Doctor's Note

What’s this about calcium supplements and heart attacks and strokes?! You must have missed my “prequel” video, Are Calcium Supplements Safe?

And the more milk = more fractures galactose thing? That was covered in Is Milk Good for Our Bones?

For those not getting enough sun (see my recommendations here) I do advise vitamin D supplementation. For background on how I arrived at my recommended dose, check out my vitamin D video series from a few years ago:

If you haven't yet, you can subscribe to my videos for free by clicking here.

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  • UCBAlum

    Good information. I was one who for a long time was satisfied by “if it’s natural it’s safe” and I used that “argument” because the US RDA is so high that it seemed nearly impossible to get enough calcium even with a healthy diet…let alone a poor one…

    which looking back seems like an odd thing to believe. But that’s what the “experts” were saying and that held a lot of weight. Then I saw the WHO calcium recommendation and everything changed. I now look at a variety of sources before making decisions on supplements.

    I also started thinking our reductionist approach to nutrition can itself lead to problems and is an indication of how much we don’t know. I no longer think a pill is the answer in most cases. It can be sometimes, but I am skeptical now unless there is some pretty compelling evidence to support it.

    • Leonid Kalichkin

      > Then I saw the WHO calcium recommendation and everything changed.

      Where did you see it? Can you link it?

      • Here is a link you might find more useful than a blanket number.
        http://www.fao.org/docrep/004/y2809e/y2809e0h.htm

        Take a look at the charts: Figure 18. The effect of varying
        protein or sodium intake on theoretical calcium requirement.
        You can see if you eat a low sodium and low (animal) protein diet you calcium reqs are drastically lower than if you eat a high animal protein/high sodium (SAD) diet. 450mg CA instead of 840mg CA

        Table 31 has CA recommendations based on average eating patterns (this is from the 80s so it is worse now) of North America/Europe. This is about 70-80g animal protein
        For me, its 1000mg

        Table 33 shows recommendations if I eat 20-40g of animal protein
        For me its 750mg

        So if I eat 0g of animal protein?

        I’m no longer concerned about Calcium

        • Kevin

          Actually table 30 has calcium INTAKES from 1987-1989. They are not recommending calcium based off of animal protein. Table 33 has a theoretical calcium allowance based on an intake of 20-40g of animal protein and that’s around 800mg give or take depending on how old you are and your gender. Animal protein does boost the calcium absorption to counteract the loss from the acid load so long as you are getting enough calcium which is 800mg in men (http://www.ncbi.nlm.nih.gov/pubmed/23873776 ). Which would tell me that it’s probably safer to try and shoot for 800mg (or maybe 750mg in your case) because that just seems like the optimal and the safest level.

  • HemoDynamic, MD – NF Volunteer

    As always your information is helping me save lives every single day! Keep up the absolutely great work.

  • Leonid Kalichkin

    Still more questions than answers.

    1. No dose-dependent relationship was revealed. Are 100mg supplements as harmful as 1000mg?

    2. Again, all conclusions are made predominantly on postmenopausal women or adult men and women. Children and young adults are not studied. Studied adults are already past peak bone mass, while children and young adults are still in need of calcium surplus.

    3. Most studied people already get enough calcium from their diet. Can we isolate people who get less than 700mg (or even 500mg) and look at the benefits versus risks of supplementation?

    This uncertainty drives me mad. I usually get 400–450mg, I just can’t eat more greens. According to this (http://www.ncbi.nlm.nih.gov/pubmed/17921384 ) study, I should get 554mg of calcium based on my weight to achieve neutral balance. Additional 100–200mg would help me reach this goal, but I don’t want to get a heart attack or a stroke.

    • He just said your body will absorb more if you are intaking a little less, intaking critically low amounts is a problem but you aren’t critically low you are slightly below optimal.
      Don’t let the diary industry drive your perception of the over-importance of calcium. Calcium deficiency is very very rare. Eating a more alkaline diet will help you conserve your calcium further, beyond what any RDA can account for.

      • Leonid Kalichkin

        > your body will absorb more if you are intaking a little less

        In percent, but not in the amount.

        > Calcium deficiency is very very rare.

        We are not talking about deficiency, but about suboptimal intake that can result in lower peak bone mass and higher risk of fractures.

        > Eating a more alkaline diet will help you conserve your calcium further, beyond what any RDA can account for.

        No proof of that. Protein increases calcium absorption, while sodium increases calcium urinary excretion. That’s what we know.

        • I posted a link in another post you might find useful, it can help you find out where you need to be.
          http://www.fao.org/docrep/004/y2809e/y2809e0h.htm
          Protein increases excretion of calcium and requirement to be calcium neutral, calcium absorption curves are also shown

          • Leonid Kalichkin

            > Protein increases excretion of calcium

            Which is only half-true. Excreted calcium is not from bones, it is from your meal. Protein increases absorption, so you get more calcium in your blood and then dump it into the urine. This study is based on the old hypothesis that animal protein causes calcium loss from bones, which was proven to be not true.

            In your comment below it should be emphasized that it was a ‘theoretical calcium requirement’. It was not proven by experiments, and it was calculated based on a disproven hypothesis, so it is no longer can be applied. There is no proof that decreasing of protein (animal or not) intake results in lower calcium requirements.

            If you don’t believe my words, then listen to Dr. Greger: http://nutritionfacts.org/2014/07/31/does-animal-protein-cause-osteoporosis/

          • I’ve seen that, but it doesn’t answer anything, only makes things more inconsistant. We know the higher protein intake the worse your bones are, this happens all around the world. Because this one mechanism was proven different, I don’t think it negates what the end results are, right?

          • Leonid Kalichkin

            > We know the higher protein intake the worse your bones are, this happens all around the world.

            I would like to see actual studies. As far as I know, there aren’t any that can prove that protein in isolation causes bone loss. Higher protein intake can be just a marker for high sodium, high dairy, high sugar, high processed food intake or anything else.

            Observational studies can’t disprove intervention trials that show that protein intake positively affects calcium absorption and has no detrimental effect on bone resorption. (http://www.ncbi.nlm.nih.gov/pubmed/19279077, http://www.ncbi.nlm.nih.gov/pubmed/21248199 )

            This study (http://www.ncbi.nlm.nih.gov/pubmed/8661965 ) shows that protein intake positively correlates with bone density. This study (http://www.ncbi.nlm.nih.gov/pubmed/11127216 ) shows that people with the lowest intake of animal protein has the lowest bone density. Higher intake of protein is associated with higher bone mineral density (http://www.ncbi.nlm.nih.gov/pubmed/12791633 ).

          • Rph1978

            A more recent study also shows that a high protein diet does not cause osteoporosis instead it can increase bone density especially if there is adequate Ca, fruits and vegetables in the diet.
            Jay J. Cao and Forrest H. Nielsen,Acid diet (high-meat protein) effects on calcium metabolism and bone health,Current Opinion in Clinical Nutrition and Metabolic Care 2010, 13:698–702

          • Kim

            “Which is only half-true. Excreted calcium is not from bones, it is from your meal.”

            Regarding this, you’re right, Leonid, so long as people are getting enough calcium in their diet. If people aren’t getting enough calcium but are getting an abundance of animal protein, the old hypothesis still seems to hold: your body will use calcium from its bones to neutralize it. So, our bodies are smart. Animal protein seems to be detrimental, but if the body can grab something from the food in our intestines to neutralize it and spare its bones, it will. If it can’t, it will sacrifice the calcium in bones.

            You’re also right that the relationship between protein and bone health is still rife with controversy, that it’s not fully understood yet (will all these things being studied ever be fully understood? I’m skeptical). There’s no doubt that the body can utilize some components of animal food for good; not all components are bad, and situation likely affects this (affluence vs. starvation, for instance). Protein is needed for healthy bones, and perhaps in terms of just this one thing, the body doesn’t care whether that protein comes from animals or plants (once it’s all split down to amino acids, as far as the bones are concerned, it might all be the same thing). That of course doesn’t negate the other effects of animal foods; that doesn’t make these foods smart choices overall as far as the body is concerned.

          • Leonid Kalichkin

            > If people aren’t getting enough calcium but are getting an abundance of animal protein, the old hypothesis still seems to hold: your body will use calcium from its bones to neutralize it. So, our bodies are smart. Animal protein seems to be detrimental, but if the body can grab something from the food in our intestines to neutralize it and spare its bones, it will. If it can’t, it will sacrifice the calcium in bones.

            That’s just your opinion. Where is the proof?

            I’m not debating that meat is good. I’m debating about bad science.

          • Kevin

            Calcium isn’t leached from your bones following an acid forming meal. It’s leached from the food in your stomach. Then the protein increases the absorption so that there’s no net loss (http://nutritionfacts.org/video/alkaline-diets-animal-protein-and-calcium-loss/ ). Animal protein isn’t detrimental to bone health so long as you are getting in 800mg of calcium as a male (http://www.ncbi.nlm.nih.gov/pubmed/23873776 ). I’d just shoot for as much as you can get in your diet while still being reasonable at this point — no sense in risking it. Kale, collards, and beans have a good amount while carrots, oranges, raisins, oatmeal, flax seeds, and potatoes can help supplement that. I don’t know what your situation is, but I’d at least try to reach Dr. Greger’s recommendation of at least 600mg a day. http://nutritionfacts.org/2011/09/12/dr-gregers-2011-optimum-nutrition-recommendations/

    • Embrace the uncertainty in science and keep up with the best science. We know so much more now than back in the 1980’s but undoubtedly will learn more. We need to trust our adaptive or complex system to make the appropriate adjustment. If you want to pursue the details of calcium and the other 18 nutrients that contribute to bone strength I would recommend Amy Lanou’s book, Building Bone Vitality. She reviewed over 1200 studies and explains the difference between the types of studies. She even has a chapter on drug treatment for osteoporsis. However the book was published several years ago so you need to keep tuned to NutritionFacts to get the latest updates and perspectives. Thomas Kuhn wrote “The Structure of Scientific Revolution” in 1962. He describes how scientific knowledge keeps building up until we undergo a paradigm shift… popularized more recently as a tipping point. Currently the science doesn’t favor of taking isolated supplements as a general population recommendation except for Vitamin B12. Care needs to be taken for some other nutrients like iodine which is added to most salt. As Dr. Greger mentioned in Mondays video the dose and time line of absorption into the body seems to contribute to the risk associated with supplements.

