The Calcium Controversy: To supplement or not…

This is the 3rd post in this calcium series, so if you want to catch the first 2 make sure you read this one and this one and then you’re all caught up! So now.. let’s get onto the calcium controversies – there are 2 main ones I’ve found and they are:

  • Whether you need to add extra calcium to your diet and
  • Whether you need dairy to get your calcium

Why does it matter?

Because wrong advice now isn’t something you’re going to find out about until later in your life. That’s why getting this right sooner rather than later– is important.

  • if you’re in your 30s you don’t want to miss out on the best bone density foundation years of your life,
  • if you are older, you want to reduce your losses to protect your independence and mobility as you age,
  • and if you’re pregnant or
  • taking care of the nutritional needs of kids you certainly don’t want to mess with their nutritional needs either.

So why does this controversy exist?

Well, I’m summarising the finding of research as discussed in my two my favourite text books for this matter (see reference list below):

  • There are studies which show that calcium intake isn’t protective against fractures
  • There are studies which indicate that calcium from dairy isn’t protective because the people eating the most dairy in the world also show the highest rate of osteoporosis.
  • There is a question about the actual bioavailability from calcium in the diet from various foods, not just in terms of the different types of calcium but also the efficiency of every ones intestines varies considerably as does the rate of excretion (the loss of calcium in your urine)
  • There is data which indicates that people from other countries don’t have the osteoporosis and hip fracture problems that countries like America and Australia do.
  • And there are researchers on both sides of the fence who disagree with each of these studies and findings.

NB, Defining what I mean by the term “Researcher”

When I use the word “researcher” I mean:

Scientists, doctors, dieticians, nutritionists, naturopaths or herbalists who conduct research which gets reviewed by other researchers. These academic researchers have in common a bachelor degree which includes basic sciences (biology, chemistry, biochemistry, physiology, molecular biology, etc.) followed by a research higher degree (eg. honours, masters and or PhD) and time spent in research (conducting research, writing papers, preparing literature reviews, attending conferences and presenting research at conferences).

The recommendations of the 2 main nutritional perspectives:

(1) Plant-based research and health professional recommendations

In the plant-based world there are various groups advocating different plant-based approaches for optimal health. The general consensus is that you can obtain enough calcium in your diet with a plant-based diet. Although there is some discussion about how much exactly is the amount you need to obtain from the diet. In terms of the RDI some vegan health care practitioners recommend eating fortified foods, while others believe that you don’t need to supplement, but can get enough calcium in your diet providing you’re eating enough calories (based on their interpretation of the research and looking at nutrition status in other countries in the world).

(2) Omnivorous health professional recommendations

In this group the recommendation is generally that you need to eat dairy in order to meet your daily calcium needs and if you don’t eat dairy you need to supplement and or consume fortified foods.

So what do you do?

Well if you have an allergy or an intolerance then it’s a no-brainer – clearly dairy is off the menu for you. (Although with an intolerance people have different amounts of the food they can cope with before their symptoms show up. There’s a good chance that this amount of food won’t be enough to meet the total dietary needs, so you need to look at other options).

But what about the people who don’t “have” to avoid it but “choose” to avoid it… eg. people who don’t have an intolerance or allergy but choose to avoid dairy for other health reasons (eg based on research demonstrating links between dairy and various health conditions) , and people like vegans who choose not to eat dairy due concerns for animal welfare?

What do they do?

Well I don’t have a clear answer for you.

My children and I have a dairy intolerance. While they can get away with the odd cupcake at a party, if we eat too much dairy we tend to get eczema flare ups and I find my kids tend to get tummy aches. But apart from cheese – which I don’t miss any more since finding some great plant-based options, I haven’t really eaten dairy since I was in high school because I just don’t like the smell or taste of milk, cream or ice cream).

So… from what I have read so far there is enough research to show that you aren’t doomed to a future of osteoporosis just because you follow a plant-based diet or can’t eat dairy (though bear in mind – if you eat junk food and don’t eat a lot of the whole foods that contain calcium and you don’t supplement  and there are some other factors in your diet and lifestyle (read the next post) then it’s unlikely you’re going to have adequate calcium in your diet and you could develop osteoporosis – and other health problems in the future) .

In our house – we buy a calcium enriched dairy free milk alternative. And each day we make an effort to eat a lot of whole foods which contain calcium (and other nutrients). I’ve tried supplementing in the past, but find I tolerate the fortified milk alternative better than the supplement – so that’s the current best solution in our lifestyle. Yours might be a different solution. If you make your own milk alternatives at home you could get an idea from this episode here on how to boost the calcium content of it

So what should you do? You should discuss this with your doctor and your qualified nutritional healthcare practitioner because there are a lot of factors that need to be taken into consideration:

  • Your particular health history (intolerances, tests you might have had – eg. bone mineral density etc. medications you might be taking etc.)
  • Your current health needs
  • Your age or life stage
  • and your current and past diet (what you eat and how much you eat)

Beyond the question of whether or not you should supplement – I think is a more important question – as there are 2 key parts to this calcium equation:

  1. What goes in (from diet, supplementation and the efficiency of your body to absorb that calcium which can be affected by the bioavailability of that calcium and the efficiency of your gut to absorb the calcium (or other nutrients) and the other issue-
  2. What goes out (calcium losses through excretion).

Rather thank focusing on the controversy – I prefer to look at the consensus. So next we talk about the calcium consensus which is how to reduce calcium losses and we’ll discuss that in the next post.



  • Davis,B., Melina, V. and Berry, R. (2010)Becoming Raw. The essential guide to raw vegan diets. Book Publishing Company, USA
  • Gropper, S., Smith, JL., Groff, JL. (2009) Advanced nutrition and human metabolism (international student edition)(5th Edn). Wordsworth, Cengage Learning USA.
  • Mangels, R., Messina, V. and Messina, M. (2011) The Dietician’s Guide to Vegetarian Diets: Issues and applications (4th Ed). Jones & Bartlett Learning USA.