Calcium and vitamin D: how much is enough?

Osteoporosis is a disease that causes bones to weaken, increasing the risk of breaks. If you're concerned about preventing the condition, you may have heard advice to get more calcium and vitamin D in your diet. But how much do you really need and how should you go about doing so?

Calcium is a mineral vital to maintaining healthy bones and teeth. To determine how much a person should have each day, it's important to consider their age and whether they have certain medical conditions, such as hypocalcemia or hypercalcemia (when the body has too little or too much calcium in the blood).

Vitamin D is a vitamin the body needs to absorb calcium. Research has shown that many people are vitamin D deficient due to diet, lack of adequate sun exposure, and a variety of other factors. How much vitamin D a person needs also depends on age group and health status.

With that in mind, here's how to make sense of your calcium and vitamin D requirements.

Importance of diet and lifestyle

When considering recommendations for these key nutrients, it’s important to remember two things.

Try to get calcium and vitamin D from your diet.

When looking for high-calcium foods, the richest sources are milk, calcium-enriched non-dairy milks (such as soy milk), plain yogurt, and hard, waxy cheeses, such as cheddar and Swiss. Some tofu and cereal options are also high in calcium and may contain up to 15 percent or more of the daily value per serving. Always check your food labels to be sure.

There are fewer dietary sources of vitamin D. It can be found in fatty fish such as salmon and tuna, as well as in fortified foods like milk, yogurt, breakfast cereal, and orange juice.

You may want to consider supplementation if it’s recommended by a healthcare provider (HCP). Note that supplemental calcium can increase your risk of developing kidney stones. A similar link has not been reported for dietary calcium.

Healthy lifestyle habits are important for strong bones.

In addition to getting enough of certain nutrients, exercise is proven to help maintain and increase bone mass and density. Resistance routines, such as those that use resistance bands, weight machines, or medicine balls, may be particularly beneficial. Smoking and drinking too much alcohol can lower bone density; avoid or limit these activities.

Calcium and vitamin D recommendations

Here are some general guidelines for how much calcium and vitamin D people need at each age for strong bones and overall health.

Birth through age 18

Adequate calcium and vitamin D consumption is critical during the early years to support bone growth and health. For calcium, recommended daily intake is largely dependent on age group:

• 0 to 12 months: 200 to 260 milligrams (mg) per day
• 1 to 3 years: 700 mg/day
• 4 to 8 years: 1,000 mg/day
• 9 to 18 years: 1,300 mg/day

Some adolescents may need a supplement to get enough calcium, but check with a pediatrician first. The recommended amount of vitamin D for children under 1 year is 400 IU (International Units) per day. From age 1 through 18, the recommended amount is 600 IU of vitamin D per day.

Adults ages 19 to 30 in good health

Crucial bone building takes place during the second and third decades of life. Once you hit 30, bone mass reaches its peak and will begin to decrease. That’s why getting adequate calcium and vitamin D before reaching 30 is essential. Many guidelines say ages 9 to 18 is the best window to build bone mass, but since your bones are still building in your 20s, you should strive to get good amounts of calcium and D during this decade, as well. Aim for 1,000 mg/day of calcium and 600 IU of vitamin D per day.

Adults ages 31 and older

Most adults should aim to get 1,000 mg of calcium per day. If you’re a woman older than 50 or a man older than 70, the target amount moves to 1,200 mg/day.

For people in this age group with osteoporosis or osteopenia (low bone density), many experts recommend calcium supplements, especially if you don’t get enough calcium in your diet. Supplements can help reduce the rate of bone loss.

If you don’t have either condition, there’s little evidence that calcium supplementation is beneficial. In fact, the risks of heart disease and kidney stones may outweigh the benefits. As a result, the United States Preventive Services Task Force (USPSTF) doesn’t recommend calcium supplements for people in this age group without osteoporosis or osteopenia.

Adults at risk for vitamin D deficiency should have their vitamin D levels checked, and take a supplement as needed if recommended by a healthcare provider (HCP). This group includes:

• Older adults
• Anyone who has been hospitalized
• People with kidney or intestinal disease, or other chronic conditions
• People who don’t get adequate sun exposure
• People with darker skin
• People who are obese
• People who have had gastric bypass surgery

Both men and women should get 600 IU per day of vitamin D up to age 70. People ages 70 and older should aim for 800 IU per day.

Ultimately, when it comes to calcium and vitamin D, stick to the daily recommended intake for your age and health status. Most dietary supplements are not regulated by the U.S. Food and Drug Administration so always talk with your HCP first before taking one, and follow the recommended doses indicated on the label.