Osteoporosis

Q. What is my daily Calcium and Vitamin D requirement if I have osteoporosis? Is there a risk of taking too much?

A. If you were diagnosed with OP, your daily calcium requirements range between 1200-1500 mg. You should only consume 500 mg of calcium from your diet or elemental calcium from your supplement at one time, as your body is only able to absorb this amount. If you are taking calcium supplements, ensure that you are not taking them along with calcium-rich foods. You would also need to take between 400-800 International Units (IU) of vitamin D, to help with better absorption of calcium.

To avoid calcium and vitamin D toxicity, it is recommended to keep your dietary intake and supplementation below the Upper Limit (UL). The UL of calcium is 2500 mg per day; intakes of the mineral above this level may pose health risks. The UL for vitamin D is 2000 IU per day.

Your health care team will provide you with more precise calcium and vitamin D requirements. Do not be concerned about the amount you are getting from diet, as the risk of toxicity rarely occurs from diet. Excessive intake of supplements may pose danger; make sure to talk to your doctor or dietitian about daily requirements.

Q. Can I get enough Calcium and Vitamin D from my diet or should I take a supplement?

A. More than 50% of Canadians do not consume enough calcium from their diet. This might be due to low dairy product intake. A dietitian can review your dietary habits and figure out the amount of calcium you are getting from your diet. If you find it difficult to obtain the recommended amounts of calcium through diet alone, a combination of foods rich in calcium and calcium supplements is a good strategy.

Q. What are some Calcium-rich foods?

A. Click to check out our brochure on calcium-rich foods

Q.  What are some Vitamin D rich foods?

A. Foods such as vitamin D fortified milk, margarine, eggs, chicken liver, fresh or canned fish (such as salmon, sardines, herring, mackerel) and fish oils all contain small amounts of vitamin D. Exposure to sunlight also contributes to production of vitamin D in our bodies.

Since it may be difficult to obtain enough vitamin D from foods alone, you may wish to consider supplementation. If you are taking a calcium supplement, check whether there is any vitamin D in it as well. Also, keep in mind that if you are taking multi-vitamins on a daily basis, most contribute approximately 400 IU vitamin D per pill.

Q. I am lactose intolerant. What are some lactose free foods that are high in calcium?

A. Fortunately, there are many alternative sources of calcium-rich foods for you if you are lactose intolerant. Calcium fortified soy, almond or rice beverages provide the same amount of calcium as cow’s milk and are lactose free.  There is also lactose free cow's milk (i.e. Lactaid) or you can take lactase enzymes when you drink regular milk or eat dairy products that contain lactose. Some people are able to tolerate hard cheeses which have a lower amount of lactose than milk and there are also lactose free cheeses on the market. 

Q. I do not like dairy products. Are there any alternative foods and beverages that are rich in Calcium?

A. Calcium fortified fruit juices are a great substitution for dairy products in that they contain as much calcium as milk. Make sure that you read the labels of the products you are consuming for calcium content. Canned salmon or sardines, soy products such as tofu, soybeans and soy nuts, and green leafy vegetables also provide an excellent source of calcium. Snacking on almonds, hazelnuts or foods containing sesame seeds will also boost your calcium intake. Incorporating beans, broccoli or brussel sprouts into your diet more frequently will increase your daily calcium intake.

Q. There are so many calcium supplements on the market. Which one should I choose and when should I take my supplements?

A. The two main sources of calcium include calcium carbonate and chelated calcium (calcium citrate, calcium gluconate or calcium lactate). To calculate your true daily intake of calcium from supplements look at how much elemental calcium can be found in a tablet. 

You should only consume 500 mg of calcium from your diet or elemental calcium from your supplement at one time, as your body is only able to absorb this amount. If you are taking calcium supplements, ensure that you are not taking them along with calcium-rich foods.

Also, the timing of taking supplements is important. If you are taking calcium carbonate, ensure that you take it with meals. In order to absorb calcium carbonate stomach acid production is required. Calcium citrate/lactate/gluconate supplements can be taken at any time of the day, but not with high-calcium meals or snacks.