Calcium and Vitamin D: Important at Every Age

January 2012

The foods we eat contain a variety of vitamins, minerals, and other important nutrients that help keep our bodies healthy. Two nutrients in particular, calcium and vitamin D, are needed for strong bones.

The Role of Calcium

Calcium is needed for our heart, muscles, and nerves to function properly and for blood to clot. Inadequate calcium significantly contributes to the development of osteoporosis. Many published studies show that low calcium intake throughout life is associated with low bone mass and high fracture rates. National nutrition surveys have shown that most people are not getting the calcium they need to grow and maintain healthy bones. To find out how much calcium you need, see the Recommended Calcium Intakes (in milligrams) chart below.

Recommended Calcium Intakes
Life-stage group mg/day
Source: Food and Nutrition Board, Institute of Medicine, National Academy of Sciences, 2010.
Infants 0 to 6 months 200
Infants 6 to 12 months 260
1 to 3 years old 700
4 to 8 years old 1,000
9 to 13 years old 1,300
14 to 18 years old 1,300
19 to 30 years old 1,000
31 to 50 years old 1,000
51- to 70-year-old males 1,000
51- to 70-year-old females 1,200
70 years old 1,200
14 to 18 years old, pregnant/lactating 1,300
19 to 50 years old, pregnant/lactating 1,000

To learn how easily you can include more calcium in your diet without adding much fat, see the Selected Calcium-Rich Foods list below.

Selected Calcium-Rich Foods
Food Calcium (mg)
Source: The 2004 Surgeon General’s Report on Bone Health and Osteoporosis: What It Means to You. U.S. Department of Health and Human Services, Office of the Surgeon General, 2004, pages 12–13.
Fortified oatmeal, 1 packet 350
Sardines, canned in oil, with edible bones, 3 oz. 324
Cheddar cheese, 1½ oz. shredded 306
Milk, nonfat, 1 cup 302
Milkshake, 1 cup 300
Yogurt, plain, low-fat, 1 cup 300
Soybeans, cooked, 1 cup 261
Tofu, firm, with calcium, ½ cup 204
Orange juice, fortified with calcium, 6 oz. 200–260 (varies)
Salmon, canned, with edible bones, 3 oz. 181
Pudding, instant (chocolate, banana, etc.) made with 2% milk, ½ cup 153
Baked beans, 1 cup 142
Cottage cheese, 1% milk fat, 1 cup 138
Spaghetti, lasagna, 1 cup 125
Frozen yogurt, vanilla, soft-serve, ½ cup 103
Ready-to-eat cereal, fortified with calcium, 1 cup 100–1,000 (varies)
Cheese pizza, 1 slice 100
Fortified waffles, 2 100
Turnip greens, boiled, ½ cup 99
Broccoli, raw, 1 cup 90
Ice cream, vanilla, ½ cup 85
Soy or rice milk, fortified with calcium, 1 cup 80–500 (varies)

Calcium Culprits

Although a balanced diet aids calcium absorption, high levels of protein and sodium (salt) in the diet are thought to increase calcium excretion through the kidneys. Excessive amounts of these substances should be avoided, especially in those with low calcium intake.

Lactose intolerance also can lead to inadequate calcium intake. Those who are lactose intolerant have insufficient amounts of the enzyme lactase, which is needed to break down the lactose found in dairy products. To include dairy products in the diet, dairy foods can be taken in small quantities or treated with lactase drops, or lactase can be taken as a pill. Some milk products on the market already have been treated with lactase.

Calcium Supplements

If you have trouble getting enough calcium in your diet, you may need to take a calcium supplement. The amount of calcium you will need from a supplement depends on how much calcium you obtain from food sources. There are several different calcium compounds from which to choose, such as calcium carbonate and calcium citrate, among others. Except in people with gastrointestinal disease, all major forms of calcium supplements are absorbed equally well when taken with food.

Calcium supplements are better absorbed when taken in small doses (500 mg or less) several times throughout the day. In many individuals, calcium supplements are better absorbed when taken with food. It is important to check supplement labels to ensure that the product meets United States Pharmacopeia (USP) standards.

Vitamin D

The body needs vitamin D to absorb calcium. Without enough vitamin D, one can’t form enough of the hormone calcitriol (known as the “active vitamin D”). This in turn leads to insufficient calcium absorption from the diet. In this situation, the body must take calcium from its stores in the skeleton, which weakens existing bone and prevents the formation of strong, new bone.

You can get vitamin D in three ways: through the skin, from the diet, and from supplements. Experts recommend a daily intake of 600 IU (International Units) of vitamin D up to age 70. Men and women over age 70 should increase their uptake to 800 IU daily, which also can be obtained from supplements or vitamin D-rich foods such as egg yolks, saltwater fish, liver, and fortified milk. The Institute of Medicine recommends no more than 4,000 IU per day for adults. However, sometimes doctors prescribe higher doses for people who are deficient in vitamin D.

A Complete Osteoporosis Program

Remember, a balanced diet rich in calcium and vitamin D is only one part of an osteoporosis prevention or treatment program. Like exercise, getting enough calcium is a strategy that helps strengthen bones at any age. But these strategies may not be enough to stop bone loss caused by lifestyle, medications, or menopause. Your doctor can determine the need for an osteoporosis medication in addition to diet and exercise.

The National Institutes of Health Osteoporosis and Related Bone Diseases ~
National Resource Center acknowledges the assistance of the National Osteoporosis Foundation in the preparation of this publication.

For Your Information

This publication contains information about medications used to treat the health condition discussed here. When this publication was developed, we included the most up-to-date (accurate) information available. Occasionally, new information on medication is released.

For updates and for any questions about any medications you are taking, please contact

U.S. Food and Drug Administration
Toll Free: 888–INFO–FDA (888–463–6332)
Website: http://www.fda.gov

For additional information on specific medications, visit Drugs@FDA at www.accessdata.fda.gov/scripts/cder/drugsatfda. Drugs@FDA is a searchable catalog of FDA-approved drug products.

NIH Osteoporosis and Related Bone Diseases ~ National Resource Center

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Email: NIHBoneInfo@mail.nih.gov
Website: http://www.bones.nih.gov

The NIH Osteoporosis and Related Bone Diseases ~ National Resource Center provides patients, health professionals, and the public with an important link to resources and information on metabolic bone diseases. The mission of NIH ORBD~NRC is to expand awareness and enhance knowledge and understanding of the prevention, early detection, and treatment of these diseases as well as strategies for coping with them.

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