By Tiffany Pulgiano, DNP
Let’s Talk Calcium
Why Dietary Calcium is Better than Supplements
Dietary calcium is preferred over supplements for several reasons. Foods naturally rich in calcium provide additional essential nutrients that are beneficial for overall health. For example, dairy products not only contain calcium but also provide protein, vitamins, and other minerals. Additionally, calcium from food sources is generally better absorbed by the body compared to supplements, which can sometimes cause gastrointestinal issues like constipation and bloating.[1][2]
Calcium and Heart Health
Calcium is important for bone health, but how you get your calcium matters for your heart. Research shows that calcium supplements might increase the risk of heart problems, while calcium from food sources does not have the same risks.
Studies have found that taking calcium supplements can increase the risk of heart disease, including heart attacks. For example, one study showed that calcium supplements increased the risk of heart disease by 8% and heart attacks by 14%. Another study found that men who took calcium supplements had a higher risk of dying from heart disease.[1][2]
On the other hand, getting calcium from food sources like dairy products, leafy greens, and fortified foods does not increase the risk of heart disease. In fact, dietary calcium has been associated with a lower risk of heart disease and stroke.[1][3][4]
Therefore, it is generally safer to get your calcium from food rather than supplements. If you need to take supplements, it is important to discuss this with your doctor to weigh the benefits and risks.
Recommended Calcium Intake
The American Association of Clinical Endocrinologists and the American College of Endocrinology recommend that adults aged 50 years and older consume 1,200 mg of calcium per day from all sources. This can be achieved through a balanced diet rich in calcium-containing foods.[1]
Calcium-Rich Foods and Serving Sizes
Here are some foods that can help you meet your daily calcium needs:
- Milk: One cup of milk contains approximately 300 mg of calcium.
- Yogurt: One cup of yogurt provides about 450 mg of calcium.
- Cheese: One ounce of cheddar cheese contains around 200 mg of calcium.
- Kale: One cup of cooked kale offers about 100 mg of calcium.
- Broccoli: One cup of cooked broccoli contains approximately 60 mg of calcium.
- Almonds: One ounce of almonds provides about 75 mg of calcium.
- Fortified Orange Juice: One cup of calcium-fortified orange juice contains around 300 mg of calcium.
Additional Tips
- Variety: Include a variety of calcium-rich foods in your diet to ensure you get other essential nutrients.
- Bioavailability: Some plant-based sources of calcium, like spinach, have lower bioavailability due to compounds like oxalates that inhibit calcium absorption. Opt for foods with higher bioavailability like kale and broccoli.[3]
- Fortified Foods: Consider calcium-fortified foods if you have dietary restrictions or preferences that limit your intake of natural calcium sources.
Conclusion
Meeting your calcium needs through dietary sources is beneficial for overall health and bone strength. Incorporate a variety of calcium-rich foods into your daily diet to achieve the recommended intake and support your bone health.[1][3][2]
Key Points:
- Calcium is essential for bone health.
- Calcium supplements may increase the risk of heart disease.
- Calcium from food sources is safer for heart health.
- Discuss calcium supplementation with your doctor.
References
- American Association of Clinical Endocrinologists/American College of Endocrinology Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis-2020 Update. Camacho PM, Petak SM, Binkley N, et al. Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2020;26(Suppl 1):1-46. doi:10.4158/GL-2020-0524SUPPL.
- The Importance of Meeting Calcium Needs With Foods. Miller GD, Jarvis JK, McBean LD. Journal of the American College of Nutrition. 2001;20(2 Suppl):168S-185S. doi:10.1080/07315724.2001.10719029.
- A Comparison of the Bioaccessible Calcium Supplies of Various Plant-Based Products Relative to Bovine Milk. Muleya M, F Bailey E, H Bailey E. Food Research International (Ottawa, Ont.). 2024;175:113795. doi:10.1016/j.foodres.2023.113795.
References for for Heart Health:
- The Evidence and Controversy Between Dietary Calcium Intake and Calcium Supplementation and the Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Cohort Studies and Randomized Controlled Trials. Yang C, Shi X, Xia H, et al. Journal of the American College of Nutrition. 2020 May-Jun;39(4):352-370. doi:10.1080/07315724.2019.1649219.
- Dietary and Supplemental Calcium Intake and Cardiovascular Disease Mortality: The National Institutes of Health-Aarp Diet and Health Study. Xiao Q, Murphy RA, Houston DK, et al. JAMA Internal Medicine. 2013;173(8):639-46. doi:10.1001/jamainternmed.2013.3283.
- Vitamin D, Calcium Supplements, And Implications for Cardiovascular Health: JACC Focus Seminar. Michos ED, Cainzos-Achirica M, Heravi AS, Appel LJ. Journal of the American College of Cardiology. 2021;77(4):437-449. doi:10.1016/j.jacc.2020.09.617.
- Associations of Dietary Calcium Intake and Calcium Supplementation With Myocardial Infarction and Stroke Risk and Overall Cardiovascular Mortality in the Heidelberg Cohort of the European Prospective Investigation Into Cancer and Nutrition Study (EPIC-Heidelberg). Li K, Kaaks R, Linseisen J, Rohrmann S. Heart (British Cardiac Society). 2012;98(12):920-5. doi:10.1136/heartjnl-2011-301345.
- Cardiovascular Effects of Calcium Supplementation. Reid IR, Bolland MJ, Avenell A, Grey A. Osteoporosis International : A Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2011;22(6):1649-58. doi:10.1007/s00198-011-1599-9.