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Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...

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May 04, 2009

Dear Mark: Calcium for Women

By Mark Sisson
61 Comments

Dear Mark,

I have been following the PB way of life quite closely now for about five months, and I haven’t felt or looked better!  Well, following it closely except for the dairy part. My question here is “How do I get all my calcium following the PB?” Also, as a female do I need more calcium than a male as we are lead to believe this by normal mainstream information? I guess my problem is I really don’t know how much calcium I should be having as the information ‘out there’ can be misleading and conflicting too. I am worried that I may be doing myself some harm later in life if osteoporosis could stem from not having much dairy.

Thanks to Sonya for this week’s question. I always believe in having a long term vision for your health, and the question is an important one for that plan. The National Academy of Sciences currently recommends 1000 mg/day for women ages 19-50 and 1200 mg/day for women 50+ (post-menopausal women being the real target here). I tend to think that this is probably more than most women need – and definitely higher than most men require. (I’d suggest that pregnant or nursing women maintain these higher levels though.) The fact is, the vast majority of people around the world consume much less calcium than we do in the U.S. (primarily because they eat less dairy), and these populations generally have much lower rates of osteoporosis. On the flip side of this picture is our society’s situation: high calcium intake and sizeable osteoporosis rates.

The fact is calcium recommendations are the subject of ongoing debate. The tide of expert opinion, however, is more recently steering toward lower intake of calcium itself and higher intake of those vitamins and minerals that work in concert with calcium and/or are independently supportive of bone health. Let me tackle both the calcium/other nutrient subject and the dairy issue.

First, the nutrients… Ironically, too much calcium can inhibit the absorption of another mineral that the body needs for bone health: magnesium, which aids in bone formation and helps regulate calcium transfer as well as maintain bone density. (They compete for the same absorption pathways.) Most of us could use more of this mineral. Think leafy greens, seeds, nuts, fish. On the same note, vitamin D is absolutely essential for bone density and may be more important than calcium. As I’ve mentioned time and again, we tend to be sorely lacking in that department. Among the other nutrients crucial for bone health? Add vitamin K and boron (important for bone formation among other regulatory activities) to the list.

And it’s not just about isolated nutrients. As part of the intricate homeostatic mechanisms, the body routinely takes calcium from the bones to counterbalance any increase in acidity. As a result, an alkaline environment is important for calcium absorption. (Diets high in grains are especially problematic in this regard.) An “alkaline” diet includes copious amounts of fresh fruits and vegetables. The potassium in those fruit and vegetables helps regulate acid load. Beyond the questions of acid/alkaline, produce appears to protect in other ways too. A study out earlier this year suggests that the protective antioxidant properties of fruits and veggies (found in their natural pigments) help stave off bone loss in older men and women, presumably by reducing the oxidative stress that contributes to bone breakdown.

As to the dairy, it’s true that dairy products offer among the highest amounts of calcium in any food. However, dairy is acid-forming, which counters the alkaline ideal for absorption. The fact is dairy isn’t necessary for adequate calcium intake and/or bone health. As mentioned, most of the world is testament to that (and let’s not forget Grok’s prior two million years of dairy-free living). On a timely note, research out last month showed that Buddhist nuns who ate a vegan diet and consumed less than 400 mg of calcium daily had the same bone density as non-vegetarian women who consumed 1000 mg of calcium each day. I’m hardly backing a vegan diet by mentioning this study. Nor do I think it’s the best designed research out there, but it’s another illustration of the non-necessity of dairy in a healthy diet.

Ultimately, bone health depends on a number of factors – a constellation of nutrition, activity, and various hormone factors. Here are my nutrient and lifestyle recommendations to maximize calcium absorption and overall bone health…

Get your calcium from alkaline-forming foods like leafy greens, nuts, broccoli, sweet potatoes and calcium-rich fish like wild salmon and sardines.

Eat a diet high in antioxidant fruits and veggies. Go low to moderate on carbs to help maintain hormonal balance, and eliminate grains (phytates in grains can bind to calcium and decrease absorption). Reduce caffeine, which can encourage calcium excretion, and limit alcohol, which can decrease bone density and strength over time.

Ensure adequate vitamin D primarily by spending quality time out in the sun and by taking a supplement containing D3 if need be.

Do plenty of weight-bearing exercise to maintain bone density. I’d recommend a combination of resistance training and some impact interval activities like sprints.

