Are your bones getting enough calcium?
Calcium and vitamin D are essential to building strong, dense bones when you’re young and to keeping them strong and healthy as you age.
About 99% of the calcium in our bodies is in our bones and teeth. When we don’t get the calcium our body needs, it is taken from our bones. This is fine once in a while, but if it happens too often, bones get weak and may break.
Vitamin D plays an important role in protecting our bones, too, both by helping the body absorb calcium and by supporting muscles needed to avoid falls. If you don’t get enough vitamin D, you’re more likely to break bones as you age.
How much do you need?
Calcium is a mineral that is necessary for life. In addition to building bones and keeping them healthy, calcium enables our blood to clot, our muscles to contract, and our heart to beat.
Our bodies cannot produce their own calcium. That’s why it’s important to get enough calcium from the food we eat.
The amount of calcium you need every day depends on your age and sex. Women age 51 and older should get 1,200 mg. daily. Men age 70 and younger should get 1,000 mg. daily and 1,200 mg. after age 70. This includes the total amount of calcium you get from food and supplements.
To calculate how much calcium is in your diet, use the International Osteoporosis Foundation’s calculator at iofbonehealth.org/calcium-calculator.
Food is the best source of calcium. Dairy products such as milk, yogurt and cheese are high in calcium. Certain green vegetables and other foods contain calcium in smaller amounts.
Some juices, breakfast foods, soymilk, cereals, snacks, breads and bottled water have added calcium. If you drink soymilk or another liquid that is fortified with calcium, be sure to shake the container well, as calcium can settle to the bottom.
A simple way to add calcium to many foods is with a tablespoon of nonfat powdered milk, which contains about 50 mg. of calcium. It’s easy to add a few tablespoons of powdered milk to almost any recipe.
Try to get the daily recommended amount of calcium from food. In general, you shouldn’t take supplements that you don’t need. There is no added benefit to taking more calcium than you need. Doing so may even carry some risks. [See “Supplements may raise men’s cancer risk.“]
When choosing a supplement, keep the following in mind:
—Choose brand-name supplements with proven reliability. Look for labels that state “purified” or have the USP (United States Pharmacopeia) symbol.
—Calcium is absorbed best when taken in amounts of 500 to 600 mg. or less. This is the case for both foods and supplements. Try to get your calcium-rich foods and/or supplements in small amounts throughout the day, preferably with a meal. While it’s not recommended, taking your calcium all at once is better than not taking it at all.
—Take (most) calcium supplements with food. Eating food produces stomach acid that helps your body absorb most calcium supplements. The one exception to the rule is calcium citrate, which can absorb well when taken with or without food.
When starting a new calcium supplement, start with a smaller amount to mitigate possible side effects, such as gas or constipation. If increasing fluids in your diet does not solve the problem, try another type or brand of calcium. It may require trial and error to find the right one.
How much vitamin D do you need?
Both men and women over age 50 should try to get 800 to 1,000 IU daily. Some people need more vitamin D. According to the Institute of Medicine, the safe upper limit of vitamin D is 4,000 IU per day for most adults.
There are three ways to get vitamin D: from sunlight, food or supplements.
Sunlight: Your skin makes vitamin D in reaction to sunlight and stores it in fat for later use. How much vitamin D your skin can produce depends on the time of day, season, latitude, skin pigmentation, age and other factors.
There are many reasons people do not have enough vitamin D. As we age, our skin loses its ability to generate vitamin D. People who live in cities or in institutional settings like nursing homes spend too little time outdoors. And sunscreen with an SPF as low as 8 reduces vitamin D production by 95 percent.
Vitamin D in food: Vitamin D is found in very few foods. Sources include fatty fish like wild-caught mackerel, salmon and tuna. Vitamin D is added to milk and other dairy products, orange juice, soymilk and fortified cereals.
It is very difficult to get all the vitamin D you need from food alone. Most people must take vitamin D supplements to get enough to support bone health.
Vitamin D supplements: If you aren’t getting enough vitamin D from sunlight and food, consider taking a supplement. There are two types: vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Both are good for bone health.
Before adding a vitamin D supplement, check to see if any of the other supplements, multivitamins or medications you take contain vitamin D.
For more information, visit nof.org/patients.