“Why Don’t I Need to Worry About Calcium?”

September 16, 2013 in Categories: , , , by

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This is one of the biggest areas of concern when people (especially women, who are at greater risk for developing osteoporosis) switch to a paleo diet. If we aren’t eating any dairy products, how do we make sure we get enough calcium??? It is one of the many pervasive bits of misinformation that we battle against (akin to saturated fat causing heart disease): that we need to consume dairy products to protect our bones. This simply isn’t true. And it isn’t true for three reasons. First, dairy is hardly the only source of dietary calcium out there. Second, the calcium from other food sources is actually more absorbable than the calcium in dairy. Third, bone health is determined by a whole lot more than just calcium.

Most importantly, dairy products are not the only good source of calcium out there. In fact, fruits, vegetables, nuts, seeds, meat, and seafood all contain calcium. Let’s compare some paleo foods against a glass of milk:

Food Calcium / Serving
Milk

300 mg per 1 cup

Collard greens 210 mg per ½ cup
Kale 205 mg per ½ cup
Bok Choy 190 mg per ½ cup
Figs 135mg per 5 figs
Turnip Greens 104 mg per ½ cup
Spinach 99 mg per ½ cup
Almonds 93 mg per ¼ cup
Sesame Seeds 51 mg per 1 Tbsp
Sardines (with bones) 213mg per 2oz
Salmon (with bones) 241 mg per 4oz
Orange 52mg per medium orange
Mushrooms 18 mg per 2oz

Not only do fruits, vegetables, nuts, seeds and seafood contain substantial amounts of calcium, there is scientific evidence that you actually absorb more calcium from cruciferous vegetables (like kale) than you do from dairy! Cruciferous vegetables (like kale, cabbage, broccoli, collard greens, turnip greens, etc.) may actually be your best source of dietary calcium. And in fact, several studies show that fruit and vegetable intake correlates much more strongly than dairy intake with bone health–yes, to prevent osteoporosis and look after your bones, eat your veggies!

Other great sources of dietary calcium include: green leafy vegetables, nuts (almonds especially), seeds (especially sesame seeds), figs, oranges, dried apricots, okra, bok choy, seafood (especially when you eat the bones like canned salmon or sardines), and to a lesser extent, all fruits and vegetables. Organ meat and bone broth are also excellent sources of not only calcium, but magnesium and phosphorous, which are also critical for bone health. Yes, you need other minerals to make bones too! This might be one of the reasons why higher vegetable intake correlates with better bone health–vegetables also provide these other essential minerals.

Bone health is about much more than calcium and the other minerals used to physically make up bone. Not only do you need minerals as raw materials, but fat soluble vitamins (A, D and K2 in particular) are essential regulators bone mineralization. Where do you get these essential fat-soluble vitamins? Seafood, dairy fat from grass-fed cows (meaning grass-fed ghee, butter, or heavy cream), and the fat from grass-fed and pasture-raised meat. Because the majority of people still don’t source meat and dairy from pasture-raised sources, for most people the dominant dietary source of these vitamins comes from seafood. No wonder high seafood intake also correlates with bone health!

You know what else is critical for bone health? Weight bearing exercise–meaning exercise where you move your own body weight around, like walking!

Basically, if you are eating plenty of fruits and vegetables (especially cruciferous vegetables) and seafood, sourcing the best quality meat you can, maybe incorporating some bone broth into your diet, and getting some exercise (even if it’s just walking), you are doing a great job of looking after your bones.

Heaney RP and Weaver CM. Calcium absorption from kale. Am J Clin Nutr April 1990 vol. 51 no. 4 656-657

Charoenkiatkul S, et al. Calcium absorption from commonly consumed vegetables in healthy Thai women. J Food Sci. 2008 Nov;73(9):H218-21.

New SA et al. Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health? Am J Clin Nutr. 2000 Jan;71(1):142-51.

Chen YM et al. Greater fruit and vegetable intake is associated with increased bone mass among postmenopausal Chinese women. Br J Nutr. 2006 Oct;96(4):745-51.