Avoid chronic stress. Excess cortisol messes you up. You know that. It also decreases calcium absorption. In my book (coming soon!), stress is a huge reason we see rampant osteoporosis in our society.

If you’re still concerned about calcium intake, you can always consider a good supplement that includes not just calcium but vitamin D3 and magnesium. In terms of additional therapies for those at risk, research suggests that an aspirin regimen can help treat osteoporosis by balancing bone formation and resorption rates. Of course, talk to a trusted physician about these possibilities in your overall treatment plan.

As always, thanks for your questions and comments, and keep ‘em coming!

Further Reading:

The Definitive Guide to Primal Supplementation

Cranberry Juice and UTIs

Should I Be Taking Vitamin K2 Supplements?

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61 Comments on "Dear Mark: Calcium for Women"

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Holly
Holly
7 years 4 months ago

Thank you for writing this. Definitely a helpful clarification.

Dave, RN
Dave, RN
7 years 4 months ago

I’ve read that goats milk (which is what 70% of the world drinks) is not acid forming like cows milk. Goat milk compares quite favorably to cow milk with dramatically more vitamin A and the B vitamin niacin, a higher amount of calcium, and 20% less cholesterol – all without extra calories! Also much lower in casein and the fat molecules are 5 times smaller. I got some for the first time a couple of days ago (raw of course) and I can’t tell the difference between it and cow milk.

Mike T.
Mike T.
7 years 4 months ago

I believe this may be the first time I’ve been informed that I don’t need more than the RDA. Good to know!

DJ
DJ
7 years 4 months ago

Thank you for addressing this topic. What about the calcium : phosphorus ratio? I have heard that because milk is higher in phosphorus, the actual absorption of calcium is not that great. Also, there are phospates added to so many foods… I know this group is not eating a lot of processed foods anyway, but they seem to be everywhere!

mm
mm
6 years 1 month ago

you need as much phosphate as you need calcium to build up calcium phosphates in your bone cells… phosphorous is rarely mentioned only because it is generally more abundant than calcium but a deficiency is just as bad

Nate
Nate
7 years 4 months ago

“As part of the intricate homeostatic mechanisms, the body routinely takes calcium from the bones to counterbalance any increase in acidity. As a result, an alkaline environment is important for calcium absorption. (Diets high in grains are especially problematic in this regard.)”

Yes! Yes! Yes!

Jennifer
Jennifer
7 years 4 months ago

“Avoid chronic stress. Excess cortisol messes you up. You know that. It also decreases calcium absorption.”

So for those of us already in midstage adrenal fatigue (characterized with lower than average levels of cortisol), what happens to calcium absorption then? Of course, when the adrenals are pooped out, calcium intake is not as high on the priority list as is repairing the adrenals…

Jeff
Jeff
7 years 4 months ago
Mark, Great article. I think we need to be careful when looking at studies that compare American health with those in other parts of the world. For instance it may be true that Americans eat more dairy and have a higher incidence of osteoporosis than other countries but you also have to factor in that Americans live longer as well. In places such as Africa the life expectancy is very low and medical examination and treatment are non-existent in many areas and so there are probably many many cases that never get diagnosed or never occur due to death at… Read more »
mm
mm
6 years 1 month ago

So, they don’t autopsy anyone to determine the cause of death/general health in all of those other countries? Not even when making a comparative study of oesteroporosis?

Also,
“It doesn’t matter what we eat or drink; our blood contains substances that can act as acids or bases to maintain our blood pH at 7.4.”

One of those “substances” happens to be at times a calcium hydroxide base to neutralize acidity

Greg at Live Fit
7 years 4 months ago

The fact that vegetables like broccoli, spinach, and asparagus are such excellent sources of calcium gets totally obscured by the marketing clout of the National Dairy Council.

DThalman
DThalman
7 years 4 months ago

Try seaweed wraps (sushi style), garlic and watercress, too! Spinach in your eggs. Lots of people can’t digest dairy and still get plenty of calcium. I’ve gone without dairy (other than cream, eggs) for about four years and came out fine on my bone density testing, even with some risk factors. Weight-bearing exercise is important, I think. It’s a good thing to be aware of. Yet another MDA blog of interest and relevance!

Meese
Meese
7 years 4 months ago

Question: is decaf coffee as bad as or worse than regular coffee as it relates to calcium being leeched from the bones to marvelously buffer the blood?

