The Importance of Calcium and Vitamin D for Bone Strength
Betty Chaffee, PharmD, is owner and sole proprietor of BetterMyMeds, a Medication Management service devoted to helping people get the maximum benefit from their medications.
Calcium and vitamin D are essential for maintaining bone strength. From children all the way on up to the elderly, these vitamins and minerals are important for health. But I've found that there's a fair amount of misunderstanding about just HOW important they are. You'll find more detail about calcium and vitamin D in some of my previous posts, but here's a brief refresher.
We tend to focus on the need for calcium and vitamin D after menopause for women, and after about age 70 for men. But the fact is that getting enough of them early in life is just as important. Research shows that bones that are as strong as possible by age 30 are less likely to become weak in old age. So paying attention to calcium and vitamin D intake, as well as weight-bearing exercise, is essential to overall health at all ages. And if we start thinking about it when we're young, it won't be as hard to maintain that focus as we get older.
Here are the recommendations for the vitamin D and calcium requirements for children and teenagers, as well as adults of all ages. For anyone in their formative years, starting to think about this now will keep you healthier as you age. But what about those of us who are well past the formative years?
What can we do NOW to maintain bone strength?
The great majority who read the BetterMyMeds blog are middle-aged and older adults. So for us, there's nothing we can do about what happened before we were 30. We have to make the most of what we have now. Here's how:
Watch your diet for a week or 10 days. Look at nutrition labels carefully and do your best to estimate the amount of calcium you typically eat on a daily basis. If you usually eat less than 1000mg of calcium daily (1200mg if you're a woman post-menopause or a man over 70) you'll want to begin taking a calcium supplement to make up the difference. It doesn't have to be exactly 1000-1200mg; getting close to that on average is fine. Your body can only absorb about 500-600mg at a time, so if you need more than that it'll be best to take it in divided doses during the day.
Typically there are few side effects from calcium, constipation being the most common. If that happens to you, talk to your pharmacist about the best ways to combat it.
We can't count on the sun so much as we get older, because our skin isn't as good at taking in the sunlight needed to make vitamin D. And if, like me, you live in a place that's too cold to go outdoors in a t-shirt and shorts in the winter, it'll be best for you to to get used to taking a supplement. The recommended dietary allowance (RDA) is 600 units (15 mcg) per day for adults up to age 70, and 800 units (20 mcg) per day for adults over 70.
You can get calcium and vitamin D in the same product if it's easier to take that way. It may be less expensive, too, depending on the product you choose. Vitamin D doses up to 2000 units (50 mcg) daily and even higher seem to be quite safe, so don't be concerned if you can't find a product that gives you the exact dose you're looking for. Talk to your pharmacist if you're having trouble finding a product that works for you.
A note on vitamin D deficiency: If your doctor has told you in the past that your vitamin D levels were low, you probably needed higher doses of vitamin D for several weeks to bring the level up. But typically, once your vitamin D stores are replenished, you don't need to continue taking doses that are significantly higher than the RDA. If you're in this situation and you're not sure what dose to take, talk with your doctor or pharmacist.
Weight-bearing exercise is great at improving overall health. One way it does this is to keep your bones from losing calcium so they maintain their strength.
Find some weight-bearing exercise you can enjoy (or at least tolerate!) and work it into your regular schedule.
Stay healthy and keep your bones strong.
Make sure you get the right amount of calcium between your diet and supplements. Take around 600-1000 units (15-25mcg) of vitamin D every day, even if you go outside in the sun. And start or continue your regular weight-bearing exercise.
If you have any questions about how this affects you, we'd love to hear from you. Add your comments or questions in the space below, or contact us directly at BetterMyMeds. Our goal is to help you improve your health by getting the best value from your medications and supplements!
I have been looking into the benefits of cacao powder and capsules(can be pricey).. I was wondering about your thoughts?.
Great question Judy, and I’m going to start my answer with more questions! Are you considering using it as a substitute for Cocoa powder in tasty recipes, or using it exclusively as a dietary supplement? And what health benefits are you hoping to get from it?
Thanks for the great article on Bone Health, Betty! I have 2 questions for you: do you have any suggestions that might help a person better absorb calcium, vitamin D, and other minerals for bone health? Do you know anything about “anti-nutrients”, such as phytic acid, and the negative effect it has on the absorption of minerals? I had never heard about this until recently and would love your perspective.
Thanks for bringing that subject up Lisa! Honestly, I’d never heard of anti-nutrients either until you asked. I did a little investigating and found that, in general, antinutrients are compounds found in plants that can decrease absorption of some nutrients in our diet. By how much is a question that doesn’t seem to have been answered well. Here’s a link to an easy-to-read article about antinutrients if you’re interested: https://www.hsph.harvard.edu/nutritionsource/anti-nutrients/
We already know that calcium isn’t completely absorbed, especially when eaten (or taken) in large amounts. But daily nutrient requirements take into account whether they’re fully absorbed or not. So for calcium, the experts believe that if we take in 1000-1200mg daily, we’ll absorb enough to keep our bones as strong as possible.
My take on this interesting subject is that while antinutrients are real, it’s not clear that they make a significant difference in our overall nutrition. If you’re like me and you want to keep things simple, making sure you eat a variety of foods to maintain a balanced diet, and taking the recommended amount of calcium and vitamin D (as well as continuing to stay active!) is likely to be more important than getting too concerned about antinutrients.
Thanks for the comment!