Calcium is very important to ensure strong, healthy bones and teeth. It also helps muscles and nerves to work properly and can help control your blood pressure. Your body needs vitamin D to help absorb calcium and to build strong bones.
When there is not enough calcium in the diet, the following can happen:
Osteopenia is the very beginning stage of osteoporosis, sometimes called "brittle bone disease".
Osteoporosis is the more advanced stage where bones in the hips, wrist and spine begin to weaken and become thin and porous.
How Much Do You Need?
The amount of calcium and vitamin D you need changes throughout your life.
- Growing children need calcium and vitamin D to help their bones grow bigger and stronger.
- Teenagers need more calcium and vitamin D than adults or children because they go through growth spurts.
- All adults need enough calcium and vitamin D as they get older to help keep bones healthy.
Research has shown that having 3 to 4 servings of lower fat dairy products in a balanced diet may help maintain a healthy weight and meet your calcium and vitamin D needs.
General Recommendations
Recommended daily calcium & vitamin D intake
Even though your body can make vitamin D from sunlight, some Canadians do not get enough vitamin D because of low levels of sun exposure. The table below gives safe intake levels of vitamin D and Calcium that will help your body be strong and healthy.
Osteoporosis Society of Canada/Capital Health region*
Calcium Vit. D
2-3 years 500 mg 400 IU
4-8 years 800 mg 400 IU
9 - 18 years 1300 mg 400 IU
19 - 50 years 1000 mg 400 IU
51-70 years 1500 mg 800 IU
70+ years 1500 mg 800 IU
Recommendations for pregnant and breastfeeding women are the same as the age guidelines above.
*There is recent evidence that some Canadians have vitamin D deficiency because of low levels of sun exposure. The recommended amounts of calcium and vitamin D above are from the 2002 clinical practice guidelines of the Osteoporosis Society of Canada.
Sources of Calcium and Vitamin D
Some people find it difficult to get the recommended amounts of calcium and vitamin D from foods. To increase your intake of calcium and vitamin D, plan your food choices carefully. The lists on the next page show what foods contain calcium and vitamin D. Choose a variety of these foods each day.
Sources of Calcium
| Milk - 1 cup (250 mL) | Calcium |
| Skim, 1%, 2%, whole | 310 mg |
| Flavoured milk | 300 mg |
| Buttermilk | 300 mg |
| Evaporated milk, canned 2% M.F. | 740 mg |
| Skim milk powder, reconstituted 25 g to make 1 cup (250mL) milk | 300 mg |
| Soup made with milk | 190 mg |
| Cheese - 50 g (3"x1"x1") | Calcium |
| Swiss cheese | 480 mg |
| Cheese, brick | 350 mg |
| Cheese, cheddar | 365 mg |
| Processed cheese slice - 2 slices (50 g) | 285 mg |
| Processed cheese spread (50mL) | 300 mg |
| Milk Alternatives - 3/4 cup (175 mL) | Calcium |
| Yogurt, flavoured 2% M.F. | 210 mg |
| Milk Products - 1/2 cup (125 mL) | Calcium |
| Cottage cheese | 80 mg |
| Pudding, made with milk | 150 mg |
| Ice cream | 90 mg |
| Frozen yogurt, vanilla | 110 mg |
| Fortified Beverages - 1 cup (250 mL) | Calcium |
| Calcium fortifed milk | 500 mg |
| Calcium fortified soy beverage** | 200 mg |
| Calcium fortified rice beverage | 300 mg |
| Calcium fortified soy beverage | 310 mg |
| Meat & Alternatives | Serving |
Calcium |
| Almonds, blanched | 1/2 cup (73 g) |
200 mg |
| Soybeans, boiled | 1 cup (250 mL) |
185 mg |
| Calcium fortified tofu | 3 oz. (90 g) |
155 mg |
| Canned salmon with bones | 3 oz. (95 g) or 150 mL |
146 mg |
| Baked beans, canned | 1 cup (250 mL) |
135 mg |
| Tofu | 3 oz. (90 g) |
93 mg |
| Oysters | 9 small |
85 mg |
| Vegetables & Fruit | Serving |
Calcium |
| Dried figs | 10 |
270 mg |
| Bok choy, cooked | 1/2 cup (125 mL) |
80 mg |
| Broccoli, boiled | 1/2 cup (125 mL) |
50 mg |
| Kale, cooked | 1/2 cup (125 mL) |
50 mg |
Sources of Vitamin D
| Source | Serving |
Vitamin D |
| Milk, skim, 1%, 2%, whole | 1 cup (250 mL) |
92 IU |
| Herring | 3 oz. (100 g) |
900 IU |
| Soy Beverage** | 1 cup (250 mL) |
88 IU |
| Mackerel | 3 oz. (100 g) |
652 IU |
| Salmon | 3 oz. (100 g) |
652 IU |
| Margarine | 1 tsp. (5 mL) |
56 IU |
| Sardines | 3 oz. (100 g) |
252 IU |
| Tuna | 3 oz. (100 g) |
252 IU |
| Eggs | 1 large |
24 IU |
*Shake these products well before drinking them to make sure all the added vitamins and minerals are mixed into the beverage.
** Not all soy beverages are fortified with calcium and vitamin D. Read the label to see if it contains vitamin calcium and D.
It is important to try and meet all of your needs for calcium and vitamin D through the foods you eat. If you are not meeting your requirements talk to a registered dietitian about your diet, or to a pharmacist to help you choose the right supplement for you.
