From the Guidelines
For osteopenia in someone who doesn't consume dairy, I recommend taking 1,000-1,200 mg of calcium daily through supplements, divided into two doses of 500-600 mg each for better absorption. This recommendation is based on the most recent and highest quality study available, which suggests that calcium supplementation can help reduce the risk of fractures in individuals with osteopenia 1. Calcium citrate is often better tolerated and doesn't require food for absorption, while calcium carbonate is less expensive but should be taken with meals.
Key Considerations
- Vitamin D supplementation of 800-1,000 IU daily is also essential as it helps calcium absorption, and studies have shown that vitamin D plus calcium supplementation can reduce the risk of hip fracture and any nonvertebral fracture 1.
- Non-dairy calcium sources to incorporate include fortified plant milks (almond, soy), leafy greens (kale, collards), canned fish with bones, tofu made with calcium sulfate, and fortified orange juice.
- Weight-bearing exercise for 30 minutes most days of the week is also crucial for bone health, although the evidence suggests that exercise may not be sufficient to improve bone health in survivors of cancer on its own 1.
- Taking calcium supplements at different times than any prescribed medications is important as calcium can interfere with absorption of certain drugs.
Additional Guidance
- The British Society of Gastroenterology consensus guidelines recommend that all patients receiving a course of corticosteroids for a disease flare should receive an intake of 800–1000 mg/day calcium and 800 IU/day vitamin D 1.
- The National Osteoporosis Foundation and American Society for Preventive Cardiology adopt the position that there is moderate-quality evidence that calcium with or without vitamin D intake from food or supplements has no relationship to the risk for cardiovascular and cerebrovascular disease, mortality, or all-cause mortality in generally healthy adults at this time 1.
From the Research
Calcium Dose for Osteopenia
The recommended calcium dose for osteopenia varies, but most studies suggest a daily intake of at least 1200 mg of calcium, combined with vitamin D supplementation 2, 3, 4.
Non-Dairy Calcium Sources
For individuals who do not like dairy products, there are alternative sources of calcium, such as:
- Calcium-fortified foods
- Calcium supplements, including calcium citrate, which has been shown to have greater absorption than other forms of calcium 2
- Plant-based sources, such as leafy greens and fortified plant-based milk
Recommended Dosage
Studies have shown that calcium supplementation, combined with vitamin D, can help improve bone mineral density and reduce the risk of fractures 2, 3, 5. The recommended dosage of calcium is:
- 1200 mg per day, combined with 800 IU of vitamin D per day 2
- 500 mg per day, combined with 400 IU of vitamin D per day, with or without collagen peptides 5
Important Considerations
It is essential to note that calcium absorption can be affected by various factors, including the type of calcium supplement, the presence of other nutrients, and individual factors, such as age and digestive health 2, 4. Therefore, it is crucial to consult with a healthcare professional to determine the best course of treatment for osteopenia.