      • Leonid Kalichkin

        > If you want to pursue the details of calcium and the other 18 nutrients that contribute to bone strength I would recommend Amy Lanou’s book, Building Bone Vitality.

        Thank you, I’ll look into it. But if you don’t get enough calcium, it is going to be a limiting factor. I want to make sure I get enough. Current scientific evidence tells that I don’t.

        • Depends on the recommendations you are following. If you need to take supplements the lower doses involved in plant based milks would appear to me to be a better alternative than a pill. Not to get lost in this discussion is the value of weight bearing exercise which has been shown to consistently benefit avoiding fractures of hip and spine along with other benefits… see http://nutritionfacts.org/topics/exercise/. You might want to view some of the other video’s on NutritionFacts.org…. http://nutritionfacts.org/video/calcium-absorption-soy-milk-versus-cow-milk/ (shake up the soy milk) and http://nutritionfacts.org/video/omnivore-vs-vegan-nutrient-deficiencies-2/. Good luck.

          • Kim

            We’ve started including plant milks in our diet again recently in order to boost our vitamin D intake (which over the summer we didn’t worry about on account of getting plenty of sunshine), but these videos give me pause. Was thinking it likely wasn’t as big a deal on account of being smaller amounts (of calcium in plant milks), but I still wish there were plant-based milks that weren’t fortified, or only fortified with D and B12. Zero need for any of the other stuff, imo. We’d love to invest in a sun lamp (anyone else here doing this?), but worry about initial cost and cost of upkeep (new bulbs), so we’ll likely end up buying supplements, at least for this winter.

          • Kim

            Just thought I’d add that I know Greger and many others recommend sticking with supplements over UV lamps, but I don’t find their reasoning to be particularly convincing if we’re talking about responsible use. UV lamps, to the best of our knowledge, should be on par with sunshine exposure in increasing cancer risk, so if avoiding lamps and supplementing instead makes sense, then it should also make sense to avoid sunshine and to supplement instead. Some people do actually advocate this, but myself I’d rather enjoy the myriad benefits of responsible sun exposure (something we’ve likely only scratched the surface of) and rely on my body’s natural production of vitamin D where this is possible.

          • Tom

            Vitamin k2, k2, k2 !!!!!! Without it calcium is dangerous.

          • Graceread

            You say above that it would be better to get calcium from plant based milks rather than a calcium pill. Just wondering why? Usually in the nut milks they use calcium carbonate and if you take a pill I usually get calcium citrate or calcium gluconate. Aren’t these better absorbed?

      • Fred Pollack

        Today mother jones had a pretty good post on this topic:
        http://www.motherjones.com/environment/2015/10/dairy-industry-milk-federal-dietary-guidelines

        Of particular interest was their link to Hegsted’s 1952 article on calcium balance. In addition to the small study that Hegsted did, he also reviews much of the research previous to his:
        http://www.motherjones.com/documents/2461295-j-nutr-1952-hegsted-181-201

        The Hegsted article is very much consistent with Dr. Greger’s analysis.

        • Lawrence

          Excellent post, Fred. Thank you. Harkinson’s reporting is top-notch. And, the Hegsted study has allayed any concerns I previously had about ‘getting enough calcium’ following a starch-centric whole food, plant-based (WFPB) lifestyle. Anyone who can understand the equation of a straight line will understand Hegsted’s conclusion way back in 1952 that it is almost impossible to be in a state of negative calcium balance eating humble foods in sufficient quantities to meet calorie needs. Hegsted’s study also underscores Dr. Greger’s recommendations for vitamin D supplementation as he explains in today’s Doctor’s Note.

          It is hard to imagine that Dr. Greger’s videos (this one and the previous one) will not change one’s attitude and behavior with respect to calcium and vitamin D supplementation. It has certainly changed mine.

    • Julie

      Leonid, I’m thinking along the same lines. What about dose? What was the calcium dose in these studies showing supplementation is harmful?

      On days where I can’t eat more greens due to availability or whatever, and my calcium intake is 400 mg, I really don’t see any harm coming from taking 150 mg of calcium to reach the minimum recommended level.

    • Thea

      Leonid: re: “Children and young adults are not studied.”
      I thought you might be interested in the following study that focuses on adolescent girls.

      “Dairy Products Do Not Promote Bone Health
      Dairy products and calcium do not prevent stress fractures, according to a new study published in Archives of Pediatrics and Adolescent Medicine. Researchers followed adolescent girls for seven years, tracking their diets, physical activity, and stress fractures. Girls consuming the most dairy products and calcium had no added protection. In fact, among the most active girls—exercising more than one hour per day—those who got the most calcium in their diets (coming mostly from dairy products) had more than double the risk of a stress fracture, compared with those getting less calcium. Researchers found that vitamin D intake did help cut risk. Girls getting the most vitamin D had half the risk of a fracture, compared with girls getting less vitamin D.” – from PCRM in 2012
      Sonneville KR, Gordon CM, Kocher MS, Pierce LM, Ramappa A, Field AE. Vitamin D, Calcium, and Dairy Intakes and Stress Fractures Among Female Adolescents. Arch Pediatr Adolesc Med. Published ahead of print March 5, 2012.

      • Leonid Kalichkin

        Again, it’s dairy. And the lowest quntile of calcium intake was mean 825mg. It only shows that when you get enough, there is no point in getting more. I don’t get 825mg.

        • Kim

          I’ve found, using Cron-o-Meter, that when I’m eating healthfully, when I’m eating my greens and legumes, I easily get over 500 mg, usually in the 600 to 800 mg range. Having researched this issue a bit, I’m highly skeptical of the government guidelines of 1000 mg a day (with past proposals aiming to get this bumped to 1500 mg), and am glad to see the science challenging this. I’m not buying that this is necessary for people that aren’t abusing their bodies with excess salt, animal protein, alcohol, cigarettes, etc. That said, many people aren’t getting enough calcium. Also, physical activity is one of the biggest protective factors, and most of us aren’t active enough.

    • Thea

      Leonid: re: “I usually get 400–450mg,…”
      I’m not a doctor nor expert and can’t say what any one person needs or not. But I thought you would find the following information helpful/something to think about: “…, some populations who eat less than 400 mg of calcium per day have lower rates of osteoporosis than populations who consume more than 1,000 mg per day.” From “Becoming Vegan Express Edition” by Brenda Davis and Vesanto Melina (both well respected RDs and even featured in a guest blog once here on NutritionFacts), page 41.

      I bring this up to say that while Dr. Greger is recommending 500-1000 mg of calcium, he also says that the science isn’t really all that clear, and we have some good evidence that dietary calcium may not be a big concern for most people. Now combine that thought with the following: a vital point that Dr. Forrester made in a comment here somewhere and I want to SHOUT to everyone — that we can’t ignore the importance of *certain kinds* of exercise on bone health. (Which is addressed very well in the Building Bone Vitality book.) Personally, I suspect that exercise is more important than calcium intake (above say 400 or 500 mg) in promoting bone health.

      With all that in my head, I wonder how much you need to be concerned for your situation? Are you eating a whole plant food diet? And are you getting around 400-450 mg calcium from your foods? And do you do weight bearing exercise daily? (No need to answer these questions. I’m just making a point.) So, maybe you are fine? Or maybe you could add some tofu or non-dairy milk to up your levels just a bit more to hit that 500 mark?

      My 2 cents: re: “This uncertainty drives me mad.” There is definitely a lot of uncertainty. And I can understand why that is hard. But I also think we need to accept and fully understand that there really is a lot of uncertainty. This is just one of those areas where we have a general idea about where things stand, but still lack a lot of important details. So, you have take what we know (such as a whole food plant diet with lots of greens is best) and then apply the smaller details (such as exactly how much calcium do you need and would a small calcium supplement be OK) based on what feels right to you. Good luck.

      • David Johnson

        Let’s not forget about the role of vitamin D in bone health.

        It can be difficult to get enough via the sun, either because of season, location or age, and to make matters worse, people are typically told to avoid the sun like the plague these days. But the optimal range for vitamin D is unclear (appears to be a U or backward J curve), and the effects of supplementation can be quite varied e.g. I take 2000 mg per day, which I think Dr. Gregor recommends, and my levels are slightly above 50, which some say is great, and others somewhat too high. (I think my level is as high as it is because I have a low BMI.)

        • Thea

          David: Thank you for this point. I (mostly) agree with you.

          To share: I take two supplements (when I remember to do it – argh, I’m bad at that!): B12 and D. I take the 2000 of D because I work all day inside (in a windowless office), and I live at a latitude where I can’t get enough sun anyway at certain times of the year.

          The reason I qualified my reply (by saying “mostly”) is this: I think that if we are going to talk about specific substances relating to bone health, then I think we have to acknowledge Lanou and Castleman’s point (from the book Building Bone Vitality) that bone is made up 18 nutrients: boron, copper, flouride, magnesium, manganese, phosphorus, silica, zinc, calcium, vit A, vit C, vit B6, vit B12, vit D, vit K, and folic acid. Also strong bones require essential fatty acids and protein (preferably plant protein). To focus on only one or two of these things does not make sense to me. Yes, vitamin D is important, but so is boron, etc.

          And here’s another key point that I got from the book: “These … nutrients are not only necessary for strong bones, but also must be consumed *in the proper proportions.* For example, without enough vitamin A, bones cannot develop normally. But too much *increases* fracture risk…” page 99.

          The book also states (based on an extensive review of the literature) that the most reliable way to improve bone mineral density is to eat more fruits and vegetables. page 100 and then gives some great examples of veggies that have lots of the above nutrients. One of my favorite lines is: “There’s no need to obsess about eating these specific fruits and vegetables. Just eat a wide variety of fruits and vegetables. Have fruits and vegetables at every meal. Eat a serving of beans or peas daily and snack on fruit and nuts.” And then of course, the obligatory warning about needing to get B12.