Primal Palate
Primal Palate
5 years 3 months ago

Coffee (chocolate, etc) are HIGH in phytic acids that bind with nutrients, especially minerals and flush them out of your body.
Coffee is very very, VERY BAD.

Kimi @ The Nourishing Gourmet
7 years 4 months ago

As a dairy free family, we drink a lot of homemade bone broths for calcium and other minerals. It’s a delicious way to get calcium in, especially when made into soups.

By the way, part of the reason that Americans can consume large amounts of diary and still have bone problems is because their milk is pasteurized which adversely effects calcium absorbency. Raw milk is considered PH neutral by many (so it won’t have the acidic effects of pasteurized milk), and it’s calcium is also much easier to absorb.

But I agree, we don’t need diary for calcium.

Primal Palate
Primal Palate
5 years 3 months ago
No we dont need dairy..but in the old days people ate the marrow from bones in many dishes. Germans use marrow to glue dumplins of all kinds together, marrow and eggs is used. Especially the dumplins that go into all kinds of soups which have been consumed several times per week. I know so because my mother and both grandparents made them coming from 2 different countries in europe. Humans can’t break down cellulose in plants (or it is extremely difficult)and therefor calcium and many other nutrients are locked away and inaccessible to us. You’d have to graze ALL day… Read more »
Feather
Feather
1 year 11 months ago

“Humans can’t break down cellulose in plants (or it is extremely difficult)and therefor calcium and many other nutrients are locked away and inaccessible to us.”

That’s where cooking comes in handy…

Kimi @ The Nourishing Gourmet
7 years 4 months ago

oops! I meant “we don’t need dairy” 🙂

Harrie
Harrie
7 years 4 months ago

Very informative article. Thank you for writing it.

trackback

[…] Calcium […]

Seth
Seth
7 years 4 months ago
Calcium is not used to counteract acidity. Ca2+ simply cannot do so in any way. Increased calcium excretion is a byproduct of hydroxylapatite (main mineral in bones and teeth) catabolism. The “active” substance liberated from hydroxylapatite by the body is phosphate which is used as a pH buffer, calcium is only its counterion. You can counteract “acidic foods” by eating more phosphate (dairy, meat, eggs and organs contain a lot of it) or (bi)carbonate (fruits and vegetables). Besides even without phosphate, healthy kidneys can excrete protons indirectly by ammoniogenesis main substrate being glutamine (an aminoacid readily formed from other aminoacids… Read more »
mm
mm
6 years 1 month ago

Interesting.

But we still need phosphorous to build bones, so it’s almost like when we take calcium supplements we’re taking the wrong essential mineral.

I wonder what are the signs of phosphorous deficiency for people whose kidneys can’t take out those hydrogen atoms/protons as easily…

Milemom
Milemom
7 years 4 months ago

I remember learning that a large protein consumption leeches calcium from the bones… and that is why americans have such high incidence of osteoporosis…and why certain tribal people (ie who DON’T have high protein) can have strong bones w. a very low calcium intake. Nutrition is still murky.

Jacqueline
Jacqueline
7 years 4 months ago

Great post and thanks for tailoring PB diet info specifically for women. @Jeff, here are a few articles that helped me better understand acid-alkaline balance (in my case, especially how it related to bone health):
pH and bones: the science

ACID-FORMING FOODS
ALKALINE-FORMING FOODS

Hart
7 years 3 months ago

quitting dairy cleared up my allergies and asthma. i’m now asked “where do you get your calcium then?”. i eat a lot of the foods leafy greens, nuts, broccoli and wild salmon… but honestly i’ve never really worried about it.

this post was awesome.. thanks mark!

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[…] What?! No dairy?! But where are you getting your calcium from?! […]

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[…] interfere with progression of osteoarthritis”. I’d say it’s worth a shot.Calcium – I’ve downplayed the importance of large amounts of supplementary calcium in the past, but that doesn’t mean it’s not important. It’s the raw material for bone […]

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[…] – I’ve downplayed the importance of large amounts of supplementary calcium in the past, but that doesn’t mean it’s not important. It’s the raw material for bone […]

Shelly
Shelly
5 years 10 months ago

But isn’t meat acidic, too? Yet we are supposed to be eating meat!

Shelly
Shelly
5 years 10 months ago

i’ve read that the calcium in green veggies are hardly even absorbed. You’d have to eat gargantuan-sized amounts to even get a little bit of absorption from veggies .

