Bone health: The role of calcium and vitamin D

Girl drinking milk 

T​he foods we eat have important minerals and vitamins that help build strong and healthy bones. Calcium and vitamin D are two important nutrients for bone health.

Calcium

Almost all the calcium in the body is found in the bones and teeth. Calcium is also found in the blood, where it helps the heart, muscles and nerves to work properly.

The bones are like a bank - they build up deposits of calcium from the foods that we eat and drink or from calcium supplements. They also 'give' calcium to the rest of the body by allowing it to enter the bloodstream.

If you do not eat enough calcium, your body cannot replace the calcium that the bones lose quickly enough. Soon, the bone bank becomes empty and bones get weaker.

How much calcium does a person need?

The amount of calcium that a person needs is based on their age, as you can see in the table below.

Age​

Amount of elemental calcium every day

0-6 months

210 mg

​7-12 months ​ 270 mg

1-3 years

700 mg

4-8 years

1000 mg

​ 9-18 years  1300 mg
​ 19+ years ​ 1000 - 1200 mg

Food sources of calcium

You can use the calcium-rich foods listed in the tables below to reach the recommended daily intake of calcium for you and your family.

Excellent choices: Foods with 240 to 350+ mg of calcium per serving

Food​​​

Serving

Calcium (mg)

Milk (whole, 2%, 1%, skim), chocolate milk or lactose-free milk

1 cup (250 mL)

300

​ Cheddar cheese ​ 1 1/2 oz (50 g) (size  of thumb) ​ 300

Calcium-fortified drinks (soy or rice milk, orange juice)

1 c​up (250 mL)

300

Soybeans, cooked (sometimes called edamame)

2 cups (500 mL)

350

​ Tofu, firm, made with calcium  ​1/2 cup (100 g) ​ 250
​ Sardines ​ 4 medium (3 oz or  92 g) ​ 250​
 Soybeans, roasted ​ 1 cup (250 mL) ​240


Very good choices: Foods with 100 to 200 mg of calcium per serving

Food Serving
​Calcium (mg)

Yogurt

 170 g (1 container) 200

Yogurt drink

 200 mL (1 serving) 200

Salmon, canned with bones

 3 oz (85 g) 190
​ Blackstrap molasses ​ 1 Tbsp (15 mL) ​170
​ Cream soups, such as cream of mushroom, broccoli or  chicken,  prepared wtih milk ​ 1 cup (250 mL) ​170
​ Processed cheese slices ​ 2 slices ​ 150 to 200
​ Mozarella, Colby or marble cheeses ​ 1 oz (28 g) ​ 150
​ Hazelnuts, Brazil nuts ​ 1/2 cup (125 mL) ​ 110

Pudding, chocolate or vanilla

1/2 cup (99 g)

105 to 120

Almonds

1/4 cup (60 mL)

100

Cereal fortified with calcium

3/4 cup (175 mL)

100

Frozen yogurt, plain soft serve

1/2 cup (125 mL)

100

Good choices: Foods with up to 100 mg of calcium per serving

Food

Serving

Calcium (mg)

​ Kale, cooked ​​ 1 cup (250 mL) ​ 90
​ ​Broccoli, cooked ​ 1 cup (250 mL) ​ 80

Ice cream

1/2 cup (125 mL)

85

Figs, dried

3 figs

80

​ Almond butter (100% crushed almonds only) ​ 2 1/2 Tbsp (35  mL) ​ 80
​ Tahini (sesame seed butter) ​ 1 Tbsp (15 mL) ​ 60
​ Tortilla chips ​ 12 chips ​ 60

Orange

1 medium

55

Parmesan cheese

1 Tbsp (15 mL)

55

Pancakes or waffles, frozen

2

40

Corn tortilla

1, 6-inch (25 g)

40

Molasses, regular

1 Tbsp (15 mL)

40

Cream cheese

1 Tbsp (15 mL)

20

Helpful hint: Look at the serving sizes on food labels to find out how much calcium you are eating.

Other ways to add calcium to your family's diet

  • Use milk instead of water when making soup or oatmeal.
  • Make "smoothies" using yogurt, fruit and milk.
  • Offer yogurt for a dessert or snack.
  • Serve your child calcium-rich snacks, such as cheese cubes, yogurt, tortillas, almonds or cereal with milk.
  • Add shredded cheese to tortillas, soup and stews.