          ———–

          I just think this is an important perspective to have when it comes to bone health. It’s not just about calcium. It’s not just about calcium and vitamin D. It’s about all of it and all of it in the correct proportions. And happily, that’s not as complicated as it sounds! Just eat your fruits and veggies and beans…

          • David Johnson

            Thanks for your response! I agree with your points (and will read Building Bone Vitality).

          • Gary

            Hi Thea

            Whenever I run into confusion about recommended Vit levels I pretty much check on the Okinawan levels. After all many of them are still walking around and exercising at 100.

            On their meager diet of pretty much no fruit, seeds or nuts, (<1%) of total calories they had,

            505 mg calcium. 82% of the RDA

            Vit K 87.6 mcg, 160% of RDA

            Vit D very low levels of 0.4mcg , 2% of RDA

            Not saying their diet couldn't be improved, but they did very well with what they had to eat.

            The women pretty much avoid the hot sun by wearing a big hat, shirt, and pants. They like blemish free white skin rather than the tan look that's popular in the US.

            http://okicent.org/docs/anyas_cr_diet_2007_1114_434s.pdf

          • Thea

            Gary: Great post. I also often refer to the traditional Okinawan diet as a starting place for figuring these things out. But I hadn’t seen your particular information before. Thanks for sharing.

        • SeedyCharacter

          Vitamindcouncil.org seems to be a good source for research on vitamin D and latest thoughts on optimal levels. From my reading, my hunch is that osteoporosis is more a result of insufficient vitamin D and insufficient weight bearing exercise. A walking/jogging sunbath at noon (the best time for sun exposure to minimize skin cancer risk, per the Vitamin D Council) seems better than gobbling calcium and vitamin D pills.

    • Tom

      Vitamin k2 is needed to guide absorbed calcium to bones, not to damaing plaque. See Dr. Dennis Goodman’s new book on k2. Are u getting your k2?

  • Leonid Kalichkin

    Still more questions than answers.

    1. No dose-dependent relationship was revealed. Are 100mg supplements as harmful as 1000mg?

    2. Again, all conclusions are made predominantly on postmenopausal women or adult men and women. Children and young adults are not studied. Studied adults are already past peak bone mass, while children and young adults are still in need of calcium surplus.

    3. Most studied people already get enough calcium from their diet. Can we isolate people who get less than 700mg (or even 500mg) and look at the benefits versus risks of supplementation?

    This uncertainty drives me mad. I usually get 400–450mg, I just can’t eat more greens. According to this (http://www.ncbi.nlm.nih.gov/pubmed/17921384 ) study, I should get 554mg of calcium based on my weight to achieve neutral balance. Additional 100–200mg would help me reach this goal, but I don’t want to get a heart attack or a stroke.

  • Veganrunner

    So I will continue with the practice of eating my veggies, getting sunshine and plenty of weight bearing exercise. Perfect!

  • Veganrunner

    So I will continue with the practice of eating my veggies, getting sunshine and plenty of weight bearing exercise. Perfect!

  • Stephanie

    So, does this mean Vitamin D supplementation alone is still acceptable and safe?

    • Joseph Gonzales R.D.

      Yes, vitamin D is still important and can be supplemented if levels are low. Of course, sunshine and mushrooms may be the best way to obtain it.

      • Good evening Ms. Gonzales I’m looking for a study about the different resorbtion of sun relatet vitamin d by white and black people. backround is, I voluntary refugees from Eritrea next to my house and I beliefe that they are getting to less vitamin d because they don’t get outside for hours (in germany we have temperatures about 10 °C now and its cold for this guys) and they have no idea ob sublements but have some blues yet.
        So it would help my to argue with the gouverment to get some money for vitamin d.
        Thank you for your answer…

        • SeedyCharacter

          Steffen: So great that you are concerned about your refugee neighbors. Go to vitamindcouncil.org If they don’t have the information you are looking for, they would likely direct you to the proper sources. What I have learned is that the darker the skin, the less vitamin D is produced from sunlight. Dark skinned people need longer exposure times.

      • Fred

        What about the combination or nexus of calcium…vit D…vit K? Vit K helps to keep the calcium in the bones…not your blood vessels?

        How does magnesium fit in?

        I also take a strontium capsule.

        http://drhoffman.com/article/strontium-for-bone-health-2/

        “Further, scientists are looking into the benefits of strontium for osteoarthritis because researchers hypothesize that strontium might also improve cartilage metabolism; additionally there may be protection against dental caries since 10 percent of subjects that had no dental carries in a 10-year study sponsored by the U.S. Navy resided in a small town that had unusually high levels of strontium in the municipal water supply.

        It is my clinical opinion that strontium citrate is absorbed better than the other forms of this mineral.

        Remember that strontium is very closely related to calcium. They both utilize the same carrier protein for transport.”

  • mbglife

    Anything to suggest what was causing the increase in heart attacks and stroke, like calcium-based plaque?

    Any guess as to whether the risk reverses itself when supplementation is stopped?

    • Joseph Gonzales R.D.

      Yes, from Monday’s video on calcium safety “Within hours of taking supplemental calcium, the calcium levels in the blood shoot up and can stay up as long as eight hours. This evidently produces what’s called a hypercoagulable state, your blood clots more easily, which could increase the risk of clots in the heart or brain. And, indeed, higher calcium blood levels are tied to higher heart attack and stroke rates. So, the mechanism may be calcium supplements lead to unnaturally large, rapid, and sustained calcium levels in the blood, which can have a variety of potentially problematic effects.”

      There’s likely further explanations in the studies themselves. Hope that helps!

      • mbglife

        That does help, thanks. So it sounds like the risk goes down when you stop supplementation.

        • David Johnson

          I’m also wondering – I supplemented with probably 1000 mg of calcium per day for years but quite probably 15 years ago… still wondering where all that calcium went.

  • Tom

    I have followed these guidelines and now have osteoporosis. Why is there no mention of vitamin k2, deficient in most Americans, especially those on plant based diets. As discussed in nih fact sheet on k, k2 directs where calcium goes — soft tissue or bones. K2 is used in Japan to treat osteoporosis. The studies showing calcium supplementation raised coronary risk used non-plant based calcium without K2, and often no mention of vitamin D. I agree, get your calcium from plant foods. But what if u still end up with osteoporosis? Vitamin D helps us absorb calcium from any source. But how that absorbed calcium is used, too rebuild bones or caused calcified coronary lesions appears to be the job of K2 that many people are deficient. Please look at the ongoing research on k2 and report. This is a safer way to treat osteoporosis than bisphosphonates.

    • Joseph Gonzales R.D.

      I cannot say why you developed osteoporosis. I bet that’s frustrating when it seems you’ve done everything right diet wise! Dr. Greger addresses vitamin K2 in his Q & A. And someone made a great link on Monday’s page to an article about vitamin K and calcium. I think you’re onto something, as all of these vitamins and minerals work together to support bone health. It is not just about calcium, but vitamin D, K, C, and others. Dr. Greger does say in the video “this is not to say these supplements don’t play a role in treating osteoporosis”

  • Tom

    Lara Pizzorano, author of Our Bones, points out that all the calcium studies mentioned do not consider the necessity of vitamin k2:It’s been well known for more than 15 years now, at least among those who read the peer-reviewed medical literature, that vitamin D not only greatly increases our ability to absorb calcium, but also increases the body’s production of the vitamin K2-dependent proteins, including osteocalcin and matrix Gla protein, which regulate our – healthful – use of calcium. For this reason, vitamin D supplementation actually increases our need for vitamin K2. In addition, it’s also well known that vitamin K2 insufficiency is both widespread and all too common, except in Japan in those individuals who regularly eat the only food that is rich in K2 (in its MK-7 form), natto. (We do get some K2 when healthy bacteria in our gut converts K1 to K2’s short-lived MK-4 form and some K2 in the form of MK-7– MK-10 from certain cheeses and eggs, but the amounts of K2 these foods provide is nowhere near adequate. If you’re not eating natto, your likelihood of K2 insufficiency is astronomically high unless you are taking a supplement that is providing you with at least 100 mcg daily of the MK-7 form of vitamin K2.)

    For a very small sampling of the peer reviewed-medical journal articles on the necessity of vitamin K2 for calcium regulation, prevention of cardiovascular disease, kidney diseases and osteoporosis. Please review research on K2 and report.

    • Joseph Gonzales R.D.

      Thanks for sharing. Others have mentioned the role of vitamin K for bone health. I have added some links below. Let’s keep looking into this and sharing the research we come across!

      • Julie

        Dr. Dennis Goodman, a cardiologist and the chairman of the Department of Integrative Medicine at the New York University (NYU), has authored the book, Vitamin K2: The Missing Nutrient for Heart and Bone Health. In it, he explains why vitamin K2 is every bit as important as vitamin D.

      • VegGuy

        Here’s a good review article from the British Journal of Nutrition on the role of vitamin K2 in human health.
        http://205.251.124.92/Europe/Documents/Menaquinones%20and%20human%20health.pdf

    • David Johnson

      >>>at least 100 mcg daily of the MK-7 form

      Where did you get this amount? I see that Dr. Fuhrman’s multi provides 30 mcg of MK-7, better than nothing but a lot less than 100 mcg.

  • you can

    Hi, I’m currently taking 300mg daily of Kind Organics Calcium in which the calcium is derived from organic algae, is this any better? I’m assuming none of the studies mentioned used this type of calcium.

    • Joseph Gonzales R.D.

      I just don’t know. Usually studies lump together all calcium supplements so unless there is a clinical trial on just that brand it’s too hard to say. The important thing that I take away from the video is taking any calcium supplement is not better than dietary sources. The only reason to consider taking a calcium supplement is if suffering from osteoporosis. Of course everyone should discuss the risks:benefits with their doctors.

  • Tobias Brown

    What is your basic opinion on using fortified foods? Soy milk has extra calcium. Nutritional yeast has some “stuff” normally, I believe. Etc. Etc. The list goes on and on.

    • Joseph Gonzales R.D.

      Still okay. The calcium is readily absorbed in fortified plant milks. We see that swapping soy protein for dairy protein may help lower body weight.

      What’s interesting to me is that if 500-1000mg is the “range” for calcium intake then one-cup of fortified plant milk (300mg on average) is quite a lot! We may not need so much, but there is also no reason to stop drinking it. For kids, they still need tons of calcium and their needs are even higher (1300mg per day), according to the IOM. So the amount of calcium-fortified plant milks really depends on how much other sources of calcium are in the diet.

