A diet built around non-diary high calcium foods provides not only necessary calcium but also a host of other vital vitamins, minerals and other healthy sources of nutrition and is low in calories.

Calcium Recommendation for Prevention of Osteoporosis for Children, Adolescents, and Adults
Source Instruction Total Calcium
Follow a high calcium diet Dairy + green leafy vegetables + beans + nuts 1200 – 1300 mg per day

No supplements needed. Include the foods from the non-dairy high calcium diet list in your regular diet because they are a great source of calcium and very healthy too. Ensuring good vitamin D3 nutrition is more important.

Calcium Recommendation for Adults with Osteoporosis 1250 mg/ Day
Source Instruction Amount Total Calcium
1) Calcium Citrate 250 mg to 315 mg Take one tablet twice daily 600 mg 1200 – 1300 mg per day
2) Follow a high calcium diet Dairy + green leafy vegetables + beans + nuts 650 mg

Supplements used only when the average total daily elemental calcium consumed is chronically less than 1,200 mg. The best supplement is calcium citrate with the reasons for this choice presented in the text. Only use as much supplement as you need to meet your daily goal of 1,200 mg of elemental calcium from all sources. Elemental calcium is the portion of the supplement molecule that is calcium, not the other part of the molecule.

Calcium is the 5th most common metal on Earth whose formation requires to nuclear fusion heat of star supernova. Pure calcium metal has a molecular weight of 20 on the periodic table.

Pure metal calcium

Pure metal calcium

 

Calcium is a necessary element for human health. It is used all over the body in a variety of roles. While most know that calcium is essential for bone, its metabolic role is more important and takes precedence over its skeletal function. Nature is economic in its use of resources. It uses skeletal calcium simultaneously in a structural role to support the body and make locomotion possible and where 99% of the body’s calcium is stored. Calcium’s critical metabolic functions include as a cofactor in nerve conduction, muscle contraction, and energy production. Life absolutely depends upon these functions. That is why they take precedence over simple skeletal structure and why the body will deplete the skeletal calcium to the last molecule to support these metabolic functions.

In 2016, the US FDA updated the Reference Daily Allowance for calcium to 1,300 mg. All nutrition authorities agree that the best source of calcium is food. There is plenty of disagreement too. Some are against dairy. Others warn about the evils of phytate in spinach that bind calcium in the gut. Despite being a common metal, calcium is rare in food. You can count on dairy products having about 1 mg of calcium per cc of milk or yogurt or 250 mg per cup. I recommend Greek yogurt to people because it is made with 5 probiotic cultures that are good for overall health. The accompanying table lists the non-dairy calcium rich foods along with their service size and calories per serving. I culled these from the nutrition tables and they are the best examples I could find.

The goal is to make it a habit of including these foods in your daily diet. You might be able to get the entire recommended daily allowance from your diet or most of it. To the extent you fall short, make up for it by using a supplement.

Calcium Citrate
The best calcium supplement is calcium citrate. The reasons for this are many. The first and foremost is it dissolves in the stomach and is in the ionized state needed for absorption before it enters the first part of the small intestine, the duodenum where most of the calcium is absorbed. This property is one of the reasons calcium citrate is absorbed 150% better than other calcium supplements.

Good Non-Dairy Sources of Dietary Calcium

Food Item

Quantity

Calcium Mg

Calories

Almond Milk unsweetened

1 cup

450

40

Sardines

3 oz

372

175

Soy milk unsweetened

1 cup

301

80

Collard Greens, cooked

1 cup

252

65

Oysters

1 cup

226

160

Wild Alaska Canned Salmon

3 oz

167

120

Kale

3 oz

150

50

Spinach, cooked

½ cup

146

30

Broccoli

1 cup

136

40

Soybeans, dry

1/3 cup

130

225

Ocean perch

3 oz

116

103

Cowpeas, dry

½ cup

105

80

Shrimp

3 oz

98

100

White beans, dry

1/3 cup

96

153

Okra

½ cup

88

26

Blue crab

3oz

86

84

Beet Greens

½ cup

82

19

Almonds

1 oz

75

165

Cabbage, cooked

1 cup

75

12

Tofu

4 oz

75

165

Turnip Greens, cooked

1 cup

75

30

Bok Choy

1 cup

74

9

Dandelion greens

½ cup

74

17

Rainbow trout

1.5 oz

73

144

 

Calcium citrate prevents kidney stones because most stones are caused by absorption of dietary oxalates that are found in certain foods. Since the calcium in calcium citrate is released from the citrate in the stomach, any excess calcium not absorbed is free to bind the oxalate in the gut forming an insoluble and unabsorbable complex preventing oxalate from gaining access to the kidneys. The released citric acid is absorbed and excreted in the urine. It inhibits kidney stone formation by interfering with the initial step in kidney stone formation, nucleation, where a tiny crystal forms in the kidney that becomes the center of the larger stone.

The calcium citrate molecule is twice as large as the calcium carbonate molecule. This means that a calcium citrate tablet containing 300 mg is about the same size as a calcium carbonate table with 600 mg. What is important to bear in mind is that most people cannot absorb more than 300 mg of calcium from a supplement or a meal at one time. It therefore makes no sense to consume more that 300 mg of calcium at any one time. Any amount over 300 mg will be malabsorbed.