Calcium supplements

If your child cannot eat or drink all of the calcium they need in a day, they may need to take calcium supplements. These can be in a liquid, a pill or capsule, a chewable tablet, a gummy or a dissolving tablet. Talk to your child's doctor, dietitian or pharmacist before starting your child on any supplements and tell them if your child is taking any other medication.

Tips for taking supplements

  • Read the label of the supplement to find out how much elemental calcium each serving contains. Watch for the weight in mg of elemental calcium, not the weight of the tablet itself.
  • Do not give your child any more than 500 mg of elemental calcium at one time.
  • Give calcium supplements with food. They are best absorbed on a full stomach.
  • Do not give calcium supplements at the same time as other medicine. The calcium may make other medications less effective. For example, calcium can make it harder for the body to absorb iron and antibiotics.

Vitamin D 

Like calcium, vitamin D is very important for growing bones. Calcium needs vitamin D to help it move from the stomach to the bloodstream and from the bloodstream into the bones.

The amount of vitamin D that a person needs is based on their age and bone health, as you can see in this table.

Age​

International Units (IU) of vitamin D every day for children with normal bone​ health​

International Units (IU) of vitamin D every day for children with poor bone health

0-1 years

400 IU

400 IU

​ 1-3 years ​ 600 IU ​ 600-1000 IU

4-8 years

600 IU

1000-2000 IU

9-18 years

600-1000 IU

1000-2000 IU

​ 19+ years  ​600-1000 IU ​ 1000-2000 IU

Sources of vitamin D

You can get vitamin D in three ways:

  • exposing the skin to direct sunlight
  • eating foods that are rich in vitamin D
  • taking a vitamin D supplement.

Sunlight

Your body can make vitamin D naturally from being exposed to 10 to 15 minutes of sunshine two or three times a week without sunscreen. However, most of us cannot make enough vitamin D naturally year round. It is harder to make enough vitamin D if:

  • a person's skin is not exposed to the sun for long enough, for example if they work indoors or wear long robes or head coverings
  • a person lives in a northern community- northern parts of Canada experience long periods with little sunshine in the winter months
  • a person has dark skin - the higher level of melanin in the skin interferes with the body's ability to make vitamin D.

Many people need to take vitamin D through their diet or from supplements to prevent a vitamin D deficiency.​

Foods sources of vitamin D

The foods listed in this table are excellent sources of vitamin D.

Food​​

Serving

Vitamin D (IU)

Salmon, canned, pink, with bones

1/2 cup (125 mL)

370

Sardines 

1/2 cup (125 mL)

200

​ Tuna, canned, light ​ 1/2 cup (125 mL) ​ 140

Milk

1 cup (250 mL)

100

Orange juice fortified with vitamin D (such as Minute Maid)

1 cup (250 mL)

100

Fortified soy or rice beverage (such as Silk or So Good)

1 cup  (250 mL)

100

Fortified margarine

2 tsp (10 mL)

60

Egg (yolk)

20

Vitamin D supplements

Unfortunately, not many foods are rich in vitamin D. As a result, many people may need a vitamin D supplement to get enough vitamin D every day. Supplements come in tablets or drops. Ask your pharmacist for help when you buy them.

If your child finds it hard to remember to take their vitamin D every day, they can take a whole week's worth of vitamin D on just one day and repeat that every week. For example, if your child usually takes 1000 IU of vitamin D a day, you may give them 7000 IU of vitamin D on one day of the week and repeat it on the same day the next week.

Remember, this approach does not work for all vitamins and minerals. Most of them need to be taken in much smaller doses. In fact, some vitamins and minerals can be very harmful if someone takes too much at one time. Always ask your doctor or pharmacist before you group daily doses of any vitamins or minerals together.

Key points

  • ​Calcium and vitamin D are two important nutrients for bone health. 
  • Good sources of calcium include milk, cheese, soybeans, tofu, sardines, salmon, blackstrap molasses, almonds, sesame seeds, brocolli and kale. 
  • Sources of vitamin D include sunlight and foods such as sardines, salmon, tuna, milk and fortified orange juice.
  • Many people need to take a supplement to make sure they get enough vitamin D every day.
Esther Assor​, RD
Anne Murphy, RN

12/18/2013




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