Should You Take Calcium Supplements for Stronger Bones?

Maintaining strong and healthy bones is necessary for overall well-being throughout life. Our skeletal system provides support, protects vital organs, and stores essential minerals, most notably calcium. While a balanced diet rich in calcium is essential for good bone health, the question often arises: Should you take calcium supplements for stronger bones?

Calcium is a vital mineral that plays a fundamental role in building and maintaining strong bones. Think of your bones as a bank account for calcium. When your body needs calcium for other functions, like nerve transmission and muscle contraction, it can withdraw it from your bones. If you don't deposit enough calcium through your diet, your bone "bank account" can become depleted over time, leading to weaker bones and an increased risk of fractures.

While obtaining calcium through diet is generally preferred, certain situations might make calcium supplementation a consideration:

• Inadequate Dietary Intake: If your diet consistently lacks calcium-rich foods like dairy products, leafy green vegetables, fortified foods, and fish with edible bones (like sardines), you might not be meeting your daily calcium needs.
• Certain Medical Conditions: Some medical conditions, such as Crohn's disease, coeliac disease, and kidney disease, can interfere with calcium absorption.
• Medications: Certain medications, like long-term corticosteroids, can increase bone loss and may necessitate calcium supplementation under medical guidance.
• Age: As we age, our ability to absorb calcium from food may decrease. Postmenopausal women, in particular, experience a decline in oestrogen levels, which can accelerate bone loss, making adequate calcium intake even more critical.

The recommended daily calcium intake varies depending on age and sex. Here are general guidelines:

• Adults (19-64 years): 700mg per day
• Pregnant and breastfeeding women: No increase is generally recommended, but ensuring a calcium-rich diet is important.
• Older adults (over 65 years): 700mg per day

It's important to note that these are general recommendations. Your individual needs may vary depending on your specific health status and risk factors for osteoporosis.

Getting Calcium from Your Diet: Food First

Before reaching for a supplement, prioritise obtaining calcium through a balanced diet. Here are some excellent dietary sources of calcium:

• Dairy Products: Milk, cheese, yoghurt (choose lower-fat options).
• Leafy Green Vegetables: Kale, spinach, collard greens (although absorption is slightly lower than from dairy).
• Fortified Foods: Plant-based milk alternatives (soy, almond, oat), orange juice, cereals, and bread often have added calcium. Check the nutrition labels.
• Fish with Edible Bones: Sardines and canned salmon.
• Tofu (calcium-set): Check the packaging to ensure it's calcium-set.
• Nuts and Seeds: Almonds, sesame seeds, and chia seeds contain some calcium.
• Pulses: Beans and lentils contribute to overall mineral intake.

Calcium doesn't work alone. Vitamin D plays a crucial role in helping your body absorb calcium from the gut. Without sufficient vitamin D, even a calcium-rich diet or supplementation might not be fully effective.

Most of our vitamin D comes from sunlight exposure. However, in the UK, particularly during the autumn and winter months, sunlight levels are often insufficient for adequate vitamin D production. Therefore, the NHS recommends that adults consider taking a daily supplement containing 10 micrograms (400 IU) of vitamin D, especially during these months. Individuals with limited sun exposure year-round may need to supplement throughout the year.

If dietary intake is insufficient and supplementation is deemed necessary by your healthcare provider, there are various types of calcium supplements available:

• Calcium Carbonate: This is a common and relatively inexpensive form of calcium. It's best absorbed when taken with food.
• Calcium Citrate: This form is generally more easily absorbed, even when taken on an empty stomach. It might be a better option for individuals with low stomach acid or malabsorption issues.
• Calcium Phosphate: Another readily absorbed form of calcium.
• Calcium Lactate and Gluconate: These forms contain less elemental calcium per dose and are less commonly used.
  The amount of elemental calcium in a supplement is what matters. Always check the product label to see the actual amount of calcium it provides, not just the total weight of the compound.

Your doctor will recommend the appropriate dosage based on your individual needs. It's crucial not to exceed the recommended dose, as excessive calcium intake can lead to potential side effects.

When dietary intake is inadequate, and under the guidance of a healthcare professional, calcium supplements can offer several benefits:

• Increased Bone Density: Supplementation can help increase bone mineral density, particularly in individuals at risk of or with osteoporosis.
• Reduced Fracture Risk: Studies have shown that adequate calcium and vitamin D intake can help reduce the risk of fractures, especially in older adults.
• Management of Certain Medical Conditions: Calcium supplements may be part of the treatment plan for specific medical conditions affecting calcium levels.

Potential Risks and Side Effects of Calcium Supplements

While generally safe when taken as directed, calcium supplements can have potential side effects:

• Constipation: This is a common side effect, especially with calcium carbonate. Increasing fluid and fibre intake can help.
• Bloating and Gas: Some individuals may experience digestive discomfort.
• Kidney Stones: High doses of calcium supplements have been linked to an increased risk of kidney stones in some people.
• Interaction with Medications: Calcium supplements can interact with certain medications, such as some antibiotics and thyroid medications. It's essential to inform your doctor about any supplements you are taking.

While a balanced diet should always be the priority, certain individuals may be more likely to benefit from calcium supplementation under medical advice:

• Postmenopausal Women: Due to oestrogen decline.
• Older Adults: Due to reduced calcium absorption and increased bone turnover.
• Individuals with Osteoporosis or Osteopenia: As part of a comprehensive management plan.
• People with Certain Medical Conditions: That impair calcium absorption.
• Individuals Taking Medications: That increases bone loss.
  Those with Restricted Diets: That limit calcium-rich foods.

Prioritise Dietary Calcium: Focus on incorporating calcium-rich foods into your daily diet.

• Ensure Adequate Vitamin D: Spend some time outdoors safely in the sun (when appropriate) and consider a daily 10 mcg vitamin D supplement, especially during autumn and winter.
• Talk to Your Doctor: Discuss your bone health with your GP, especially if you have risk factors for osteoporosis, are considering supplements, or have any concerns about your calcium intake.
• Don't Self-Medicate: Never start taking calcium supplements without consulting your doctor. They can assess your individual needs and recommend the appropriate type and dosage, if necessary.
• Report Side Effects: If you experience any unusual side effects while taking calcium supplements, consult your doctor.

The decision of whether or not to take calcium supplements for stronger bones is a personal one that should be made in consultation with your healthcare provider. Supplements may be beneficial in specific circumstances, but it's crucial to understand the potential risks and benefits and to follow medical advice. By prioritising a calcium-rich diet, ensuring adequate vitamin D intake, and adopting other healthy lifestyle habits, you can take proactive steps towards building and maintaining strong bones for a healthier future.