From the Guidelines
Calcium is indeed helpful for osteopenia, and adults with osteopenia should consume 1,000-1,200 mg of calcium daily through a combination of diet and supplements if needed. The most recent and highest quality study, 1, suggests that calcium supplements can reduce the risk of total fracture and vertebral fracture, although the evidence is not as strong for hip or forearm fracture. It is essential to note that calcium should be paired with vitamin D (800-1,000 IU daily) to enhance calcium absorption, and regular weight-bearing exercise should be performed to stimulate bone formation.
Key Recommendations
- Consume 1,000-1,200 mg of calcium daily through a combination of diet and supplements if needed
- Pair calcium with vitamin D (800-1,000 IU daily) for optimal effectiveness
- Perform regular weight-bearing exercise to stimulate bone formation
- Consider the calcium content from dietary sources and use supplements to reach the recommended total calcium dose
Important Considerations
- Calcium supplements can help reduce the risk of total fracture and vertebral fracture, but the evidence is not as strong for hip or forearm fracture 1
- High-dose vitamin D supplementation (≥ 800 IU/d) may reduce hip fracture and any nonvertebral fracture in persons age 65 years or older 1
- Exercise, particularly high-force exercise like progressive resistance strength training, may not be sufficient to improve bone health in survivors of cancer, but combination exercise programs can be effective for BMD at the spine 1
Calcium Intake and Supplementation
- Food sources like dairy products, fortified plant milks, leafy greens, and canned fish with bones provide natural calcium
- Calcium supplements (calcium citrate or calcium carbonate) can help reach the recommended amount, though they should be taken in divided doses of no more than 500-600 mg at once for better absorption
- It is crucial to maintain consistent intake over time, as calcium's benefits for bone health accumulate gradually rather than producing immediate results.
From the Research
Calcium and Osteopenia
- Calcium is often used in combination with vitamin D to treat osteoporosis, and this combination may also be beneficial for osteopenia 2, 3, 4.
- Studies have shown that correcting calcium and vitamin D deficiencies can improve bone density and reduce fracture risk in older adults with osteosarcopenia, a condition that includes osteopenia 3.
- A study found that supplementation with calcium, vitamin D, and collagen peptides reduced bone turnover in postmenopausal women with osteopenia, suggesting a potential benefit for bone health 5.
- However, the usefulness of calcium supplementation for osteoporosis and osteopenia has been questioned, with some studies reporting only weak efficacy in reducing fragility fracture risk and potential adverse cardiovascular effects 6.
Key Findings
- Calcium citrate combined with vitamin D is a commonly recommended combination for the prevention or treatment of osteoporosis and may also be beneficial for osteopenia 2.
- Adequate intake of calcium (1000-1200 mg/day) and vitamin D (800 IU/day) is well tolerated and effective at mitigating some aspects of osteosarcopenia, including lean mass, bone density, and fracture risk 3.
- Correction of calcium and vitamin D deficiency, along with regular exercise such as walking, can improve bone density in the hip and spine in individuals with osteopenia 4.