition information line, sponsored by the American Dietetic Association, provides nutrition advice and information on how to reach a registered dietician in your area.
800-366-1655

American Dietetic Association
This national association of dieticians maintains a Web site of nutrition information.
www.eatright.org

References

  • Nutrition for Women by E. Somer, MD
  • The National Academy of Sciences Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride, The Institute of Medicine, National Academy Press, Washington D.C.

The information provided is for educational purposes and should not replace the professional advice of a physician, nurse or dietitian. Medical recommendations regarding calcium change frequently. If you have any questions on your individual calcium intake or other personal concerns, be sure to seek the advice of your health care provider.

A Member of Trinity Health
© 2014 Trinity Health

St. Joseph Mercy Ann Arbor | 5301 McAuley Drive, Ypsilanti, MI 48197 | 734-712-3456