Thursday, October 2, 2014
By Margaret Polaneczky, MD
How much extra calcium should I be taking?”
It’s a question I get several times a day from women of all ages, but mostly from those in menopause or nearing menopause.
The answer I almost always give is “less than you think.” And for most women, probably none.
It’s not that I don’t think calcium is important.
It is. Adequate calcium and vitamin D are critical for building and maintaining a healthy bone mass.
But most women, with the exception of those who can’t tolerate dairy, are already getting a significant amount of calcium in their diet. So much so that taking calcium supplements adds little to their overall health.
In fact, the U.S. Preventive Services Task Force recently recommended against routine calcium and vitamin D supplements for healthy postmenopausal women.
What harm can a little extra calcium do me?
More than you might think. Too much calcium can lead to:
- Kidney stones
- Constipation (If constipation is a problem for you, try taking calcium with magnesium)
- Trouble absorbing iron and zinc
You may also have heard that taking calcium supplements can lead to heart disease. It’s still an open question. Some studies suggest up to a 20% increase in heart disease in men and women who take calcium supplements, but other studies do not find this risk, or find it only in men and not women.
My Recommendation
Unless you’re at increased risk for a fracture (you can calculate your fracture risk here), forgo the supplements and get your calcium from food and drinks. If you don’t eat dairy, look to non-dairy calcium sources. If you can’t get your entire recommended daily allowance (RDA) of it from food, only take as much calcium supplementation as you need to make up the difference between dietary sources and the RDA for your age group.
Food | Milligrams (mg) calcium per serving |
Yogurt, plain, low fat, 8 ounces | 415 |
Mozzarella, part skim, 1.5 ounces | 333 |
Sardines, canned in oil, with bones, 3 ounces | 325 |
Yogurt, fruit, low fat, 8 ounces | 313–384 |
Cheddar cheese, 1.5 ounces | 307 |
Milk, nonfat, 8 ounces** | 299 |
Soymilk, calcium-fortified, 8 ounces | 299 |
Milk, reduced-fat (2% milk fat), 8 ounces | 293 |
Milk, buttermilk, lowfat, 8 ounces | 284 |
Milk, whole (3.25% milk fat), 8 ounces | 276 |
Orange juice, calcium-fortified, 6 ounces | 261 |
Tofu, firm, made with calcium sulfate, ½ cup*** | 253 |
Salmon, pink, canned, solids with bone, 3 ounces | 181 |
Cottage cheese, 1% milk fat, 1 cup | 138 |
Tofu, soft, made with calcium sulfate, ½ cup*** | 138 |
Ready-to-eat cereal, calcium-fortified, 1 cup | 100–1,000 |
Frozen yogurt, vanilla, soft serve, ½ cup | 103 |
Turnip greens, fresh, boiled, ½ cup | 99 |
Kale, raw, chopped, 1 cup | 100 |
Kale, fresh, cooked, 1 cup | 94 |
Ice cream, vanilla, ½ cup | 84 |
Chinese cabbage, bok choi, raw, shredded, 1 cup | 74 |
Bread, white, 1 slice | 73 |
Pudding, chocolate, ready to eat, refrigerated, 4 ounces | 55 |
Tortilla, corn, ready-to-bake/fry, one 6″ diameter | 46 |
Tortilla, flour, ready-to-bake/fry, one 6″ diameter | 32 |
Sour cream, reduced fat, cultured, 2 tablespoons | 31 |
Bread, whole-wheat, 1 slice | 30 |
Broccoli, raw, ½ cup | 21 |
Cheese, cream, regular, 1 tablespoon |
Cheese, cream, regular, 1 tablespoon | 14 |
Chart from NIH Dietary Fact Sheet on Calcium
Additional Reading
- NIH Dietary Supplement Fact Sheet on Calcium
- National Osteoporosis Foundation – Calcium and Vitamin D: What You Need to Know
- NY Times Well Blog – Thinking Twice About Calcium Supplements
- Calcium Confusion from the WHI – TBTAM