      • Leonid Kalichkin

        I don’t get what’s the difference between consuming fortified foods and taking the same dose of a supplement with food. It is still added calcium, not balanced with fiber, vitamins and minerals. Absorption rate and elevated blood calcium levels are going to be the same, so are the health effects and risks. If it’s okay to consume fortified foods, then it’s okay to take supplements of the same dosage with food.

      • Tom

        The calcium in soy milk comes from tri-calcium phosphate that is added. This is just a calcium salt — a supplement, not a plant form of calcium. It seems to me drinking soy milk is just taking a calcium supplement. In addition there are PubMed articles that show soy can lower free testosterone as it increases Sex Hormone Binding Gloublin (SHBG) which is harmful to bone health. The calcium supplementation studies lumped all types of calcium supplements together and did not consider plant vs.rock supplements, nor the synergy necessary for calcium absorption first, and then where calcium is deposited second. It seems to me calcium enriched (added to) foods is just another form of taking a supplement.

      • guest

        Yeah, but these soy milks often contain synthetic vitamins that Dr. Gregor and other vegans doctors have advised us
        under no uncertain terms to avoid, 100% in synthetic from. Joseph, please see the bigger picture here, most store bought
        soy and almond, rice, coconut millks are fortified with synthetic vitamins, some of the ones we are told by science to avoid in
        supplement form.

        • Ben

          The dose makes the poison. Supplements are dangerous because they are too concentrated.

      • SeedyCharacter

        I’ve heard it’s really important to shake the heck out of the calcium fortified plant milks before serving because the calcium settles to the bottom.

        • jm

          So theoretically if one leaves the thick stuff at the bottom that might leave less calcium in the soymilk?. I like the taste of the fortified much better.

          • Joseph Gonzales R.D.

            Yes do not leave that stuff out or you’ll miss the calcium boat ;-)

        • Joseph Gonzales R.D.

          Most definitely! The science says so.

          • SeedyCharacter

            It’s one thing when Simon Says . . . another altogether when Science Says. (That joke may be a little dated.)

  • rumicat

    I just started taking a calcium supplement and stopped thanks to this information. I am taking a magnesium supplement to help with sleep. Is there any harm in that? Only taking 100% RDA of magnesium. Basically hoping to help combat perimenopausal insomnia which is driving me bonkers. I’m not depressed, just wake up (or sometimes try to fall asleep) feeling like my entire body is vibrating. I think my nervous system is unhappy about shifting hormone levels. Tested for by no thyroid issues. Also taking iron to help with low ferritin levels. Anybody got any ideas I’m listening.

    • Joseph Gonzales R.D.

      I am not sure magnesium supplements run the same risks, but like calcium supplements they are not needed. If you are searching for sleeping aids that’s a different story and gosh I am not sure what the research says on magnesium. We do have many videos on sleep. Kiwifruit, cherries, and other foods and techniques may help.

    • Tom

      Does the vibrating feeling go away or lessen if you get up and walk around? If so that is a strong indication of Restless Leg Syndrome. I have the same thing, It improved a little when I got serum ferritin over 100. Coffee, alcohol, sugar, lack of exercise, and many pharmaceuticals and herbal preparations also make the tingling/vibration/creepy-crawling sensations worse, especially at night. Check http://www.rlshelp.org for a complete list of triggers if this continues.

      • rumicat

        Thanks Tom. Ferritin level is 25 right now, was even worse at one time and I constantly felt tired. I suspect restless leg. I take iron pills, but maybe will try taking them with some citrus, I’ve heard than helps adsoption. And yep, alchohol and any caffeine make it worse.

  • Joe Caner

    At one point in my life, I was a real pill popper. I was downing over 20 dietary supplement pills daily in an attempt combat the ravages of the western industrial diet. I am now down to one 5000 mcg. B12 table taken weekly. I felt confident doing this due to the disparity in the published RDI for Calcium, (450 mg-1200 mg) which was sited in today’s video and changing to the most nutritionally dense diet available, WFPB…

  • Julie

    Gee, are the inflated US calcium requirements influenced by Dairy Industry lobbying, by any chance?

  • Nancy Altman

    What about whole food, plant based vitamins? I take a raw, whole food, plant based supplement, and a lot less (1/day) than recommended on the bottle (3/day) because I tend to eat a whole foods, plant based diet. The supplement is made from a raw fruit & vegetable blend as well as a raw pro-biotic & enzyme blend. Does that work like the calcium fortified plant milks?

  • rvillacis6

    I am a breast cancer survivor, and take anastrozole, an aromatase inhibitor, to suppress estrogen in my system and hopefully prevent a cancer recurrence. It has been recommended that I take a calcium/vitaminD supplement, but now I am worried that I am doing more harm than good. Any thoughts?

    • Joseph Gonzales R.D.

      It’s hard to say and I don’t want to detour anyone from taking their doctor’s advice. It does seem based on this video that supplementing with calcium is really only warranted for those with osteoporosis. Taking it for prevention doesn’t seem to help. There may be more to this considering your cancer history. I suggest taking with your doctor/oncologists about supplementing with vitamin D without the calcium, but of course making sure dietary calcium needs are met. Calcium is just one piece to the puzzle and there are so many things to consider regarding survivor health. If you’d like some more video suggestions or tips please do let me know! There are over 140 videos and blogs on cancer and survival by Dr. Greger. And I used to work at MD Anderson Cancer Center with stage 3 breast cancer survivors in a comprehensive lifestyle study. Diet is so important and we have many tips that can help.

      Best regards,

      Joseph

    • Vegan Chick

      I too am a breast cancer survivor. I have been on Anastrazole for 4 1/2 years now. I only have about 6 months to go on the pill. I had chemotherapy which took me from having good/normal bone density to having osteoporosis of the spine and osteopenia of the hip. I have been a whole foods, healthy-eating vegan now for the same 4 1/2 years. My oncologist and primary care doctor want me to be on a bisphosphonate drug, but I refuse to take it due to the side effects of the drugs. I really thought a healthy vegan diet, walking and weight lifting exercises would put a halt to the decreasing bone mass caused by the lack of estrogen, but every two years my bone density test is worse. I’ll be off the drug in less than a year, but I hope I still have some bones left! My doctor keeps telling me that the only way to BUILD bone mass is with a bisphosphonate drug. He says that eating healthy is good for prevention of losing bone mass but not BUILDING it. Because I don’t want to take the bisphosphonate drug, I have searched far and wide for other options. My good friend also had breast cancer (it really is an epidemic) and had all the same treatments and drugs that I had. She took 750mg of calcium citrate, magnesium, vitamin D3, about 100mg of vitamin K2 (MK-7 form), and about 300mg of strontium citrate for the five years she was on Anastrazole. Her bone density tests got better and better each time. She is now back to normal bone density. By the way, she is a meat and dairy eater. Anyway, unless I can find something else to do, I have started on her regimen ( but not her eating regimen). I am only 49. I want my bones to last for a long time!! If anyone out there has some advice, I’d really appreciate it! Thanks Dr. Greger for your amazing site! Good luck rvillacis6!

      • Darr

        A recent presentation at the International Symposium on Nutrition and Osteoporosis about research on prunes increasing bone density was written about by Happy Healthy Long Life on FB; 6 prunes a day is effective, according to Dr. Shirin Hooshmand.

        • Darr

          Look at the date of November 11 in the postings of Happy Healthy Long Life, which is chock full of good info for your situation. Good luck!

    • Joseph Gonzales R.D.

      Hi rvillacis6, I had to change my comment a bit and just wanted to let you know. Thanks for your question.

    • Matthew Smith

      Hello! This website has some recommendations for cancer.

      They include Fruits like Lemons, Cranberries.
      Spices like Turmeric, Ginger,
      Vegetables like Garlic, spinach, beets, broccoli
      nuts like walnuts, pecans
      tea like matcha, and hibiscus or white tea with lemon

      Some foods are very good for cancer like white button mushrooms, amla, fenugreek, and Nori sheets.

      Did you know that D3 is strongly recommended for cancer prevention? The drug companies three times released 50,000 IU of vitamin D as a cancer treatment. Dalsol and Deltin were their names. Do you get enough sun? I can strongly recommend high dose vitamin D therapy because I am on it myself for Lyme disease.

      Scientists have known since the 1900s that low phosphorus is related to cancer. Do you ever drink dark colas? Pumpkin seeds were recommended for cancer by Dr. Group. http://www.globalhealingcenter.com/natural-health/7-health-benefits-of-pumpkin-seeds/ They are a rich source of Phosphorus. Non vegan sources of Phosphorus that have been used to treat cancer include Calf liver juice and certain goat cheeses.

      Iodine has been recommended for the treatment of breast cancer. BEWARE. Iodine consumption can and does cause a weak pulse. I had just one half teaspoon of Iodized table salt and had to go to the emergency room with said “weak pulse.” I can no longer feel my heartbeat. Iodine has strong effects on the heart. You could cautiously increase your intake of Iodine until you find an amount you are comfortable with.

      Some alternative herbs for cancer include PawPaw, Essiac tea (some preparations contain Iodine and Kelp), and wormwood http://www.livestrong.com/article/488611-paw-paw-herbs-and-cancer/ http://www.collective-evolution.com/2014/03/26/this-little-known-chinese-herb-kills-12000-cancer-cells-for-every-healthy-cell/

      Dr. Abram Hoffer used vitamins to treat cancer.

