by Jack Norris, RD
Vegans and Calcium Intake
Americans are regularly being urged to consume more calcium in order to prevent osteoporosis, but it’s practically impossible to meet the recommendations without large amounts of dairy, calcium-fortified foods, or supplements. Because vegans don’t eat dairy products, without fortified foods or supplements their calcium intakes tend to be low (about 400–600 mg per day compared to the U.S. recommended intake of 1,000 mg per day for adults aged 19–50 years).
During the 1990s, the vegan community responded to our lower calcium intakes by promoting the idea that osteoporosis is a disease of calcium loss from the bones rather than a lack of calcium in the diet. This view was based on research showing that there are more hip fractures in countries with higher dairy product intake and research showing that animal protein causes an increase in calcium loss through the urine. Therefore—the thinking went—calcium intake isn’t important for preventing osteoporosis and vegans are protected due to the lack of animal protein in their diets.
But both of these ideas have turned out to be misleading.
Further research showed that between countries, hip fractures are more indicative of the risk of falling than of osteoporosis. A recent study from Hong Kong found that while men and women in Hong Kong had lower rates of hip fractures, they had higher rates of vertebral fractures, and the women had higher rates of osteoporosis than Caucasian women.
As for protein leaching calcium from bones into the urine—the studies showing this used protein isolates whereas eating protein from whole foods does not result in a calcium imbalance. Population studies and clinical trials show that protein, including animal protein, doesn’t have a negative effect on bones.
So where does it leave vegans?
Vegans and Bone Health
Bone mineral density, a measure of osteoporosis, has been shown in many studies to be slightly lower in vegans than non-vegans. More importantly, two studies on Western vegans measuring fracture rates over time found that vegans had higher rates.
In the more thorough of the two studies, one from Oxford, vegans eating less than 525 mg of calcium per day had a higher fracture rate than vegans eating more than 525 mg. The vegans in the higher calcium intake group had the same fracture rates as the meat-eaters and lacto-ovo vegetarians.
This indicates that if vegans eat enough calcium they should be at no higher risk for fractures than meat-eaters.
Plant Sources of Calcium
High-calcium, lower-oxalate, dark leafy greens are the best sources of calcium for vegans—turnip greens, mustard greens, kale, bok choy, and collard greens. Choy sum and gai choy are two high-calcium greens common in Asian cuisine. Although less common in the United States, some specialty Asian markets may carry them. In addition to calcium, greens also contain vitamin K, potassium, and magnesium, which contribute to better bone health.
While spinach, Swiss chard, and beet greens are high in calcium, the calcium isn’t well absorbed due to their high content of oxalate, which binds calcium and prevents absorption from the digestive tract.
Other sources of calcium are fortified drinks, calcium-set tofu, figs, and supplements.
It’s safe for vegans to take 500 mg of calcium per day or less if you aren’t getting large amounts of calcium from other sources. Research is mixed about whether calcium intakes above 1,400 mg per day can put people at risk for chronic disease.
Please see Daily Needs for our most up-to-date calcium recommendations.