🗝️ Key takeaways:
Calcium is an essential nutrient for bone health.
Many adults are not hitting the daily recommendations, which range from 1,000 to 1,200 mg.
Diet and exercise build bone density, even in people with existing bone loss.
For most bones, “calcium is a more important focus than protein,” says Adrienne Bitar, co-founder of Seen Nutrition, and author of Diet and the Disease of Civilization, in a recent interview with Livelong.
A bold claim in a protein-obsessed culture. But Bitar, co-founding the first dietary calcium chew for bone health, argues that most people overlook calcium in their daily diet, and it can come at a cost to long-term health.
An estimated 42% of Americans still fall short of their daily calcium targets—even when supplements are included. Low calcium is most often linked to poorer bone health, like osteoporosis and fractures, but mixed evidence now suggests a higher risk of cardiovascular disease and colorectal cancer, too.
Far fewer people are missing their protein targets.
So while Bitar—a food studies scholar —says there’s no single ‘optimal’ longevity diet, if she had to choose between the one that focuses on protein or calcium, it would be the latter.
Calcium: Bone health and biological reserve
Longevity is strong bones. Unfortunately, our biology is not designed to maintain peak bone strength. For most adults, natural bone mass peaks around age 30. The older we get, the faster bone loss then accelerates (often more sharply after menopause in women).
Brittle bones are a major longevity concern because they raise the risk of hip fractures. For roughly 20–30% of adults over age 65, hip fractures can lead to death within the year, often due to complications, immobility, and increased risk of chronic illness
If our bones are bound for brittleness, then the goal would be to develop the strongest bones today and lessen the impact of this decline.
This is why Bitar says that calcium—which gives bone its strength and structure—comes first.
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Protein vs calcium: A bone to pick
All eyes are on protein for healthy aging, whether it’s for muscle, metabolism, mitochondria, and yes—bones. The International Osteoporosis Foundation does acknowledge protein’s role in preserving bone mineral density, slowing bone loss, and preventing dangerous hip fractures.
But for protein to benefit bones, you need enough calcium. Plus, 99% of calcium is found in our bones and teeth, making it one of our bones’ most important building blocks.
How much calcium do you need?
Women over age 50 and men over age 70 are generally advised to consume 1,200 mg of calcium daily. Men aged 51–70 and women under 50 should aim for 1,000 mg.
When it comes to diet, dairy might actually be one of the most efficient ways to hit those goals.
In one analysis of older adults with a mean age of 86 years, two servings of dairy per day were linked to up to a 46% reduction in hip fracture risk—though not all studies suggest such a dramatic link.
Fermented dairy may offer extra bone benefits by supporting the gut microbiome and reducing inflammation.
What if you don’t eat dairy? Though moderate dairy consumption—particularly of low-fat or fermented dairy—can fit comfortably into a healthy aging diet for most adults, many people don’t eat it for different reasons. For them (and even for people who do eat dairy), calcium-fortified foods can be an important strategy to meet nutritional calcium needs.
Why processed foods might be a secret weapon
Though plant-based foods like chia seeds and leafy greens contain calcium, some also contain compounds that prevent absorption, such as oxalates. Fortified foods (technically processed) can be important for maintaining skeletal health.
“[This] isn’t an excuse to eat Froot Loops,” Bitar says.
Instead, cereals, plant milks, whole-grain pastas, and other fortified foods can provide substantial amounts of calcium and fill in nutritional gaps that might otherwise stay lacking in another eating pattern.
Note: Synthetic forms of calcium used to fortify foods are not as readily absorbed as dietary calcium, Bitar says.
The almond milk mistake: Avoiding excess calcium
If you’re the unlucky person who drinks the carton’s unshaken last sips, you could end up consuming a concentrated dose of calcium.
Fortified foods can also have risks. In many plant-based milks, for instance, fortified calcium can gradually settle at the bottom of the container in a process known as calcium sedimentation.
Manufacturers have added gums and stabilizers to prevent this, Bitar says, but they’re not always effective.
If you don’t consistently shake the carton and happen to be the unlucky person who drinks the last unshaken sips, you could end up consuming a concentrated dose of calcium, with excess calcium coming with its own health risks.
Four tips to make the most of calcium
Consider calcium-fortified foods. Though they are processed, fortified foods can be valuable sources of calcium, especially for people who don't consume dairy.
Shake the almond milk. Fortified calcium can settle to the bottom, making a quick shake more important than most people realize.
‘Calcium first, protein second, exercise always.’ Bitar says protein matters, but adequate calcium and regular exercise are the foundation of bone health.
Consider two daily servings of dairy. Research suggests dairy, especially fermented dairy, may help slow bone loss as we age.
If bones can respond to calcium in your mid-80s, it's likely not too late for most of us to focus on getting enough calcium in our diet.
Importantly, Bitar emphasizes that there is no single perfect diet for bone health. Instead, many healthy and balanced diets can benefit bone health.
That’s not to say it’s diet-or-bust. Resistance and weight-bearing exercises are also important to stimulate bone growth, with jumping and high-impact movements shown to improve bone density in those with osteoporosis and frailty.
No matter what, don’t forget to shake the almond milk!
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The information provided about wellness and health is for general informational and educational purposes only. We are not licensed medical professionals, and the content here should not be considered medical advice. Talk to a doctor before trying any of these suggestions.