      These include high doses (10 grams+) of Vitamin C
      2 or more grams of Niacin
      Selenium
      Zinc
      Vitamin E
      The Carotenoids
      Folic Acid
      CoEnzyme Q10
      you can read about his approach here:

      http://www.orthomolecularvitamincentre.com/a_hoffer_cancer.php
      Some atoms fight cancer. These include Phosphorus, Iron, Iodine, Boron, Nickel (found in dark chocolate, oatmeal, and soy), Selenium, Zinc, and Copper.
      People who improve their diet to fight cancer have much better outcomes. I strongly recommend you get enough Vitamin D. I am glad to hear you have recovered! Beating cancer makes you a hero to anyone!
      Matthew

  • Luisa

    I agree with getting calcium from foods (molasses and almonds in addition to greens, etc) and D from sunlight. We have been on a plant based diet for more than 40 years (now age 80). However, to put it politely, stuff happens. I had to go on prednisone for two years for fibermalga rheumatica, and my husband on anti-siezure medicine for Restless Leg in order to sleep. Both cause bone loss and we both ended up with osteoporosis. Of course our doctor wants us to go on bisphosphonates which we refused. So my question is not about calcium supplements to prevent osteoporosis, but to repair it. I’ve reviewed the studies on PubMed such as the Canadian COMB study using vitamin K2 and other minerals (but no calcium), Japanese studies using K2, and others. In all of these bone density increased and fractures fell without coronary problems. It appears that calcium needs more than vitamin D to repair thin bones and prevent deposits in arteries and K2 may be that missing ingredient. I’ve quizzed my doctors and doctor friends I know. Not one knew there were several forms of vitamin K and each played a different role in health. With age, our bodies are less efficient at converting K1 from plants into K2. Everyone, it is generally agreed, should supplement with vitamin B12 if on a plant based diet. K2 is lacking in most plant foods except for a fermented form of soy called natto (which most of us would find repugnant). Just as D supplementation is sometimes necessary in far northern latitudes, could K2 supplementation be necessary for older people on a plant based diet? Users of this site generally agree supplementation is not necessary on a good, whole food, plant-based diet. But we do take B12. Maybe we should take K2. Calcium, vitamins D and K2, etc., are just part of the picture. Other minerals such as boron, etc., are important for bone health. For repair of unhealthy bones they are crucial. One study out of U of Cal., San Diego is ongoing, but has shown that 6 to 12 prunes a day increases bone density and lowers fracture rate! How could that be? Prunes are loaded with boron. Six to 12 a day provide more than you could get with a supplement. And they come packed with antioxidents useful to keep bones healthy. I hope the above inspires NutritionFacts.org to look into these facts and give us more insights.

    • SeedyCharacter

      Thanks for all of your info, Luisa! 6-12 prunes–my gosh, I would need to perch on the toilet half the day!

    • fencepost

      I found that by mixing a spoonful of honey into the natto it tasted okay.

  • Nancy Altman

    I’m having issues trying to login. When I tried to change my password, it said that my email address is unknown in the system. When I try to set up an account, it tells me that my email address is already in use. Who do I contact to resolve this? Sorry, I’m not very tech savvy…

    • Joseph Gonzales R.D.

      You can also log in via Disqus or Facebook and leave comments. You don’t really need to “log in” here to view our content, only to post comments. You can always ask us a question but it’s always better to simply ask here in the comments section so everyone can join the conversation.

      • jm

        Joseph- a comment can be made without logging in. Put in Name, Email, then click post as a guest.

  • Noe Marcial

    another topic.. but truly important. around 2% of americans have Hashimoto’s thyroiditis and this is the main cause of hypothyroidism.
    the traditional medicine does not treat the root of this disease they just replace the T4. and it is a lot of evidence about the roll of diet in this autoinmune condition particularly Gluten and Hashimoto’s and also the roll of selenium. I will really love to hear from NutritionFacts team whats the best science available says on the Nutrition for Hashimoto’s disease.

    Now my girlfriend was diagnostic with that and we are following a strict gluten and gliadin free diet.. (she still WFPBD)

    • Noe Marcial

      Here some studies on the connection between gluten intolerans (non celiac too) and Hashimoto ;
      Many researchers questionate the standard celiac test.. and some assume that 35 of americans have some degree of gluten sensitivity if people where measured by stool analysis and not with blood test that’s seems not very accurate.
      http://www.ncbi.nlm.nih.gov/pubmed/9872614
      http://www.ncbi.nlm.nih.gov/pubmed/12919165
      http://www.ncbi.nlm.nih.gov/pubmed/11768252
      http://www.ncbi.nlm.nih.gov/pubmed/22970580

      • Joseph Gonzales R.D.

        See you are more of a pro on this topic! Thanks for sharing these studies. Best to you and your girlfriend.

    • Noe Marcial

      I know this fight between pro Gluten and anti gluten and those who are against gluten normally advice for Paleo diet.. and i agree that meat is not the solution, but thas does not mean that gluten is good.. i will really like to see more research on Gluten and autoimmune disease here in Nutrition facts i think we have to brake all dogmas , and nothing better than facts to find the true.. enven is uncomfortable sometimes

    • Wegan

      It could be iodine deficiency. Many are deficient due to industrial halogens in the environment. Iodineresearch.com has some information.

      • Noe Marcial

        well her iodine is normal the hashimoto disease is more related with high iodine low selenium . but are other trigger factors apparently

  • Lara Pizzorno, MDiv, MA, LMT

    Disagree. For full review & analysis of the research please see my blog posted on the Experts Insights page here: https://www.algaecal.com/expert-insights/

    • largelytrue

      To kick off, I’m just going to add back in an important part of your quotation of the abstract in Bolland et al (2015) that you left out. You quote them this way with your own emphasis and some glossary comments:

      “In 26 randomized controlled trials, calcium supplements reduced the risk of total fracture (20 studies, 58,573 participants; 11% lower risk of any fracture) and vertebral fracture (12 studies, 48,967 participants, 14% lower risk of vertebral fracture), but not hip (13 studies, 56,648 participants, 5% lower risk of hip fracture [Bolland et al considered a 5% lower risk for fracture “nonsignificant”] or forearm fracture (8 studies, 51, 775 participants, 4% lower risk of forearm fracture [again, Bolland et al., consider a 4% lower risk “nonsignificant”].”

      The sentence immediately after, which you leave out:

      “Funnel plot inspection and Egger’s regression suggested bias toward calcium supplements in the published data. In randomised controlled trials at lowest risk of bias (four studies, n=44 505), there was no effect on risk of fracture at any site.”

      Further, you may misunderstand what the studies reviewed say. You say:

      “Note that calcium supplementation, either calcium alone or with vitamin D, lowered risk of fracture in every single one of these studies.”

      But just look at the forest plots from figures 1 through 4. If you want to report statistically insignificant protective results from a study as sufficient to claim that the study intervention lowered fracture risk, then there are a number of statistically insignificant harmful results which would be sufficient to claim that the study intervention raised fracture risk.

      • Lara Pizzorno, MDiv, MA, LMT

        Look at how the “bias” was evaluated and reported by Bolland et al. Their analysis is not objective!

        • largelytrue

          They tried to follow established guidelines:

          “Risk of bias was assessed as recommended in the Cochrane Handbook,
          and we planned a subgroup analysis for each fracture outcome stratified
          by risk of bias. Any discrepancies were resolved through discussion.”

          So yeah, there was some element open to judgment but this is true of many qualitative reviews such as your own. At least their decision was shaped by objective and likely pretty reasonable guidelines. What in particular about their evaluation process do you dispute, or are you just waving it away on general grounds?

          • Lara Pizzorno, MDiv, MA, LMT

            They cherry-picked, discounted (at length) a study in which calcium & vitamin D supplementation had highly beneficial effects, and set out with an agenda they wanted to “prove” — just look at Bolland’s earlier papers. This latest “analysis” was a set up.
            I have read so many papers — many of which are cited in my book Your Bones, 2nd edition, and which I have discussed in videos that are available on-line, on the beneficial effects of calcium supplementation. Bolland et al just “forgot” to look at the numerous papers that clearly show benefit.
            If you read my full post, you will see that I agree with Bolland that calcium alone or with just vitamin D is not adequate. What their paper actually shows is that other nutrients are also required, one primary example being vitamin K2. I also agree that calcium supplements would not be needed IF people were consuming adequate calcium in a healthy (organic, whole foods, largely vegetarian/pescatarian) diet AND were able to digest their food well and effectively absorb the nutrients it contained. If you look at NHANES data, you will see this ideal is so far from current reality as to be ludicrous.

          • largelytrue

            Any specific support for your claims about unfairly discounting a beneficial study? How did they fail to follow the Cochrane guidelines on that one, or what was biased in their judgement when following those guidelines?

            For all that you claim to read studies, my other criticism in my original post supports the idea that you will claim to have read some studies that you haven’t actually read. I don’t particularly care at present whether you agree or disagree with some aspect of Bolland et al’s review. I care about the standards of reasoning and evidence that you display when critiquing it.

    • 2tsaybow

      >>you will see this ideal is so far from current reality as to be ludicrous

      I am wondering if you know, Lara, that this website is devoted to this ludicrous idea? Dr. Greger has been working for years to promote a WFPB diet so that concept underlies his recommendation that we eat plants in order to get enough nutrients, including calcium.

      It’s not so ludicrous; it is possible and healthier if we quit eating and using sentient beings in order to survive. If we do so, then we will also help prevent our extinction. It seems like a pretty good goal to me. The slaughter of 1 billion animals a week is a huge carbon footprint.

      • Lara Pizzorno, MDiv, MA, LMT

        I TOTALLY support Dr. Greger and the diet he promotes. I did NOT say that this diet is anything but ideal. The problem is that the majority of people in the US and in the western (modern) world are not consuming this diet. Your comments are insulting. I’m done responding to you.

        • 2tsaybow

          >>”Disagree. For full review & analysis of the research please see my blog posted on the Experts Insights page here:”
          That was your first comment and it does not exactly promote a nice tone to our comment section and it needed to be answered because it directly contradicts Dr. Greger.

          >>”Your comments are insulting. I’m done responding to you”
          This is only my second comment to you. I was trying to be nice. I am so sorry that you were insulted. I hope any other interaction we have in the future is more positive.

          Joseph, if you feel this interaction between Lara and I might be confusing please feel free to remove my comments.

          • Lara Pizzorno, MDiv, MA, LMT

            I was responding to your taking out of context what I wrote and saying I thought Dr. Greger’s work and the diet he supports is “a ludicrous idea.” I did not! Also to your comment that I haven’t read the research. I have, for 30+ years now. Why don’t you read the full post I wrote before taking snippets out of context? I now have a deadline to meet for a medical journal article I am wrapping up and no more time for this “conversation.”

