Older adults are currently advised to consume a total of 1000-1200 mg of calcium per day to prevent osteoporosis and bone fractures, but this recommendation has recently come under scrutiny. Two comprehensive reviews of the literature, published in the online version of the British Medical Journal, suggest that neither dietary calcium nor supplemental calcium strengthen the bones. One review analyzed 59 studies and concluded that increasing calcium intake provides an initial and small increase in bone mineral density with no ongoing benefit after 1 year. Another review analyzed 52 studies and concluded that increasing calcium intake does not reduce the risk of fracture. This information adds fuel to the calcium controversy, which was spurred in recent years by evidence that supplemental calcium may increase the risk of heart attacks and other cardiovascular events.
These reports bring into question a belief that the medical community has perpetuated and the general public has held firmly to for years: the belief that calcium and milk are good for your bones. But the suggestion that this belief may be misguided should come as no surprise. Although 99% of the body’s calcium is stored in the bones, minerals make up only 40% of total bone weight. Healthy bones also require magnesium, vitamin D, vitamin K, vitamin C, omega-3 fatty acids, protein, and other nutrients. Exercise increases bone density, while smoking cigarettes and drinking caffeine deplete it. Hormonal changes, including the decline in estrogen at menopause, affect bone strength. Even digestive conditions, such as celiac disease of inflammatory bowel disease, can create nutritional deficiencies that weaken the bones.
The prevention of osteoporosis and fractures can never be simplified to a single nutrient. Our goal is to uncover the root cause of illness and to prevent disease by supporting total body health. For patients needing targeted bone support, we often recommend calcium combined with vitamin D3, vitamin K1, vitamin K2, magnesium, and other trace minerals. Calcium alone may not offer the best protection against osteoporosis, but when we strengthen the body with synergistic nutrients, we strengthen the bones too.
 Tai V, Leung W, Grey A, Reid IR, Bolland MJ. Calcium intake and bone mineral density: systematic review and meta-analysis. BMJ. 2015.
 Bolland MD, Leung W, Tai V, et al. Calcium intake and risk of fracture: a systematic review. BMJ. 2015.
 Bolland MJ, Grey A, Avenell A, Gamble GD, Reid IR. Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women’s Health Initiative limited access dataset and meta-analysis. BMJ. 2011.
About the Author: Dr. Gerard Guillory, MD is Board Certified in Internal Medicine and has published two books on Irritable Bowel Syndrome (IBS). In 1985, he opened The Care Group, PC. Today, his clinic is a Primary Care facility that is a hybrid of functional and traditional medicine treating patients with digestive disorders, autoimmune disease, and other conditions. You can learn more about Dr. Guillory here.