New SA. Intake of fruit and vegetables: implications for bone health. Proc Nutr Soc. 2003 Nov;62(4):889-99.

Zalloua PA et al. Impact of seafood and fruit consumption on bone mineral density. Maturitas. 2007 Jan 20;56(1):1-11. Epub 2006 Jun 27.

Comments

Nicole, do you see the “address bar” at the top of your page which shows where you are on the Web? With your mouse, highlight (click and drag the mouse over the text) the address of this page (which is http://www.thepaleomom.com/2013/09/why-dont-i-need-to-worry-about-calcium-2.html). Right-click on that text with your mouse, then left-click on Copy. Start your email to your friends, then right-click in the text area, and left-click on Paste. That should paste in the “address” or “link” to this page. When your friends click on it, it will take them straight here.

Better yet, grab a nearby kid or teenager and ask them how to do it. =)

Great post! We went Paleo almost 2 years ago and haven’t looked back. People were shocked that I never gave my 3yo cow’s milk when she turned 1. I said, ‘why does she need it?’ There are much healthier options for getting calcium that aren’t from another animal’s milk. Can’t wait to share this post :)

Very helpful article, thanks! I think I’ll post your list of calcium sources on the fridge.

Besides all this, I recently learned that osteoporosis is one of the possible effects of celiac disease. With celiac so under-diagnosed, who knows how many people with osteoporosis just need to quit eating gluten?

My brother, at about at 40, was told he had osteoporosis and “the bones of an 80-year old woman,” but not given any reasons or real solutions. I’ve just sent him the info I found about osteoporosis and celiac, and perhaps that’s his answer. It seems you can reverse some, most, or all of the damage after a few years by getting off gluten.

Thankyou for posting about this…
I have been dairy-free for 15 years after I developed a dairy allergy in my mid 20′s. and even though I am perfectly healthy, I still get people (including my Dr) saying that I need to take calcium supplements because I don’t drink milk…
I find it surprising that people are so fixated on milk as the only source of calcium in their diets, especially when you consider that we are the only animals that regularly consume milk beyond infancy.
The other thing worth mentioning is that by cutting out the grains in our diets, we are removing the major source phytates from our diets, and that means that any calcium is much more available… phytate phosphous will chelate the calcium and make it unavailable, so by pouring milk over your “heart-healthy” breakfast cereal in the mornings, you are actually making all that calcium unavailable…

Thanks for posting this information. I have known it for years, but people still tell me I need a supplement because I am not consuming dairy….I think our society has been brainwashed!

Thank you! My 18 year old daughter broke her foot last winter and it took 6 months to heal! The first doctor told her calcium didn’t matter – she didn’t need to take any (and she has a dairy allergy). 5 months later a new doctor had her on good calcium and it healed in a month. After reading your post I think the issue was not so much that calcium doesn’t matter but that she could be getting enough calcium through real food. But, as a college student, she wasn’t eating much of what you have on your list. I will be sharing this list with my family – especially my dairy allergic family members! Thank you!

I tracked my children’s calcium intake. One child was entirely way too low without dairy or supplementation. She just won’t eat enough of the kale, collard greens, sardines, etc. Providing it for her and her eating all of it are two different things. We chose to supplement for her and continue to maximize all other areas mentioned. Hopefully over the years, her intake of greens will increase.

Thanks for the great article! My daughter who is 21 months has eczema, we have recently started a no grain/dairy diet, which is helping. I have also started doing the same. I keep getting grief from well meaning concerned family members about her diary intake and lack of a source of calcium. I have printed this article to show them the facts. Thank you for your great site, it is most helpful and informative!