          • 2tsaybow

            >>”Also to your comment that I haven’t read the research.”

            I made no comment about your having read any research, Lara. You are conflating my comments with largelytrue. Get your deadline met and take care of yourself.

          • Lara Pizzorno, MDiv, MA, LMT

            My apologies to you then — be well

  • Sara

    Do fortified non-dairy milks fall under supplementation group or can we see them as just regular calcium foods?

    • Joseph Gonzales R.D.

      Good question. Further down in this thread there are some good comments on the subject.

  • Alex

    But how on earth do we get more that 500 in our diets without having to just eat all day? It’s a massive amount to try and get from our plant based diet – no matter how much we eat on cronometer our calcium is always below 500 without supplementation.

    • Joseph Gonzales R.D.

      Let’s see if we can meed that goal! I’d say by eating a ton of collard greens, beans (calcium-set tofu, edamame) and even other foods like figs, sesame seeds (tahini), and blackstrap molasses, surely calcium can get above 500mg naturally. Here is a good calcium chart that can help plan. Of course, the fortified plant-milks tend to have a ton of calcium, as well. So there are many healthful choices for dietary calcium without popping supplements.

      • jm

        ” by eating a ton of collard greens, beans (calcium-set tofu, edamame) and even other foods like figs, sesame seeds (tahini), and blackstrap molasses”

        That sounds great but I find not too practical the older I get.

  • Ralph Wiley

    In the video, the doc ignores the fact that getting enough calcium while following a vegan diet is close to impossible. That makes taking supplementary calcium a necessity.

    • Thea

      Ralph: re: “…the doc ignores the fact that getting enough calcium while following a vegan diet is close to impossible.” Lots of people on a vegan diet do it. Not sure why you think it is “close to impossible”?

  • Ralph Wiley

    In the video, the doc ignores the fact that getting enough calcium while following a vegan diet is close to impossible. That makes taking supplementary calcium a necessity.

  • Cathy Katin-Grazzini

    So why do populations that eat mostly plant-based see a vastly lower incidence of osteoporosis than in the West? Presumably, they do not need to supplement with Vitamin K2, outside Japan.

    • Joseph Gonzales R.D.

      Vitamin K makes K2. I have not seen any data to suggest K2 is a necessary vitamin. Dr. Greger addressed vitamin K2 in his Q & A.

      • Cathy Katin-Grazzini

        Thanks Joseph for your speedy reply! Re protein levels, if protein excretion is caused mostly by high dietary protein intake, not leaching from bones, can we assume that the lower incidence of osteoporosis in plant-based societies comes from their very high consumption of plant foods, which in the West are too often displaced by meats, dairy and processed foods? In other words, its the plants that confer protection, not the meat that inflicts harm, just speaking about bone health here.

        • Joseph Gonzales R.D.

          That very well could be! Of course, I am not sure the exact reasons of varying osteoporosis rates. It could also be due to AGEs and coffee. Kind of like we see in this video, it’s not the fiber in oatmeal that’s helping to reverse heart disease, but the many compounds and phytochemicals in plants. So maybe you’re on to something and the same might be true for bone health?

  • Fidel

    People saying you can’t get enough calcium on a plant-based diet strikes me as untrue, but if one chooses to eat a low-sulfur plant-based diet, then it might very well be impossible to get enough calcium. If one eats low-sulfur plant-based, throwing CaCO3 powder into recipes might be a good idea, and adding a daily total of 2000 mg of ascorbic acid might also be smart since apparently that amount lowers fibrinogen levels which can help counteract the increased tendency for blood clotting from higher blood calcium levels.

  • Thank you very much! I hope you will do another video in the future. However i still have a foggy picture about calcium. First the food is digested, then nutrients absorbed. But what now? What happens in the body (or doesnt happen) so the calcium absorbed is finally utilized (or not)? Does anyone know which system or organ is responsible for that?

    • Joseph Gonzales R.D.

      So many mechanisms are involved! This video on animal protein and calcium loss probably explains best. Calcium works closely with vitamin D. It’s first absorbed in the small intestine and coordinates absorption based on circulating levels of vitamin D that is regulated by the parathyroid hormone. That is all I recall off the top of my head, it’s a complex biochemical process that you could spend days learning about! It’s cool stuff! See if the video helps and also read the research papers in the sources cited.

  • JR
  • Mary Ellen Spahr

    How does taking Synthroid daily for hormone replacement affect the decision to take calcium supplements? I have been told that Synthroid robs the bones of calcium and a supplement is necessary.

  • Sardoc

    The information that was presented is good . . . but it is missing one critical piece of the puzzle: Vitamin K2.
    K2 activates osteocalcin (whose synthesis is boosted by Vit D) which allows bones to pull calcium into bones (where it belongs). It also blocks the activity of osteoclasts–the cells that break down bone.
    Since one of the risks for heart disease is when plaque gets calcified in the coronary arteries, preventing the deposition of calcium there (where it does not belong) is important. Vit K2 activates a protein in the walls of blood vessels called matrix Gla protein (MGP). MGP blocks the attachment of calcium to the blood vessel walls.
    So it both helps Vit D get the calcium into the bones and it helps keep it out of the arteries.
    Thus it stands to reason that someone taking supplemental calcium, or even calcium and Vitamin D3, will not necessarily get the benefits they are looking for, unless they also take Vitamin K2 (preferably in the MK7 isoform, as the MK4 isoform has a very short halflife). Now that most people do not eat a lot of cultured/fermented foods, the average person may get plenty of K1 from green leafy veggies, but will not be getting adequate K2

  • Matthew Smith

    I do not think Calcium is the right vitamin for osteoporosis. Vitamin K2 and Phosphorus are probably the right vitamins. Vitamin K2 puts Calcium back in the right place, and it is actually the phosphorus that is being leached out of bones for use in energy metabolism. You turn over your body weight in ATP every day. The phosphorus comes from your bones. Having a daily dose of Phosphorus can be very good for you. I had feelings of persecution every half hour once I gave up diet soda. With a source of Phosphorus back in my diet, those feelings were much diminished.

    Phosphate and carbonate salts of calcium support robust bone building in osteoporosis. http://www.ncbi.nlm.nih.gov/pubmed/20484446

    In the supplemented group that had both vitamins added, bone density improved by 7.2 percent.

    Does vitamin K2 play a role in the prevention and treatment of osteoporosis for postmenopausal women: a meta-analysis of randomized controlled trials.
    http://www.ncbi.nlm.nih.gov/pubmed/25516361

    “This meta-analysis seemed to support the hypothesis that vitamin K2 plays kind of a role in the maintenance and improvement of vertebral BMD and the prevention of fractures in postmenopausal women with osteoporosis.”

    • Joseph Gonzales R.D.

      It may not be, and I think the whole point of this video really highlights not taking them. Forgive me, when I mentioned taking calcium supplements for treating osteoporosis it was just in context to the video when Dr. Greger says it makes sense supplementing with calcium and vitamin helps treat osteoporosis, but it’s still risky. I’ve changed this comment to highlight that mix-up. Thanks for adding the K2 and phosphate studies.

  • Jerry LA

    We consistently get the wrong advice from our endocrinologist and family doctors.
    They do not do the slightest bit of research and are happy to recommend damaging our bones.
    What can be done to get the Medical community to recognize fact?
    Journal of Gerontology 55 (2000) M585-M592 Frasetto et. al. “A high ratio of vegetable to animal protein consumption was found to be impressively associated with a virtual disappearance of bone fractures (in elderly women)”.

    The U.S. medical community refuses to recognize the very low fracture rates in the classic Mediterranean diet, European DNA sample size in the millions, or in India with plant food diets, or in Asia where `slender boned women on mainly plant foods don’t get fractures like the high fracture rate in the U.S. with high meat, high dairy diets, and the brittle bone disease from Fosamax and the ilk. These “drugs” disrupt the normal body process of rebuilding micro fractures from normal weight bearing activity.

  • Rebecca Cody

    On a practical level, there have to be studies of people, especially postmenopausal women, still eating traditional diets in countries where they have little or no osteoporosis or heart disease. You know, where people are too poor to eat at the golden arches, so they’re still healthy. Blue Zones. Whatever you want to call them. I remember how Weston A Price studied the bone structure of the mouths and the straightness of teeth among healthy people still eating traditional diets. Some of them moved into towns and began eating processed foods, most likely canned in those days (1930s), and their children had very crowded teeth because the bones in the middle of the face failed to develop properly. Then, in at least one case, the parents moved back to their village and ate as they had as children. Subsequent children had strong bones, well developed facial structures and no crowded teeth. So, what levels of calcium are these healthy people eating? And what other nutrients? Where do they get their K2?

    I often notice on TV documentaries where they go to more primitive areas that the people all have straight teeth and jaws that are sufficiently wide to accommodate the teeth as the children grow older and get bigger teeth.

    • VegGuy

      Where the Blue Zones get their vitamin K2: Okanawa–natto, miso; Sardinia–cheese; Ikaria–goat yogurt; Costa Rica–chicken & eggs. Also many of the groups Weston A Price studied got K2 from organ meats &/or grass fed dairy products.

      • Rebecca Cody

        I agree. None of the naturally healthy groups I’ve ever read about are vegan. Animal protein is a small part of their diets, but it’s always there. Of course, it isn’t industrialized meat and eggs, like in this country. There seems to be some exception for the small group of vegetarian Seventh Day Adventists who are totally vegan.

        In Weston Price’s book he starts out talking about a remote Swiss village where they herd cattle into the highlands in summer. They eat cheese and butter, etc. They even had greenish teeth from never cleaning them, but no cavities and perfect bone structure with room for all their teeth.

        Dr McDougall says we don’t need to supplement vitamin D, because the body stores it for months. I think he needs to spend a winter in the Pacific Northwest, where we often don’t see the sun for more months than we do. Before I started supplementing, mine was low and I had been eating a healthy diet for years.

        Vitamin D has been the research darling for a long time now, so I’m glad people are starting to look more deeply into the need for K, and also learning the secrets to be revealed about our microbiome.

  • Alidaengel

    what about strontium? I hear such mixed messages and not sure what the latest research is showing.

