“Food first” is always a good approach to meeting nutrient needs. That’s especially true for calcium because the plant foods that provide this nutrient are also rich in other compounds that keep bones strong.
For example, leafy greens provide vitamin K, fortified orange juice has lots of potassium and calcium-set tofu is rich in the protein that is so important for bone health. Also, since plant foods contain thousands of phytochemicals, some with demonstrated health-promoting effects, there is just no way you can duplicate their benefits with a pill.
But meeting calcium needs is important for all women. For most of our lives, the body is either building bone or losing it. Getting enough calcium in your younger years will maximize bone density. Later on, it can help to replace what is being lost as estrogen levels decline. If your diet doesn’t provide enough—1000 milligram up to the age of 50 and then 1200 milligrams after that—it’s smart to make up the difference with a supplement.
Are these supplements safe, though? That’s a question that has been in the news quite a bit over the past several years. One theory is that supplements cause blood levels of calcium to spike, which might promote calcification of the arteries and atherosclerosis. A 2010 study raised concerns when it found that calcium supplements were linked to an increased risk for heart disease.(1)
In contrast, calcium supplements were linked to better bone health with no increase in heart disease risk in the Women’s Health Initiative.(2) In other research, they raised risk in men, but not women.(3) Finally, in the Iowa Women’s Health Study, calcium supplements were linked to a slightly lower risk for heart disease in women.(4)
The most important research on this issue however, is one that followed nearly 1300 men and women who were part of the Framingham study. The researchers directly measured calcification of the arteries and compared it to supplement intake. There was no relationship among people taking as much as 500 milligrams of calcium per day.(5)
The current evidence suggests that lower-dose supplements are safe and beneficial for those who are not getting enough calcium in their diets. And, since we vegans are already at lower risk for heart disease, it’s probably not something we need to worry about.
Here are my recommendations for meeting calcium needs:
- Aim to meet the RDA for calcium
- Get as much of your calcium as possible from food
- Make up the difference with a supplement if you need to. If you need more than 300 milligrams from supplements, try to take a couple of lower-dose tablets at different times during the day.
- Bolland MJ, Avenell A, Baron JA, et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. Bmj 2010;341:c3691.
- Prentice RL, Pettinger MB, Jackson RD, et al. Health risks and benefits from calcium and vitamin D supplementation: Women’s Health Initiative clinical trial and cohort study. Osteoporos Int 2013;24:567-80.
- Xiao Q, Murphy RA, Houston DK, Harris TB, Chow WH, Park Y. Dietary and Supplemental Calcium Intake and Cardiovascular Disease Mortality: The National Institutes of Health-AARP Diet and Health Study. JAMA Intern Med 2013;173:639-46.
- Mursu J, Robien K, Harnack LJ, Park K, Jacobs DR, Jr. Dietary supplements and mortality rate in older women: the Iowa Women’s Health Study. Arch Intern Med 2011;171:1625-33.
- Samelson EJ, Booth SL, Fox CS, et al. Calcium intake is not associated with increased coronary artery calcification: the Framingham Study. Am J Clin Nutr 2012;96:1274-80