Too little calcium costs bone: if your diet does not supply enough calcium, your body takes the calcium it needs from your bones, which over time makes them weaker and raises the risk of osteoporosis. For most people in the United States, milk, cheese and yogurt are the main food sources of calcium. Vitamin D, which helps your body absorb calcium, is a separate problem: very few foods contain it naturally. With dairy gone and your meals smaller, you can check both against the amounts set for your age and find the other foods that carry them.
Daily calcium and vitamin D for an adult your age
The daily amount of calcium an adult needs changes with age and sex, and the vitamin D amount steps up once, after 70. Vitamin D amounts are given in two units, micrograms (mcg) and international units (IU), so the table gives both: 15 mcg is the same amount as 600 IU, and 20 mcg the same as 800 IU.
| Your age and sex | Calcium a day | Vitamin D a day |
|---|---|---|
| Adult, 19 to 50 | 1,000 mg | 15 mcg (600 IU) |
| Man, 51 to 70 | 1,000 mg | 15 mcg (600 IU) |
| Woman, 51 to 70 | 1,200 mg | 15 mcg (600 IU) |
| Older than 70 | 1,200 mg | 20 mcg (800 IU) |
Each row is the amount recommended for that age and sex, not a figure set for you, because the calcium a person needs each day depends on age and other factors as well. Compare your usual eating with your row, and ask your doctor whether anything about you changes it.
Can eating far less food cost bone by itself?
Excessive dieting or poor protein intake may increase your risk for bone loss and osteoporosis, separately from any dairy you have cut. And from childhood into old age, a diet low in calcium and vitamin D can increase your risk for osteoporosis and fractures. If you are deliberately eating less, check whether the smaller amount you eat still carries calcium, vitamin D and protein.
Factors that may increase your risk for osteoporosis also include sex, age, body size, race, family history, changes to hormones, other medical conditions, medications and lifestyle. Many people with osteoporosis have several risk factors, while others who develop it may not have any specific one.
If someone in your family broke a wrist and that is what set you worrying about your bones, who it was matters, because the family history on the osteoporosis risk list concerns a parent: there is growing evidence that your risk for osteoporosis and fractures may increase if one of your parents has a history of osteoporosis or hip fracture. Fractures from osteoporosis can occur in any bone, though, and they happen most often in the hip, the spine and the wrist. Whoever it was, tell your own doctor which relative broke which bone, and whether that relative was ever told they had osteoporosis.
Osteoporosis typically has no symptoms, and you may not even know you have the disease until you break a bone. Ask your doctor whether a bone density scan makes sense for you (see Ask about a bone density scan if you are past menopause and losing weight).
Foods that carry calcium once dairy is out
You may be able to get enough calcium by eating a variety of foods, and besides dairy, those foods include:
- leafy green vegetables such as kale, broccoli and Chinese cabbage (bok choi)
- fish with soft bones that you can eat, such as canned sardines and salmon
- calcium-enriched foods such as breakfast cereals, fruit juices, soy and rice drinks, and tofu
Turnip greens, and fish such as tuna, carry calcium too. Certain brands of juice, soymilk, oatmeal and breakfast cereal have calcium added, so check the brand you buy.
Calcium-enriched foods show on their product labels how much calcium they have, and on any packaged food the actual amount of calcium and of vitamin D must appear on the Nutrition Facts label, beside a percent Daily Value. That percentage is figured against a Daily Value of 1,300 mg of calcium and 20 mcg of vitamin D, higher than every calcium amount and most of the vitamin D amounts in the table above, so total the milligrams and micrograms themselves when you compare a day of eating with your row (see Read a food label for half a serving, and compare two packages fairly).
People who don't drink milk or eat other dairy products are among those who may have trouble getting enough calcium. So are postmenopausal women, whose bodies absorb and retain less calcium after menopause, people who are Black or Asian, adults age 50 and older living in poverty, and children and teens age 4 to 18. If you are in one of those groups, add up a typical day's calcium before you next see your doctor; being in a group is not a finding about your bones.
Where vitamin D comes from when hardly any food carries it
Vitamin D reaches you in three ways: through your skin, from your diet, and from supplements, and most of what comes from your diet is vitamin D added to food. Your body forms vitamin D naturally after exposure to sunlight, but too much sun exposure can lead to skin aging and skin cancer, so many people try to get their vitamin D from other sources. Many people still have low vitamin D levels, and in the United States most people do not consume enough vitamin D to meet recommended intakes.
Most milk and some yogurts in the United States are fortified with vitamin D, but most other dairy products do not have added vitamin D, so if milk was the fortified food in your day, its vitamin D went when the milk did. Other foods that may be fortified include ready-to-eat breakfast cereals and orange juice; check the label to be sure.
Foods that carry vitamin D with none added include egg yolks, saltwater fish and liver. Some kinds of fish, such as trout, salmon, tuna and mackerel, can provide some of the vitamin D you need each day.
Certain people may need extra vitamin D, such as older adults, people with dark skin, people with certain conditions that limit the absorption of fat, such as Crohn's disease, celiac disease and ulcerative colitis, and people who have obesity or have had gastric bypass surgery. If any of those describes you, raise vitamin D with your doctor as well, and mention any past weight-loss operation (see Had a sleeve or bypass? Bring the operation to any new weight care).
Do you need a calcium or vitamin D supplement?
Check with your doctor, or with another health care provider who knows your history, before you start calcium or vitamin D as a supplement: they can tell you whether you need a supplement and, if so, how much to take, and may want to do a calcium blood test first, or a vitamin D test, to see whether you are getting enough. Tell them which foods you have cut, and name any multivitamin or antacid you already take: calcium is also included in many multivitamins, and some over-the-counter antacids contain calcium carbonate. Any calcium or vitamin D in a supplement must be listed on its Supplement Facts label.
Calcium carbonate, one of the two main forms of calcium supplement, is absorbed best when taken with food, while calcium citrate is absorbed well on an empty stomach or a full one, and people with low levels of stomach acid absorb citrate more easily. Calcium supplements might cause gas, bloating and constipation in some people. If one does that to you, tell the doctor who suggested it; spreading the calcium out through the day, taking it with meals or switching to the other form are changes to ask them about.
Vitamin D supplements come in two forms, D2 and D3, and both increase vitamin D in your blood, though D3 might raise it higher and for longer than D2. Vitamin D is fat soluble, so you absorb it better when you take it with a meal or snack that includes some fat.
If NicoCares connected you with a physician for weight care, send your care team the same two things, the foods you have cut and any supplement you take or are considering, through Spruce, the secure app you use to message them.
