Ideal Calcium Source

Ideal calcium source is from food, then pill form; Adequate amounts of vitamin D are also needed.
Barry W. Ramo, M.D., FACC

Q: I’m 48 years old and in good health. My mother had osteoporosis and I worry about it. I hear conflicting reports on how much calcium I should be getting and how I should get it. Is it better to get it from food or supplements? Are there any particular supplements that you recommend?

A: I am assuming you want to prevent osteoporosis. After age 30 you begin to lose bone and if you don’t take in enough calcium and vitamin D you will have a net loss of calcium. For a premenopausal woman that number is around 1.0 gram a day and 1,500 milligrams after menopause. So if you aren’t taking in that much calcium daily, your bones are thinning even faster. But what many women and men forget is that you have to get sufficient vitamin D.
Ideally, you should get all your calcium from food. I would suggest low-fat milk and other dairy products, such as hard cheese, cottage cheese or yogurt, as well as green vegetables, such as spinach. You can estimate your daily intake of calcium by giving each serving a value of 300 milligrams. So eight ounces of milk, an ounce of cheese or two cups of broccoli are a serving size.

There are a number of sources of supplemental calcium but don’t take more than 500 milligrams at a time as you won’t absorb it. Calcium carbonate works fine and it’s cheap. But chewable preparations might be preferable.

For those of you who think natural preparations are great, think again, as bone meal and oyster shells may be contaminated with mercury.
Vitamin D is key. Calcium won’t do it by itself and unfortunately a lot of people are gobbling down calcium pills and not getting enough vitamin D or don’t actually absorb or make enough vitamin D. You make vitamin D in your skin and liver. So if you don’t go in the sun or if you wear a sunscreen you could be vitamin D deficient. Eight hundred units (IU) is the current daily recommendation.

Many physicians are measuring vitamin D levels in the blood because some women and men don’t absorb vitamin D properly even at higher doses than 800 IU.

As a cardiologist, I would be remiss in not telling you that adequate calcium intake is important in helping control your blood pressure and even your cholesterol. Finally, cigarette smoking decreases bone density and studies in twins found that the smoking twin had about 5 percent to 10 percent less dense bone than the non-smoking twin. So if you’re looking for yet another reason to quit, having strong bones is a strong one.

Dr. Barry Ramo is a cardiologist with the New Mexico Heart Institute and medical editor for KOAT-TV. Send questions for him to Albuquerque Journal Boomer, P.O. Drawer J, Albuquerque, NM 87103, or e-mail them to

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