Calcium Citrate

Calcium Citrate

Calcium Carbonate

Calcium Carbonate


Calcium Side Effects

Some people with a history of kidney stones are advised by their doctor not to take calcium or to follow a low calcium diet. This is usually poor advice. There are people who have a genetic disorder called renal hypercalciuria that leak calcium from the kidney that causes kidney stones. These people often have a family history of kidney stones because it is an inherited disease. They also commonly have osteoporosis, especially if the follow the advice of the doctor to avoid calcium, because they still excrete excess calcium in the urine and that loss is made up from the bone, which causes osteoporosis. The correct way to treat this problem is paradoxically with thiazide diuretic and modest doses of calcium citrate supplementation and to ensure adequate vitamin D nutrition.

It is common to hear patients complain that calcium causes constipation or upset stomach. Studies show that calcium carbonate (Caltrate®, Tums®, Oscal®) products cause gastric distress in about 1 in 10 users. These products all have about 600 mg of calcium in each tablet. Calcium in calcium carbonate requires stomach acid to be released from the carbonate. If not released in the stomach by acid, it is not released. Unabsorbed calcium is a cause for constipation.

Calcium indirectly leads to stimulation of acid secretion by the stomach cells. This acid can cause an upset stomach in some people, causing gastritis.

Calcium Supplements and Heart Attack and Stroke Risk
Long-term osteoporosis studies have shown a link between use of calcium supplements and heart attack and stroke. All sources of calcium supplements are implicated. The link has been confirmed and is now better understood to affect people with chronic kidney disease class III, IV, or V. This is defined as a loss of about 50% or more of the normal amounts of kidney function people have at birth. At this point, which the majority of people reach by simple aging alone is where calcium in excess of needs can be absorbed but not excreted. People with cardiovascular disease evidenced by high blood pressure, high cholesterol, angina, history of heart attack or stroke commonly have widespread arterial cholesterol plaque that is inflamed. As the plaque matures, if it doesn’t acutely rupture causing a heart attack or stroke then it will progress to form a scar. The final step is calcification of the scar. If the scar is large, it can lead to obstruction of the artery causing unstable angina, heart attacks, TIAs, or strokes. The source of this calcium that hardens the scar is the calcium supplement the patient has been taking in excess of their needs. The studies that identified this problem discovered that it only occurred in women whose supplement dose was greater than 800 mg daily.

Proton Pump Inhibitors and Histamine Blockers Effect on Risk for Osteoporosis and Calcium Absorption
Medications prescribed and available over the counter for gastritis and gastroesphegeal reflux disease have been linked with osteoporosis. These drugs include Prilosec, Nexium, Protonix, Pepsid, and Zantac among many others. The reason they contribute to osteoporosis relates to the fact that these drugs decrease or eliminate stomach acid production. When there is no natural stomach acid produced, calcium in food and supplements except for calcium citrate are not ionized properly for optimal absorption in the first part of the small intestine. If the calcium is not in the correct state of ionization when it passes through the duodenum, it is malabsorbed and lost in the stool. This loss of dietary calcium as a source of serum calcium for metabolic needs results in the body resorts to withdrawing the needed calcium from the calcium stored in the skeleton. If prolonged, osteoporosis is promoted.

Calcium citrate does not require stomach acid to dissolve and release its calcium in a readily absorbable form in the stomach. People who use these products for gastritis and GERD and need a calcium supplement can solve this problem by using calcium citrate.

15% of seniors’ Stomach Stop Making Acid Due to Achlorhydria
Loss of the ability to make stomach acid occurs in about 1 in 7 older adults, the same people who commonly suffer from osteoporosis. There are many reasons for this with one of the most common taking one of the medications mentioned above for excess stomach acid or esophageal reflux. There are lots of other reasons too including infection with H. Pylori, being deficient in niacin or magnesium, having an autoimmune disease called pernicious anemia where the immune system attacks the parietal cells in the stomach that make acid and also intrinsic factor needed for B12 absorption. These are some of the reasons, there are more. If you have achlorhydria it is important to know about it, find out why and treat the cause if possible because those causes are associated with other problems. Calcium citrate is once again the go to calcium supplement for people with achlorhydria. The reason is the same. It dissolves in the stomach and the calcium dissociates from the citrate without need of acid in an ionic state ready for absorption in the 1st part of the small intestine.

Calcium Citrate Tablets are Too Big
This is a real problem for some people. CC is soluble is water. If you are someone who drinks bottled water all the time, place one calcium citrate tablet in the bottle and in a couple of minutes it will break down into a pile of white powder at the bottom of the bottle. Shake the bottle to suspend the calcium in the water and drink it. The dilute calcium citrate has no taste good or bad. Remember to shake the bottles to suspend the calcium in the water or it will remain in the bottom of the bottle.

A second idea is to pulverize the brittle calcium citrate caplets in a standard coffee bean grinder. Clean the grinder with alcohol to remove the coffee oils from the metal grinder surface first. Place a caplet in the grinder and depress the button a few times. Open the top and pour out the powder on a napkin. Get a feel what one caplet looks like pulverized. Moisten your finger and dip it in the powder then taste it. Nothing. No taste to speak of. Grind up the bottle of calcium citrate. Its fine if there are extra vitamins and minerals in the calcium citrate, they are not a problem. You can grind several at a time in seconds. Store them in a Tupper ware type container. At the hardware store, purchase the large aluminum BBQ style salt and pepper shakers. Fill each ½ full with the calcium citrate powder and place the strategically near where you take your meals. Salt your food with the calcium citrate liberally. Salt everything with it. Experiment with it and you will see that it dissolves as soon as it meets any wet food. It does not have its own taste, rather it takes up the taste of whatever it comes into contact with. It is not gritty or unpleasant in any way. Use it on salad, in soups, on vegetables, meats, on desert literally anything wet. Make this a habit and you will surely get all the calcium you need every day.