  • Mirror

    Can you do research on Vitamin C supplement from green tea extract pills?

  • Michael Green

    excellent Recommendations Dr. Greger ,…. I take Atlantic kelp and I eat raw sesame Tahini and two oranges a day for calcium …all natural for me ….no calcium pills for me and my kidneys are happy that i don’t burden them with supplement calcium pills .

  • Tania Foniciello

    What about liquid calcium supplement? I take vi-ra-tox n 38 calphonite as recommended per my iridologist. I am breastfeeding and noticed my teeth weakening (turning yellow, stains, aches).

    Should I discontinue? What can I do different?

    • Joseph Gonzales R.D.

      These are great questions, but I don’t know about liquid calcium supplements. If they compare to regular ones then based on this video I’d expect similar risks. However, it seem you are taking it for eye health prescribed by your doctor so like Dr. Greger says there are some benefits to weigh against the risk. I find that many folks here are asking about specific calcium supplements brands if they are still to be consumed based on their specific condition. Each case is individual and needs to be evaluated with your doctor (this goes for everyone not just you), but what’s so great about this video is that is starts the discussion. It allows folks think twice about taking supplements and consider eating more dietary calcium while understanding why there is this huge discrepancy between calcium recommendations.

      • jm

        Joseph, IRIDOLOGY (also known as iridodiagnosis or iridiagnosis) is an alternative medicine technique whose proponents claim that patterns, colors, and other characteristics of the iris can be examined to determine information about a patient’s systemic health. Iridology – Wikipedia, the free encyclopedia
        https://en.wikipedia.org/wiki/IridologyWikipedia

  • veganintraining

    Does anyone have advice for bone healing from a traumatic fracture? I had a comminuted clavicle fracture, which has not fully healed at 3 months post surgery (plate & 7 pins). I also fractured at least 1 rib at the same time, which is still slightly sore but less problematic. All the research I’ve found on this site seems to be related to osteoporosis, rather than due to injury. I have been taking calcium and Vitamin D supplements to help aid the healing, but I’m now not convinced that I should be (for calcium at least). I live in London, so I’ll keep up with Vitamin D supplements. As background, I’m a women in her early 50s, nonsmoker and generally good health (normal weight, regular exercise). As an avid rower who has been off the water during the best season, this has been incredibly frustrating! Any help/advice would be greatly appreciated.

    • VegGuy

      Vegantraining, what’s good for osteoporosis should be good for healing fractures. Definitely add vitamin K2, boron, silica, magnesium as these nutrients are all crucial for bone health and healing
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3330619/

      You may also be interested in this article on speeding fracture healing as it discusses the importance of alkalinity and cutting inflammation. http://www.betterbones.com/bonefracture/speedhealing.pdf

      • veganintraining

        Thanks, VegGuy. I had seen the second article before, but frankly I’m a little confused by some of what is said there (which seems to contradict things I’ve seen here and elsewhere), namely, 1) the recommendation to take supplements and 2) that eating a plant-based diet increases IGF-1. While it makes it sound like a good thing in the context of bone healing, I thought 1) that a plant-based diet decreases IGF-1 and 2) that higher levels of IGF-1 are not good.

        Thanks for the first article – I hadn’t seen that one before. Sounds like I should take a multi-vitamin and focus on the foods listed in the article to maximise the essential nutrients. And more beer, for the silicon, of course.

        • VegGuy

          I know, confusing right? The way I look at supplements is if your diet doesn’t supply all that you need of a nutrient, then supplementation is necessary. When we are ill or injured our nutrient requirements go up and often supplements are needed to meet that increased need.

          Here’s a quote from the book “The Whole Body Approach to Osteoporosis”(page 140) : “IGF-1 is considered to be the most powerful natural anabolic agent in your body. Its production and release from the liver is dependent on good nutrition. Although excess production of IGF-1 is not healthy and can promote cancer growth, deficiencies lead to osteoporosis and poor muscle mass, sarcopenia.”

          The author also explains that animal protein can increase the production of IGF-1. I think it’s just a case of getting the right amount of IGF-1. An anti-inflammatory diet and exercise also increase IGF-1, but I would assume in a good way.

          • veganintraining

            Thanks, that makes a bit more sense!

  • Nony

    What about calcium supplements made from greens? I thought the one from New Chapter was safe. Please set me straight on this

  • Colleen

    ‘ve been following a WFPB diet for about 10 months. It’s been going well mostly. Did get lax and revert to some old junk food habits, albeit vegan this time, but am now back on track. I have now lost a big patch of hair on the front of my head. It’s about the size of large cucumber slice. I should note that I’m 36 and female. People are already commenting on my diet as a culprit…but I know this can’t be true…I’m seeing my GP this week but he’s not fully on board with this lifestyle. Any advice would be greatly appreciated.

  • Conejo

    Now I am unsure of what to think about supplementing with standalone Vitamin D3 (no Calcium) because it is difficult to get enough sun light in the winter time. (Northern Latitude)

    Does the association of hip fracture rates and Calcium intake, commented on in this video, also hold true for just only Vitamin D intake?

    My Vitamin D3 (Als Cholecalciferol) supplement lists the ingredient “dicalcium phosphate E341”. Is this a form of calcium? Does the ingredient have similar effects as “regular” calcium mentioned in this video?

    Thank you for taking my question. Kind regards

    • Calcium and D3 are vastly different things and, in my opinion, should be disassociated in future tests.

    • Julie

      I suspect the dicalcium phosphate is just an additive to the supplement and shouldn’t provide any calcium (if it does the label will state the amount of calcium). Vitamin D does reduce hip fracture. Dr Greger advises 2000 IU of vitamin D per day which seems consistent with other professionals.

  • KLW

    Should a vegan toddler be taking calcium supplements? She eats lots of beans but not much leafy greens…
    I give her 250mg chewable calcium daily. She drinks 5 ounces of soy milk and 5 ounces of coconut milk daily.

    • Joseph Gonzales R.D.

      Are they fortified sources of soy and coconut milk? Toddlers 4-8 need about 800mg of calcium per day, according to the IOM. I would recommended avoiding if possible. Double check with pediatrician.

  • Scinni

    Off-topic question:

    Hey :),

    nutritional yeast by some brands also contain high
    doses of folic acid. Which chemical form of folic acid do they contain?
    Folic acid or the naturally occuring chemical forms of folate? Is
    nutritional yeast consumption with high doses (or even low doses) of
    folic acid safe? I have concerns because as far as i know the growing
    medium of yeast is often fortified with vitamins to achieve such a high
    content of said vitamins. Therefore my subsequent question is whether
    the folic acid in yeast is converted into a naturally occuring form.

    Kind regards,
    Daniel

  • Shawn Blakely

    Maybe I imagined this, but what’s with the bird noises in the background of the audio?

  • Hi! Does Michael Gregor plan to post links to the researches that he uses in his videos in future? If no, then why so?

    • largelytrue

      Sergey, there’s a “sources cited” tab in the panel to the right of the video, which transforms the text below the video from the Doctor’s Note to a list of references.

  • Rebecca Cody

    Does this also apply to postmenopausal women who already have osteoporosis? A friend has taken an acid blocking drug for years. I don’t know why any doctor would prescribe one for years, but of course they are now over the counter. I see that as the cause of her osteoporosis, along with too little sunshine. Now that she has osteoporosis, should she stop the calcium, take vitamin D3 and get sunshine when she can?

    I’ve seen tanning bed recommended in place of sunshine for those of us who live too far north to get sunshine in winter, because of the sun’s low angle and the cold temps that keep our skin covered. Has Dr Greger said anything about that?

  • Harry

    What about fortified beverages like soy milk and almond mild?

  • PaulaE

    Dr Dr. Greger,

    Is there anything coming down the pipe regarding osteoporosis and nutrition that can help me? I don’t want to go on meds.

    I’m 52, dx with osteopenia about 4 years ago. Only RF is small framed(5’4” 130). I eat mostly vegan. Had a negataive 24 urine calcium.

    Had a BSO 6/14. My repeat bone scan on 10/15(about 1 year later) showed bone loss greater that 13% in all areas. It took me down to osteoporosis is my splne. The doctor wants me to start meds. I looked around the internet an came up with a six month ‘home’ treatment plan. I’ll get a repeat bone scan and go on from there. Here is my home plan. Have I gone off a a tangent anywhere. Everything looks solid but not ‘proven’ to me. Thank you for looking at this, Paula

    Here is the note to my doctor.
    Here are the studies that I found when I was looking for a way not to go on medicine for osteoporosis. I’d like to start on a thiazide. Isn’t that what you would have started me on if I had high urine calcium? I also take 100g of prunes a day, 30 ml of extra virgin olive oil, and MK-7(Vitamin K2 as Menaquinone-7 180 mg/day). I am also wearing a 15 lb weight vest when I exercise and when I am at home. I’d like to repeat the bone scan at the to see if this regimen is effective. If not effective, I’ll go on medication. Please let me know about the thiazide. Thank you, Paula

    Thiazides
    http://www.ncbi.nlm.nih.gov/pubmed/21975748

    Olive oil and postmenopausal bone lose
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4259560/
    http://www.ncbi.nlm.nih.gov/pubmed/25516361
    http://www.ncbi.nlm.nih.gov/pubmed/24975408

    prunes
    http://www.fasebj.org/content/29/1_Supplement/738.12.abstract

    Vitamin K2
    http://archinte.jamanetwork.com/article.aspx?articleid=410550

    Misc
    http://www.biomedcentral.com/1471-2458/13/23

    • Paula

      Looks like Dr. Greger’s new Evidence-Based Nutrition video gave me my answer! Paula

      • Thea

        Paula: Glad you found your answer. I thought I would also refer you to a book I have read multiple times and think is *excellent*: “Building Bone Vitality – A Revolutionary Diet Plan to Prevent Bone Loss and Reverse Osteoporosis.”

        That book is based on a review of over 1,200 studies. I believe that the advice in the book is consistent with the advice find here on NutritionFacts – but with specificity to bone issues. The book even includes some meal plans and recipes and is very short and easy to read. It includes a chapter on medications and also the importance of exercise – but not just any exercise.

