Editor’s note: This post is brought to you by Creamy Bites.

As RDNs, we know that the benefits of calcium are many. This becomes so obvious to us that we sometimes neglect to remind patients that calcium cannot act alone. We teach patients that it is good to eat a variety of calcium-containing foods, from both plant and animal sources, but they must keep in mind that bioavailability differs between the two. Fundamentally, plant foods are rich in nutrients (potassium, magnesium, vitamin C) that aid calcium absorption, but also contain those that actually hinder it, such as oxalates and phytates.1-3 Patients need to understand this paradox, as it means it takes more plant sources than animal sources to net the same amount of calcium absorbed.4

Fortunately, there are simple and easy measures patients can take to increase calcium intake and absorption simultaneously. For instance, eating calcium-rich foods in combination with foods that enhance absorption, such as those high in vitamin D, potassium and protein.1,5

Consider the simple mix-and-match approach in the table to combine high-calcium foods with high-vitamin D foods. This helps patients optimize intake and absorption of both nutrients.6-9

Good Sources of Calcium

(~300 mg)

  • Milk, 1 cup
  • Cheese (cheddar, mozzarella), low fat, 1-1⁄2 oz.
  • Tofu, calcium fortified, 1 cup

(~200 mg)

  • Canned salmon or sardines (with soft bones), 3 oz.
  • Cereal, calcium fortified, 1 cup
  • Kale or collard greens, 1 cup cooked

(~50 mg)

  • White beans, canned, 1⁄2 cup
  • Corn tortilla, 1 medium
  • Broccoli, 1⁄2 cup cooked
  • Almonds, 2 tablespoons

Good Sources of Vitamin D

  • Egg yolks
  • Fatty fish such as salmon, mackerel
  • Cheese
  • Fortified milk, orange juice, cereals
  • Beef liver
  • Tuna

Simple meal ideas might include:

  • Breakfast tacos: 1 corn tortilla, 1 egg, 1 1/2 ounces 2% milk cheese, and salsa (380 mg)
  • Pasta: 1⁄2 cup white beans, 1⁄2 cup cooked kale, 1⁄2 cup pasta and 1⁄2 cup feta cheese (350 mg)
  • Salad: 3 cups baby spinach with 1⁄4 cup almonds and 3 ounces canned salmon (400 mg)

Combining foods in this way allows calcium, vitamin D, and protein to work synergistically for patients’ bone health. Each of the meal suggestions above provides at least 350 mg of calcium, not accounting for losses in absorption.4,6-9 It is clear, too, that the combination of foods is finite, and may present challenges to consistently meeting the recommended daily intake. Given the variable nature of dietary calcium absorption and bioavailability, patients may find a supplement helpful in ensuring consistent intake, especially as they age.

Calcium supplements, such as Calcet® Creamy Bites are an efficient solution — that taste good — for the absorption concern, as they contain both calcium citrate and vitamin D3. Taken together, a few clever food combinations along with tasty supplements can go a long way toward building bone health. 

References:

  1. Academy of Nutrition and Dietetics (AND). Nutrition Care Manual. Osteoporosis Q&A. http://www.nutritioncaremanual.org/client_ed.cfm?ncm_client_ed_id=58. Accessed July 31, 2014.
  2. Illich JZ, Kerstetter JE. Nutrition in bone health revisited: a story beyond calcium. J Am Coll Nutr. 2000;19(6):715-737.
  3. Miller GD, Jarvis JK, McBean LD. The importance of meeting calcium needs with foods. J Am Coll Nutr. 2001;20(2 Suppl):168S-185S.
  4. Dairy Nutrition Website. Calcium and bioavailability. http://www.dairynutrition.ca/nutrients-in- milk-products/calcium/calcium-and-bioavailability. Accessed August 4, 2014.
  5. Dawson-Hughes B, Harris SS. Calcium intake influences the association of protein intake with rates of bone loss in elderly men and women. Am J Clin Nutr. 2002;75:773-779.
  6. Nutrition Care Manual. List of foods high in calcium. https://www.nutritioncaremanual.org/vault/editor/docs/High%20Calcium%20Food%20List.pdf. Accessed July 31, 2014. \
  7. Nutrition Care Manual. Osteoporosis nutrition therapy. http://www.nutritioncaremanual.org/client_ed.cfm?ncm_client_ed_id=58. Accessed July 31, 2014.
  8. Nazario, Brunilda. Top foods for calcium and vitamin D. WebMd Website. http://www.webmd.com/food-recipes/guide/calcium-vitamin-d-foods. Accessed August 4, 2014.
  9. Nutrition Care Manual. Calcium content of foods. https://www.nutritioncaremanual.org/vault/editor/Docs/CalciumContentofFoods.final1.pdf. Accessed August 5, 2014.

 About the author

This post is by Tori Crawford, MS, RD, LD, on behalf of Creamy Bites.