The need for vitamin D increases after the age of 50. In addition to following Canada’s Food Guide, everyone over the age of 50 should take a daily vitamin D supplement of 400 IU.
Choosing a Supplement
Calcium Supplements
- The “best” supplement is the one that meets your needs based on tolerance, convenience, cost and availability.
- Supplements may be pills, liquid, chews or chewable tablets. Some supplements can be dissolved in liquid.
- Check the label of the supplement for the amount of elemental calcium. Elemental calcium is the amount of calcium your body will absorb. Calcium supplements are best absorbed when no more than 500 mg elemental calcium is taken at one time.
- Check the purity. Avoid calcium from unrefined oyster shell, bone meal or dolomite without a Drug Identification Number (DIN). The DIN tells you that it has been tested for absorbability and lead levels.
- Take your calcium supplement with plenty of water.
- As calcium can also interfere with certain medications, talk with your pharmacist to determine the best time of the day to take your medications/supplement.
Two of the most common forms of calcium supplements are calcium citrate and calcium carbonate.
Calcium Citrate is absorbed best by our bodies and can be taken any time. Calcium citrate is often recommended for the older population because as we get older, we produce less gastric acid and gastric acidity is not needed for it to be absorbed.
Calcium carbonate is another good choice. It is best absorbed when taken with food, as gastric acid is needed for it to be absorbed.
Vitamin D Supplement
Vitamin D is found in very few foods naturally (see list of vitamin D foods). Along with food sources, the sun is also a source of vitamin D. However, you need to be in the sun for at least 15 minutes daily for its benefit. Being exposed to the sun is not advised due to the risk of skin cancer. Using sunscreen will help prevent skin cancer, but also blocks out (UVB) rays needed to make vitamin D. Therefore, it is not possible to safely get all the vitamin D you need from the sun.
If you cannot get all your vitamin D from food, you may need to take a supplement. When choosing a vitamin D supplement, look on the label for vitamin D3 or cholecalciferol, which is the active form of vitamin D.
Remember: when choosing a calcium supplement look for one with vitamin D added to it.
Lactose Intolerance
Lactose intolerance means you cannot digest the sugar called lactose in milk and milk alternatives. This is because you may be lacking an enzyme called lactase.
Here are some tips to help you get the recommended calcium and vitamin D in your diet:
- Spread your milk and milk alternatives out during the day.
- Take smaller amounts of milk and milk alternatives with meals and snacks.
- Add Lactaidâ pills or drops to food. Lactaid products contain lactase, an enzyme that helps digest lactose.
- Try Lactaid â milk.
- Soy or rice milk is naturally lactose free. Choose products fortified with calcium and vitamin D.
- Yogurt and cheese are often tolerated better due to lower lactose levels
* Your doctor can diagnose true lactose intolerance.
Tips to Increase Calcium in Your Diet
- Use calcium fortified milk, orange juice and bread.
- Order a latte or order your latte ‘misto’ – which means heated milk is added instead of foam.
- Yogurt makes a great snack. Substitute yogurt for mayonnaise in fruit or vegetable dips and dressings. Mix muesli into yogurt for a crunchy taste. Bran buds with psyllium in yogurt makes a great breakfast!
- Eat cheese as a snack or grate it on top of salads, soups or casseroles.
- Add canned salmon with the bones to soups, salads or casseroles. Make salmon sandwiches often.
- Make soups with milk instead of water.
- Add broccoli and other green vegetables when you stir-fry. Sesame seeds give even more calcium.
- Enjoy a bean salad or add dried beans, peas and lentils to soups, sauces and casseroles.
- Add powdered milk to casseroles, soups, meat loaf, sauces and drinks such as milkshakes and hot chocolate. Add ¼ cup (50 mL) of powdered milk to each cup of milk that you use in recipes for muffins, cakes, pancakes and other baked foods.
- Choose milk desserts such as custard or pudding. Homemade puddings have up to 3 times the calcium of the commercial prepared ones.
High Calcium Recipes
“Powerful” porridge
1½ cups calcium fortified milk 375 mL
2/3 cup quick-cooking rolled oats 150 mL
2 Tbsp raisins 30 mL
2 Tbsp skim milk powder 30 mL
1 Tbsp molasses 15 mL
½ tsp cinnamon 2 mL
Pinch salt Pinch
In a saucepan, combine all ingredients. Bring to a boil, while stirring. Reduce heat to low; cook for 1 minute, stirring. Remove from heat. Let stand for 1 minute before serving.
Microwave directions: combine all ingredients in an 8-cup (2 L) container and microwave at high for 4 minutes. Stir. Let stand for 1 minute before serving.. Makes 2 servings
Contains 510 mg of calcium per serving and 93 IU of vitamin D
Berry Blast
1 cup cold milk 250 mL
½ cup blueberries 125 mL
(fresh or frozen)
¾ cup blueberry yogurt 175 mL
2 Tbsp skim milk powder 30 mL
Blend all ingredients until smooth. Makes 2 cups (500 mL). Serves 2.
Contains 4330 mg of calcium per serving and 69 IU of vitamin D.
Disclaimer
Reviewed by Alberta clinical experts. Brought to you by HealthLink Alberta. Copyright.
This material is designed for information purposes only. It should not be used in place of medical advice, instruction and/or treatment. For more health advice call Capital Health Link at 780-408-LINK (5465) 24 hours a day, seven days a week. In Alberta, call Toll-free: 1-866-408-LINK (5465)
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