When most of us think of foods high in calcium, dairy products come to mind. But for those who are lactose-intolerant, vegan, or just don’t like dairy, what are your alternatives? There are many non-dairy sources of calcium to choose from to make sure you are getting enough of this vital nutrient. And you likely don’t need to take a supplement; too much calcium can do more harm than good.
Non-Dairy Diets and Calcium Intake
Calcium is one of the many nutrients necessary to promoting bone health. While dairy is not necessary for adequate nutrition, there is some evidence that vegetarianism and veganism can lead to lower intakes of calcium, along with vitamin D and vitamin B-12, both of which are also important for bone health.[1]
Some studies have shown that vegan diets, which do not include dairy, may increase the risk of bone fractures; however, fracture rates are no higher in vegetarians and vegans who have adequate calcium intake (and adequate protein intake) in their diet.[1] Clearly, diets that do not include dairy can include enough calcium to keep your bones healthy. The trick is to be aware of non-dairy sources of calcium that are absorbed well by the body.
Factors That Affect Calcium Absorption
Not all sources of calcium are absorbed well. Vitamin D is vital to bone health, mainly because it helps calcium to be better absorbed. For this reason, vitamin D intake is also important when trying to get enough calcium. 8 percent of vegans show low concentrations of calcium (enough to increase the risk of bone-related disease) in the winter, when vitamin D levels are lower. Calcium concentration tends to rise in the summer as vitamin D levels also rise.[1]
Other compounds in certain foods can affect the absorption of calcium, such as oxalic and phytic acid. Foods high in calcium that also contain a lot of these compounds, like spinach, rhubarb, and beet greens, are not good sources of calcium; the absorption of calcium from these foods can be as low as 5 percent. On the other hand, broccoli and bok choy, which have low oxalic and phytic acid content, have absorptions of greater than 50 percent.[1]
Foods High in Calcium
In order to get enough calcium from your non-dairy diet, it is important to choose calcium-rich foods that are easily absorbed. There are a number of plant-based foods to choose from, including many green leafy vegetables like broccoli, bok choy, Chinese cabbage, and kale. In fact, 1 cup of bok choy or 1-1/2 cups of kale can give you about the same amount of absorbable calcium as 1 cup of cow’s milk.[1] Almonds, white beans, and canned salmon or sardines (with the bones) are also great sources. Some foods like tofu, orange juice, and soy milk are often fortified with calcium to provide adequate amounts.
You also need to watch your vitamin D levels, as calcium is not much good without it. Plant-based sources of vitamin D include many types of mushrooms, like chanterelle and portabella.[1] A vitamin D supplement might also help if you have a vitamin D deficiency.
Calcium Supplementation – Helpful or Hurtful?
You may have considered taking a supplement to make sure you are getting enough calcium on a non-dairy diet. While older women who are at high risk for fractures might benefit by a calcium supplement, studies show that most people do not need a calcium supplement, and probably shouldn’t take one. Calcium supplementation can cause side effects like constipation and digestive issues, but there are far more serious risks to take into account.[2]
Cardiovascular disease and stroke are of the biggest concern. Large meta-analyses have shown that calcium supplements (that also contain vitamin D) increase the risk of myocardial infarction by 24 percent to 31 percent, and stoke by 15 percent to 19 percent.[2] In most cases, the benefits of taking a calcium supplement rarely outweigh the risks. One study estimates that if 1,000 people were to supplement with calcium/vitamin D for five years, only three fractures would be prevented, while six people would have a heart attack caused by the supplement.[2]
Luckily, the increased cardiovascular risk does not appear to relate to dietary calcium intake as well, only supplementation.[2] Researchers suggest that a diet with adequate calcium, vitamin D, protein, and vitamin B-12, with a lot of fruits and vegetables, can support proper bone health, whether or not it contains dairy.[1] Just be sure to make foods like kale, bok choy, and even sardines a more regular part of your diet.
References
[1] Am J Clin Nutr. 2014 Jun 4;100(Supplement 1):469S-475S. [Epub ahead of print]
[2] Ther Adv Drug Saf. 2013 Oct;4(5):199-210.
Contributing editor Chelsea Clark is a writer with a passion for science, human biology, and natural health. She holds a bachelor’s degree in molecular and cellular biology with an emphasis in neuroscience from the University of Puget Sound in Tacoma, WA. Her research on the relationship between chronic headache pain and daily stress levels has been presented at various regional, national, and international conferences. Chelsea’s interest in natural health has been fueled by her own personal experience with chronic medical issues. Her many profound experiences with natural health practitioners and remedies have motivated Chelsea to contribute to the world of natural health as a researcher and writer for Natural Health Advisory Institute.
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