        If you are interested:

        http://www.amazon.com/Building-Bone-Vitality-Revolutionary-Osteoporosis–Without/dp/0071600191/ref=sr_1_1?s=books&ie=UTF8&qid=1450910523&sr=1-1&keywords=building+bone+vitality

        • PaulaE

          Thank you Thea. I did read that book and started to take Hydrochlorothiazide daily because of the information that I found. The book remarked that a reduction in hip fractures was a known ‘side effect’ of HCTZ. Here is a study that was done to investigate this observation. Dirt cheap and easy to implement if you are able to take the medication. I hope that this helps someone!
          Low-dose hydrochlorothiazide and preservation of bone mineral density in older adults. A randomized, double-blind, placebo-controlled trial.
          LaCroix AZ1, Ott SM, Ichikawa L, Scholes D, Barlow WE.

          • Cathy Katin-Grazzini

            I would be cautious taking hydrochlorothiazide if not under a doctor’s care. It’s a diuretic, usually used for other conditions. It will lower your blood pressure, eliminating water and salt in the body and may have unintended consequences.

          • PaulaE

            Yes I agree. That is how I am getting the hydrochlorothizide, through a doctor, it is a prescription drug. She is checking the K+ level after 2 weeks. HCTZ was shown to preserve bone mineral density as a ‘side effect’ in people who were taking it for other reasons than bone preservation.

  • LH

    Was wondering what are the recommendations for breastfeeding women? Babies drink up to a liter a day. If they nurse their babies up to a year that is a lot of calcium loss, no?

  • martin1223

    Any suggestions,

    I am seventy-one years old have eczema, lactose intolerance,and I am allergic to nuts but need to increase my calcium intake. Unlike my
    late mother who had osteoporosis, slipped on sidewalk ice, and broke her hip, I discovered my neck has low bone density from a body scan my doctor recommended, so if I slip and break my neck I am dead.

    Supplements are not as safe as vegetables like collards according to my doctor who mentioned a new study that shows calcification on the artery
    walls causing possible strokes or heart attacks with the use of supplements like calcium carbonate. Yet, she told me I could use fortified soymilk with a vitamin D supplement of 2000 international units a day. However, when I discovered that the fortified soymilk has calcium carbonate as an ingredient and mentioned it, she said it is fine to take in fortified food. When I asked if she could explain why, she said that is what she was told. I Googled it and found that calcium carbonate is better absorbed with food but not necessarily safer than the pill form.

    In addition, I found that a cup of frozen chopped collards has 57% calcium based on different nutrition sites, but supermarket brands of the
    same form and portion only list 8% calcium. I thought collards are one of the best sources of calcium. I would appreciate any help, thank you.

  • martin1223

    Any suggestions,

    I am seventy-one years old have eczema, lactose intolerance,
    and I am allergic to nuts but need to increase my calcium intake. Unlike my
    late mother who had osteoporosis, slipped on sidewalk ice, and broke her hip, I
    discovered my neck has low bone density from a body scan my doctor recommended,
    so if I slip and break my neck I am dead.

    Supplements are not as safe as vegetables like collards according
    to my doctor who mentioned a new study that shows calcification on the artery
    walls causing possible strokes or heart attacks with the use of supplements
    like calcium carbonate. Yet, she told me I could use fortified soymilk with a
    vitamin D supplement of 2000 international units a day.

    However, when I discovered that the fortified soymilk has
    calcium carbonate as an ingredient and mentioned it, she said it is fine to
    take in fortified food. When I asked if she could explain why, she said that is
    what she was told. I Googled it and found that calcium carbonate is better
    absorbed with food but not necessarily safer than the pill form.

    In addition, I found that a cup of frozen chopped collards has
    57% calcium based on different nutrition sites, but supermarket brands of the
    same form and portion only list 8% calcium. I thought collards are one of the
    best sources of calcium. I would
    appreciate any help, thank you.

  • Paul Duarte

    My mom has severe osteoporosis of her lower spine and ostopenia in one hip. She hasn’t had dairy for about a year and a half and had a bone scan a few months ago showing no deterioration of her condition and perhaps a small improvement. She has been on calcium supplements for many years – over a decade – and a couple of months ago she stopped talking these as an experiment. My question is should she restart the supplements? I’m worried that her condition will devolve without them. She has a fairly good diet eating homemade veggie soups twice a day and fish or seafood as her main dish a few times a week, lots of fruit too and some walnuts.

  • Jessica

    I just looked up calcium-rich foods on the USDA Agricultural Research Service’s National Nutrient Database. Among the top sources were three foods new to me: sisymbrium seeds, winged beans, and Oriental dried radishes. Anyone know what these are, where I can find them, and how to prepare them?

    (Other top plant sources, if you’re interested, include calcium-fortified orange juice concentrate, sesame seeds, tofu prepared with calcium sulfate, molasses, almonds, and some raw beans.)

  • curry

    I’ve read things recently (not on this website) that say isolated supplements are no good, but then recommend getting said nutrient via fortified foods. Isn’t the food being fortified with the same isolated nutrient?

    • Cathy Katin-Grazzini

      I’ve wondered the same.

    • Thea

      curry: I have two thoughts on this topic. Most of the time when I see that someone is recommending a fortified food as an alternative to a supplement, they are talking about two specific nutrients, not supplements in general–vitamin B12 and calcium. In the case of vitamin B12, I don’t know of any good evidence that taking a supplement in a problem. The opposite. If you watch the videos on this site, there’s every reason to believe that taking B12 in a supplement form is quite good for one.
      .
      When it comes to calcium, there is a concern that people are not getting enough calcium from their diet and/or are eating calcium stealers. A careful whole plant food based diet would cover calcium needs. But some people just aren’t getting enough greens. So, the idea is, if you eat some foods that are fortified with calcium, you could get up to the recommended amounts. The problem with the supplements is that they over-dose on calcium amounts. And having too much can be bad just like having too little can be bad. And I think that’s a problem with supplements, with rare exceptions like B12, in general. Those products give too much of something, creating an imbalance and ultimately health problems. (Read the book Whole by Cambell for more information on this idea.) But fortified foods usually have less of the nutrient in question than a supplement and the fortified foods are something that you can eat throughout the day as opposed to a megadose at one time. And further, when you eat fortified foods, you are also getting other nutrients from those foods, and that synergy may be helpful. (Again, read the book Whole for a better and more complete covering of this topic.)
      .
      What do you think?

  • DanielFaster

    Would love to see Doc G do a vid on natto and osteoporosis – the rate of hip fractures in Japan clearly correlates in geographic areas according to natto consumption rates. Fractures are lowest in areas with the highest per capita natto comsumption.

  • Anne

    How does this impact tofu? Since it is made with calcium sulfate — and, if extra firm, rather a lot — is it safe? I have heard Dr. Greger speak favorably of tofu, but what about it as a vehicle for (indirect) calcium supplementation?

    • Thea

      Anne: In Dr. Greger’s brand new book, How Not To Die, in the chapter on beans, Dr. Greger specifically recommends picking tofu with calcium. As a guess, I think the difference might be in quantities offered from tofu vs supplements and that the tofu version comes with lots of other nutrients. So, you don’t get the balance problems of eating an isolated substance. That last part’s just my opinion, though.

  • Matthew Smith

    In the book, Vitamin K2 and The Calcium Paradox, it said in a study of women there are six more heart attacks in those taking Calcium than those not. That’s it. Six heart attacks out of a thousand. Calcium supplementation prevents heart attacks in this study, or it vanishes the risk. People on Calcium don’t get heart disease. Calcium deficiencies are the rule for humanity. Almost anyone should be made aware of a Calcium deficiency. In my opinion, you can get a great deal of Calcium just sitting outside at night on a clear night sky. Calcium is one of the most essential nutrients in the body. It is pure Mercy.

  • Nancy

    But are vitamin D3 supplements safe? Dr. McDougall recommends that you not take them as there is no evidence that taking them will remedy any illness. I currently have “clinically isolated syndrome” for MS, and my neurologist recommends I take them as low vitamin D levels (which I had) correlate with MS. From the literature I have read, however, I think low vitamin D levels are a result of disease, not a cause, and that eating animal products is a cause of disease. Since supplementing, I have felt very tired, and am thinking of stopping supplementation. Are there any studies of adverse effects of vitamin D3 supplementation?

  • Mike

    Is there any way to treat calcific tendonitis (shoulder deposit) without injecting serum in the area? Thank you

  • JnetNW

    Question the, for any of you: If I don’t supplement with calcium (liquid form has been a favorite, but I have switched to a whole-foods sourced tablet), I have a big problem with leg or foot cramp at night. Yow!
    Anyone else know about this? And if you don’t supplement, what food seems to head off cramp at the pass?!

  • Gary Yuen

    Recently I have been comparing various vegetables and also looking for green leaves that are possibly more nutritious and have more calcium than what we consider good. Some: leaves of grape (not yet sure), taro, fenugreek (mehti, excellent), moringa (estimates vary and and am still looking), coriander, dill. Of what is highest, and from one estimate 626mg/100g, 4x+ more than kale/watercress, the highest I’ve found so far, and I’m curious if it is the best of the cruciferous: cauliflower leaves. Sadly found usually at farmers markets only, and often needed is asking to bring them. Hope demand goes up and someday easily found it in stores. Indications seem so far to be healthier than the floret; the same may be true of broccoli leaves.

  • JAYE R

    what about supplementing with calcium hydroxyapatite?

  • photoMaldives

    Interesting – “A study that analyzed 10 years of medical tests on more than 2,700 people, concluded : taking calcium in the form of supplements may raise the risk of plaque buildup in arteries and heart damage, although a diet high in calcium-rich foods appears be protective”. [11-Oct-16]
    https://www.sciencedaily.com/releases/2016/10/161011182621.htm

  • Salad Grazer

    After watching this video and reading about the topic, I stopped taking my calcium carbonate supplement (600 mg) and multi-vitamin/mineral awhile back. Upon going to the doctor yesterday with concern for my change in bowel habits (now very loose and more frequent), she made what I think is the accurate connection — that the calcium carbonate was helping to keep things firmer. Years ago before I went vegan and before I started eating flax seed, I could not take calcium carbonate because it was too constipating. Just wanted to share this info in case others are experiencing a similar change.