Understanding Calcium Needs for Adults Over 50
As we age, our bodies' ability to absorb calcium from both food and supplements decreases. This, combined with the natural loss of bone density, makes adequate calcium intake particularly important for adults over 50. For women aged 51 and older, the recommended daily allowance (RDA) is 1,200 mg, while for men, the 1,200 mg RDA applies after age 70. However, it's crucial to obtain this calcium from a combination of diet and, if necessary, supplements, without exceeding the upper limit of 2,000 mg daily.
The Two Main Types of Calcium Supplements
When looking at supplements, two forms dominate the market: calcium citrate and calcium carbonate. Both provide elemental calcium, but they differ significantly in elemental calcium percentage, absorption, cost, and potential side effects.
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Calcium Carbonate: This is the most common and often least expensive form. It contains a high percentage of elemental calcium (about 40%), meaning you need to take fewer pills to meet your needs. However, it requires stomach acid for proper absorption and should therefore be taken with food. It is also more likely to cause side effects like gas, bloating, and constipation, especially in older adults. Common brands include Tums and Caltrate.
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Calcium Citrate: While more expensive, calcium citrate is better absorbed, particularly by individuals with low stomach acid—a condition more prevalent in older adults and those taking acid-reducing medications. It can be taken at any time, with or without food, making it more convenient. Citracal is a popular brand containing this form. It contains a lower percentage of elemental calcium (about 21%), so you may need to take more tablets to get the same dose as calcium carbonate.
Factors to Consider When Choosing a Supplement
Choosing the right calcium supplement is not a one-size-fits-all decision. Consider these factors with your healthcare provider to find the best fit for your needs.
Stomach Acid and Medications
For many over 50, stomach acid production naturally declines. Additionally, medications like proton pump inhibitors (PPIs) for heartburn can further reduce stomach acid. In these cases, calcium citrate is the better choice, as its absorption is not dependent on high stomach acid levels. If you don't have these issues, calcium carbonate taken with a meal can be a perfectly suitable and more affordable option.
Elemental Calcium and Dosing
The amount of actual or 'elemental' calcium is what matters. Since absorption is maximized at doses of 500 mg or less, splitting your daily dose is recommended. For example, if you need 1,000 mg from supplements, take 500 mg in the morning and 500 mg in the evening. Always check the 'Supplement Facts' label for the elemental calcium amount, not the total weight of the calcium compound.
The Importance of Vitamin D
Vitamin D is crucial for the body to effectively absorb calcium. Many calcium supplements come fortified with vitamin D, which can simplify your regimen. Be sure to check the dosage, as recommendations for vitamin D vary, and you may still need a separate supplement to reach optimal levels.
Avoiding Potential Side Effects
Side effects like gas and constipation are common with calcium carbonate. If you experience these, consider switching to a calcium citrate formula. Ensuring you stay well-hydrated and increasing dietary fiber can also help manage these symptoms.
Quality and Purity
Supplements are not tightly regulated by the FDA, so it's important to choose products from reputable brands. Look for certifications from third-party testers like the U.S. Pharmacopeial Convention (USP), ConsumerLab.com (CL), or NSF International, which verify the supplement's purity and potency.
The Dietary Approach
Supplements should complement, not replace, a diet rich in calcium. For those who find it challenging to get enough from food, a supplement can fill the gap. Excellent dietary sources include dairy products, leafy green vegetables, and fortified foods like cereals and juices. You can find extensive nutritional data on food sources from reliable organizations [https://www.osteoporosis.foundation/patients/prevention/calcium-and-vitamin-d/get-the-facts-on-calcium-and-vitamin-d].
Comparison of Common Calcium Supplements
| Feature | Calcium Citrate | Calcium Carbonate |
|---|---|---|
| Elemental Calcium | 21% | 40% |
| Absorption | Better absorbed, especially with low stomach acid | Needs stomach acid for absorption; best taken with food |
| Cost | More expensive per milligram | Less expensive per milligram |
| Pill Count | Higher pill count needed for the same dose | Lower pill count needed for the same dose |
| Side Effects | Less likely to cause gas, bloating, and constipation | More likely to cause digestive side effects |
Making the Final Decision
For many people over 50, calcium citrate is the best choice due to its superior absorption profile, especially for those with reduced stomach acid. It is less likely to cause digestive discomfort, making it a more tolerable option for daily use. However, calcium carbonate remains a cost-effective and perfectly valid option, provided it's taken with meals to ensure proper absorption. Always combine supplements with a balanced diet and adequate vitamin D intake for best results.
Conclusion
While a supplement can effectively bridge nutritional gaps, the final decision on what is the best calcium to take over 50 should be made in consultation with a healthcare provider. They can assess your individual health profile, dietary habits, and risk factors to recommend the optimal form and dosage. Prioritizing calcium-rich foods first, and using a high-quality, third-party tested supplement to make up any deficit, is the most strategic approach to maintaining strong bones for years to come.
