What foods are rich in calcium and vitamin D?

Foods Rich in Calcium and Vitamin D

Calcium-Rich Foods

The optimal way to achieve adequate calcium intake is through dietary sources rather than supplements. 1, 2

Primary Calcium Sources

• Dairy products are the main dietary source of calcium, including milk, yogurt, and cheese 3, 2
• Fish with bones, particularly sardines, provide significant calcium 3
• Fortified foods including calcium-fortified orange juice, cereals, and plant-based milk alternatives 1
• Select vegetables and fruits contain calcium, though in smaller amounts 3

Dairy and Milk Alternatives

• Cow's milk (8 ounces) is a rich source of calcium and, when fortified, provides vitamin D 1
• Fortified soy beverages are recommended as they approximate the protein content and calcium bioavailability of cow's milk 1
• Other plant-based milks (almond, cashew, rice) vary considerably in nutrient density and require fortification to match dairy calcium content 1

Important consideration: Most consumers incorrectly believe plant-based milk alternatives are nutritionally equivalent to cow's milk, but only fortified soy milk provides comparable protein and calcium 1

Vitamin D Food Sources

Dietary availability of vitamin D is naturally low, making it challenging to meet requirements through food alone. 1

Natural Vitamin D Sources

• Fatty fish are among the few foods naturally containing vitamin D 1
• Some mushrooms provide natural vitamin D 1
• Fortified foods are the primary dietary source, including:
  • Fortified milk 1
  • Fortified orange juice 1
  • Fortified cereals 1

Non-Dietary Vitamin D Production

• Sunlight exposure is the major source of vitamin D for most people through cutaneous biosynthesis 4
• Ultraviolet B light triggers vitamin D synthesis in the skin, though this does not occur during winter months in northern latitudes 4

Practical Intake Recommendations

Calcium Requirements

• Adults should consume 1000-1200 mg of calcium daily according to Institute of Medicine recommendations 1
• Those at risk for low calcium should aim for 1500 mg/day to optimize bone health 1
• Spread calcium intake throughout the day as the gut cannot absorb more than 500 mg at once 1, 2

Vitamin D Requirements

• Adults over 65 years should consume 600-800 IU (up to 1000 IU) of vitamin D daily 2
• Female athletes and those at risk should take 1000-2000 IU vitamin D3 daily, depending on sun exposure and time of year 1
• Daily supplementation with 800 IU vitamin D is safe and practical without requiring prior vitamin D level testing 5

Critical Absorption Considerations

Vitamin D is essential for calcium absorption—without adequate vitamin D, dietary calcium cannot be properly absorbed. 6, 7

• Most calcium supplements contain vitamin D, and many dairy products are fortified with vitamin D to optimize calcium absorption 1
• When vitamin D is inadequate, the body extracts calcium from skeletal stores, weakening existing bones 6, 7

Special Population Considerations

At-Risk Groups for Low Vitamin D

• Individuals living above the 35th parallel (northern/southern latitudes) 1
• Athletes who train indoors 1
• Those who cover skin with sunscreen or clothing during outdoor activities 1
• Elderly individuals who have decreased cutaneous vitamin D synthesis 3

Lactose Intolerance

• Female athletes with lactose intolerance often require calcium supplementation to reach 1500 mg/day 1
• Calcium citrate may be better tolerated than calcium carbonate in those with gastrointestinal symptoms 1

Water as a Calcium Source

Tap water can contribute meaningful amounts of calcium and magnesium to daily intake. 1

• Hard water from municipal sources may provide 8-16% of the RDA for calcium when consuming 2 liters daily 1
• Water softening systems that use sodium salts eliminate this calcium benefit and increase sodium content 1