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[…] supposedly goes: phosphoric acid, which soda makers use in place of pricier citric acid, leaches calcium from your bones and reduces bone mineral density. Is it true? Well, it’s become pretty clear […]

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[…] supposedly goes: phosphoric acid, which soda makers use in place of pricier citric acid, leaches calcium from your bones and reduces bone mineral density. Is it true? Well, it’s become pretty clear […]

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[…] supposedly goes: phosphoric acid, which soda makers use in place of pricier citric acid, leaches calcium from your bones and reduces bone mineral density. Is it true? Well, it’s become pretty clear that […]

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[…] “Calcium for Women” http://www.marksdailyapple.com/calcium-for-women/ retrieved 1-4-10 Posted on May 2nd 2011 in Health […]

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[…] fact, magnesium deficiency is a great risk than calcium deficiency. Here is a terrific article on Mark’s Daily Apple all about calcium. Also overblown is the need for fiber. You don’t need extra fiber if you […]

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[…] also have to watch your calcium intake. Leafy greens like spinach and collard greens are excellent sources, as is dairy, if […]

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4 years 5 months ago

[…] attacks, diabetes, ketoacidosis, lowered marathon performance, kidney disease, and osteoporosis from “eating all that meat,” […]

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[…] called phytic acid, which binds to minerals in the grain and prevents their absorption in the gut. Calcium, zinc, magnesium, iron, and several others are susceptible to the lure of phytic acid, and research […]

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[…] called phytic acid, which binds to minerals in the grain and prevents their absorption in the gut. Calcium, zinc, magnesium, iron, and several others are susceptible to the lure of phytic acid, and research […]

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[…] called phytic acid, which binds to minerals in the grain and prevents their absorption in the gut. Calcium, zinc, magnesium, iron, and several others are susceptible to the lure of phytic acid, and research […]

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[…] […]

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[…] to spinach and broccoli. Spinach is clearly superior, almost across the board, with more magnesium, calcium, iron, potassium, and beta-carotene. Plus, it tastes better (read: not like lawn clippings) and is […]

trackback

[…] called phytic acid, which binds to minerals in the grain and prevents their absorption in the gut. Calcium, zinc, magnesium, iron, and several others are susceptible to the lure of phytic acid, and research […]

trackback

[…] called phytic acid, which binds to minerals in the grain and prevents their absorption in the gut. Calcium, zinc, magnesium, iron, and several others are susceptible to the lure of phytic acid, and research […]

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[…] called phytic acid, which binds to minerals in the grain and prevents their absorption in the gut. Calcium, zinc, magnesium, iron, and several others are susceptible to the lure of phytic acid, and […]

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[…] Second, I am not sure that the current recommendations for calcium truly reflect what the body needs.  Mark Sisson had this to say on the subject: […]

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[…] spinach and broccoli. Spinach is clearly superior, almost across the board, with more magnesium, calcium, iron, potassium, and beta-carotene. Plus, it tastes better (read: not like lawn clippings) and is […]

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3 years 4 months ago

[…] water has no effect on bone remodeling in post-menopausal women (the group perhaps most at risk for osteoporosis). Subjects drank a liter of sodium-rich bubbly water a day for months without any ill effect. In […]

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[…] we eat a lot of dairy and still have poor bone health is sound, and this is simply evidence that calcium is not enough to ensure good bone density. Vitamin D status, vitamin K2 intake, even the amount of protein you […]

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2 years 9 months ago

[…] […]

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[…] produce acid upon metabolism nor cause metabolic acidosis.” Further, dairy is a good source of calcium and – particularly in the case of gouda cheese – vitamin K2, both important co-factors in bone […]

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[…] produce acid upon metabolism nor cause metabolic acidosis.” Further, dairy is a good source of calcium and – particularly in the case of gouda cheese – vitamin K2, both important co-factors in bone […]

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[…] produce acid upon metabolism nor cause metabolic acidosis.” Further, dairy is a good source of calcium and – particularly in the case of gouda cheese – vitamin K2, both important co-factors in bone […]

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[…] produce acid upon metabolism nor cause metabolic acidosis.” Further, dairy is a good source of calcium and – particularly in the case of gouda cheese – vitamin K2, both important co-factors in bone […]

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[…] of any of the components and suffer no ill symptoms. That said, you don’t need to eat dairy to get calcium, potassium, protein, or fat (besides, I highly doubt US News and World Reports count “dairy […]

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[…] don’t want a hugely high calcium content, despite the fact that you’ve probably been told “more calcium = stronger bones!” […]

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