Thanks for repeating the message about diary. And thanks for your work, it is such a big resource, looking forward to your book. I’ve just learned I most likely have Non Celiac Gluten Sensitivity (my personal educated guess as it’s not known here yet in conventional medicine), and already developed osteoporosis (confirmed by bone scan, I’m 40). Been extremely fatigued for over a year now, having lost 9 kgs of my original 54 and trouble sleeping. Have been on AIP for 8 months, with a two week period of eating wheat bread for diagnostic purposes in the middle, most certainly worsening my symptoms, but excluding celiac disease. AIP helped curve the unstoppable and mind wrecking hunger I was having, and stopped the weight loss. Had already been off diary for almost 10 years, as I had already noted my fatigue coincided with dairy consumption. May not have been substituting well for a while, not helping the osteoporosis. I know I’m on the right track diet wise, but there is still a long way to go (still unable to work or function normally or gain any weight). Had a really bad month last month, which seems to have been due to changing my magnesium supplement from oral (solution of mg flakes) to skin (oil). Getting back to where I was from about a week after I started taking the oral supplement again. Two questions that you might be able to help with: Any other tips regarding calcium and bone health when osteoporosis has already been confirmed? (Already started adding mild strength training). And my specialist could not find any references for low magnesium being able to cause me getting worse in the University Hospital database. I am quite sure of the correlation, might you have any ideas of how it could be connected?

Here’s a good, very recent reference to give your specialist about the roll of magnesium and bone health http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3775240/

My recommendations would be to focus on both bone broth and canned fish with the bones like salmon and sardines (for the minerals, lots of leafy greens will help here too) and fat soluble vitamins (A, D, and K2 especially). For the fat-soluble vitamins the two best sources would be cultured grass-fed ghee (contains no lactose and not even trace proteins, and even my super sensitive youngest daughter can eat it with no problems, although it’s not cheap and Pure Indian Foods is the only brand I know of that makes it) or fermented cod liver oil (I recommend Green Pasture). Then adding weight bearing exercise (I would suggest walking 20-30 minutes every day in addition to your mild strength training), managing stress and getting lots of sleep. There are many great success stories out there of people completely reversing osteoporosis with a nutrient-density focused paleo diet. It might also be good to add digestive support supplements (ox bile to help digest the fats, digestive enzymes for everything else) to maximize digestion and absorption of the nutrients your body needs to repair your bone.

I hope this helps!

Absolutely helps, thank you so much for taking the time to answer my question. we kind of have to become our own doctors,and I’m considering myself very lucky to have found a specialist open to my suggestions. but knowing where to start looking without any biology background can be challenging. thanks so much for the article, and your detailed advice. the cod liver oil will be in the regime as well as the exercise. maybe One more question on the bone broth: how much would you shoot for? have been using 1 cup/day last few months, more before that.

I would say a cup a day as a minimum. There’s no good measurement of the mineral content of homemade broth, so it’s hard to say exactly how much you need. If you’re eating lots of other mineral-rich foods (like the canned fish I mentioned before), then you’re probably doing great. But, I don’t think you can overdo broth, and especially since you’re trying to repair diseased bone, I think that upping your broth, or doing 1 cup some days and 2-4 cups other days makes a lot of sense.

Thanks again! Exactly what I’ve been thinking, the impossibility of saying anything about the mineral content of homemade broth, so this gives me some extra direction. Oh, and thanks for pointing out there are many success stories out there of people revesring their bone damage. Just heard prof Volta’s interview on the Gluten Summit, expressing concern that for many of his NCgS patients, osteoporosis is part of the problem, and calcium absorption continues to be a problem even with supplementation. I do think that his supplementation would be tablets though, not so much bone broth :) Thanks again for giving me some very helpful information, will be sharing with all my familymembers.

Do you have thoughts on oxalic acid? Is there enough in raw kale to be of concern? Is calcium available in raw kale? If this has been covered elsewhere in the blog please direct me to it…..
Thanks~

Hi – I would add kelp noodles and chia seeds to the list. Are you measurements for the calcium in greens based on cooked or raw?
Also – I have read conflicting things about taking calcium with magnesium – some say yes and others say they compete for absorption?
Thanks – so sorry you are having a rough patch!

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