Calcium is necessary for bones to stay strong, and every cell in the body needs calcium to work properly. Maintaining an adequate calcium intake (1000-1200 mg daily) is an important step towards good bone health throughout life. Luckily, there are many foods that contain calcium.

Most people know dairy foods contain calcium but are unaware that low-fat and fat-free milk, yogurt and cheese actually have more calcium per serving than the regular versions. But did you know a cup of frozen broccoli has 94 mg of calcium? Or that 10 dried figs 270 mg? Dry roasted almonds pack 75 mg into each ounce.
Many foods are made with added calcium. Look for calcium-fortified orange juice, cereals, breads and other foods.

  Many people consume all the calcium they need from their diet, but others rely on a combination of calcium-rich foods and calcium supplements or on supplements alone to meet their daily needs. There are many supplements from which to choose, allowing each person to find the one that is easiest for her/him to use. Calcium supplements are available as pills, capsules, chewable tablets, chewable candies, powders and tablets that dissolve in water.

In nature, calcium is found only in combination with another substance, such as carbonate, citrate or gluconate. These combinations, or compounds, form calcium “salts” that vary in the amount of actual (elemental) calcium they contain. For example, calcium carbonate is 40 percent elemental calcium and calcium citrate contains 20 percent elemental calcium.

If a tablet contains 1250 mg of calcium carbonate, it contains 500 mg of elemental calcium (40 percent of 1250 = 500 mg).

An easier way to figure out how much calcium each preparation contains is to look at the label and find the heading titled, “percent daily value.” If the percent daily value is 20, add a ‘0’ to the 20. Taking the recommended number of tablets will provide 200 mg of elemental calcium.

If the percent daily value is 40, add a ‘0’ to the 40. The recommended number of tablets will provide 400 mg of elemental calcium.

If the percent daily value is 50, add a ‘0’ to the 50. The recommended number of tablets will provide 500 mg of elemental calcium.

Suggestions for choosing a supplement that is right for you:

1. Determine your daily calcium intake from foods.
2. If calcium intake is around 1200 mg a day, keep up the good work. If additional calcium is needed from a supplement, determine which supplement provides closest to the amount needed. (One that provides 200 mg, 400 mg, or 500 mg per pill)
3. Decide the form of calcium that will be easiest for you to take.
4. You now know how much calcium you need and the form you would prefer. Choose a recognized brand name or check with the pharmacist in a local store.
5. Calcium is easier to absorb when it is consumed in small doses throughout the day. Think about dividing your calcium intake between breakfast and dinner or bedtime. Most calcium supplements, with the exception of calcium citrates, are better absorbed if taken with food.
6. Remember, calcium alone does not protect your bones. Vitamin D (400-800 IU/day) is necessary for calcium absorption, but the vitamin D does not have to be included with the calcium. Many people take a daily multivitamin that provides 400 IU of vitamin D. Other sources of vitamin D include fortified foods, fatty fish and skin production with sun exposure. Exercise also plays an important role in lifelong bone health.

Vitamin D plays a major role in calcium absorption and bone health. The relationship between calcium absorption and vitamin D is similar to that of a locked door and a key. Vitamin D is the key that unlocks the door and allows calcium to leave the intestine and enter the bloodstream. Vitamin D also works in the kidneys to help resorb calcium that otherwise would be excreted.

Vitamin D is manufactured in the skin following direct exposure to sunlight. The amount of vitamin D produced in the skin varies depending on time of day, season, latitude and skin pigmentation. Use of sunscreen markedly diminishes the manufacture of vitamin D in the skin, as do window glass, clothing and air pollution. Skin color also affects vitamin D production; the fairer you are, the more you make.

As adults age, the ability to make vitamin D through the skin decreases. People who are housebound and experience no sunlight exposure are unable to make vitamin D.

The major food sources of vitamin D are vitamin D-fortified dairy products, egg yolks, saltwater fish and liver. Some calcium supplements and most multivitamins contain vitamin D, so it is important to check the labels to determine how much each contains.

Experts recommend a daily intake of between 1000 to 2000 mg. Do not take more than 2000 mg per day unless your doctor prescribes it, since massive doses of vitamin D may be harmful.

(The information on this page was taken from the National Osteoporosis Foundation website--a wonderful resource for osteoporosis information.)