What is calcium?

Calcium is a mineral that is very important for:

• Heart health
• Bone health
• Teeth
• Nerves
• Muscles
• Blood clotting

How much calcium do I need?

Many food products list the amount of calcium per serving on the box. Food labels list calcium as a % of the Daily Value (DV) based on 1,000 mg of calcium per day. Look for foods that provide 10% or more of the daily value for calcium.

The total amount of calcium you need, preferably from dairy foods, depends on your age and gender:

Group           Calcium/Day
--------------------------------------
Adults 19 to 50  1000 mg
Women 51 to 70   1200 mg
Men 51 to 70     1000 mg
Adults over 70   1200 mg
--------------------------------------
* mg = milligrams

What keeps me from getting enough calcium?

Here are some things that can make it harder for your body to get enough calcium:

• Not getting enough vitamin D. Vitamin D increases the amount of calcium absorbed by your body. It’s important to get enough sunlight to help your body make vitamin D and to choose foods that contain vitamin D. Milk contains vitamin D and some brands of cheese, yogurt, juice, and margarine have added vitamin D. Check labels for the amount of vitamin D per serving. Fish such as salmon, mackerel, and tuna are good natural sources of vitamin D. If your provider recommends that you take a calcium supplement, there are some that include vitamin D.
• Too much fiber in the diet. This is more of a concern if you have low amounts of calcium in your diet. Take calcium supplements or eat calcium-fortified foods 2 hours before or after eating 100% bran products. Soaking beans in water and discarding the liquid before cooking can also help.
• Soft drinks, energy drinks, tea, and coffee. People who drink these products instead of milk often don’t get enough calcium.
• Taking some medicines. Medicines such as some antibiotics, heartburn medicines that decrease stomach acid production, and antacids that contain aluminum can make it harder for your body to absorb calcium.

These things can cause you to lose calcium:

• Eating a lot of protein foods, such as meats, poultry, and eggs. The more protein you eat, the more calcium you lose. As long as your diet is balanced and contains enough calcium, this should not be a problem.
• Eating a lot of salt. The more salt in your diet, the more calcium you lose. Limit the salt in your diet. Cutting back on salt and getting enough calcium can help lower blood pressure and help prevent fluid retention.

Milk products are one of the best sources of calcium. Calcium is also in many other foods such as vegetables, beans, and soy. However, the calcium in these foods is not absorbed as well as the calcium in milk products. Calcium has been added to some foods (fortified), which makes it easier to meet daily calcium needs, but it still can be hard for your body to get enough calcium if dairy foods are not a part of your diet.

Do I need a calcium supplement?

If you can get enough calcium in your diet, you do not need to take calcium supplements. People who get too much calcium have a higher risk for kidney stones and stroke. Men who take calcium supplements are at higher risk for a heart attack. Ask your healthcare provider if you should take calcium supplements, and which kind you should take.

Calcium supplements of 1000 mg or less do not prevent fractures in postmenopausal woman. However, there may be some benefit from higher doses of calcium supplements. If you are a postmenopausal woman and you have never had a fracture, ask your healthcare provider if you should take calcium supplements.

You may need a supplement if you:

• Have digestive problems that prevent you from absorbing calcium.
• Have allergic or other reactions if you drink or eat milk products (such as lactose intolerance or milk allergy).
• Don’t eat any animal products, including dairy.
• Do not get enough calcium in your diet.
• Are pregnant or breast-feeding.
• Have osteoporosis or osteopenia (weakened bones).
• Have a vitamin D deficiency.

There are many kinds of calcium supplements. The most common are calcium carbonate and calcium citrate.

• Calcium carbonate is best absorbed with a meal.
• Calcium citrate can be taken on a full or empty stomach. Calcium citrate may be a better choice for older adults or younger people who have low levels of stomach acid.
• Calcium phosphate, lactate, and gluconate are also well absorbed. However, the amount of calcium per pill is lower, so you may need to take many pills a day to meet your needs.

Your body absorbs calcium best if you take no more than 500 mg at a time, and take it two or more times per day as recommended by your healthcare provider. Look for calcium supplements that have the USP or Consumer Lab symbol on the label. Products with these labels have been tested to make sure they are absorbed by the body.

How can I eat the right amount of calcium?

Eat more calcium-rich foods. Here are some ideas for adding calcium to your diet.

• Have low-fat or nonfat milk, cottage cheese with fruit, or yogurt for snacks.
• Eat calcium-fortified breakfast cereals with rice, almond, or soy milk, or have calcium-fortified waffles or pancakes.
• Cook hot cereals with milk instead of water.
• Serve yogurt or milk smoothies instead of juice.
• Add yogurt to lunches or use a dip made with yogurt when having a fruit snack.
• Add lean shredded cheese to baked potatoes, vegetables, soups, and salads.
• Use milk when making cream soups instead of water.
• Serve flavored milk or hot chocolate for an evening treat.
• Use Parmesan cheese topping for Italian dishes. A 2 tablespoon serving adds about 140 mg of calcium.
• Serve a healthy vegetable pizza made with low-fat cheese.
• Serve lean mozzarella string cheese with crackers and fruit for a snack.
• Make puddings with milk.
• Get plenty of exercise. Walk a mile a day if you can and do strength training exercise a few times a week. Exercise helps your body to use calcium to strengthen your bones.

Some people cannot digest milk products because their bodies lack the enzyme needed to break down milk sugar. This problem is called lactose intolerance. If you have this problem, you can buy products such as Lactaid or Dairy Ease. These products contain lactase, which can help you digest milk products.

For more information contact:

• The Academy of Nutrition and Dietetics
  800-366-1655
  http://www.eatright.org