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Calcium, needed for strong bones, is found in dark green leafy vegetables, tofu made with calcium sulfate, calcium-fortified soy milk and orange juice, and many other foods commonly eaten by vegans. Although lower animal protein intake may reduce calcium losses, there is currently not enough evidence to suggest that vegans have lower calcium needs. Vegans should eat foods that are high in calcium and/or use a calcium supplement.
Calcium is a very important mineral for humans. Our bones contain large amounts of calcium, which helps to make them firm and rigid. Calcium is also needed for many other tasks including nerve and muscle function and blood clotting. These other tasks are so important for survival, that, when dietary calcium is too low, calcium will be lost from bone and used for other critical functions. The body tightly controls calcium in the blood, so measuring blood calcium levels cannot assess calcium status.
Because of heavy promotion by the American dairy industry, the public often believes that cow's milk is the sole source of calcium. However, other excellent sources of calcium exist so that vegans eating varied diets that contain these foods need not be concerned about getting adequate calcium. Sources of well-absorbed calcium for vegans include calcium-fortified soy milk and juice, calcium-set tofu, soybeans and soynuts, bok choy, broccoli, collards, Chinese cabbage, kale, mustard greens, and okra 1. Grains, beans (other than soybeans), fruits, and vegetables (other than those listed) can contribute to calcium intake but cannot replace these key foods. Table 1 shows the amount of calcium in selected foods. When you realize that there is as much or more calcium in 4 ounces of firm tofu or 3/4 cup of collard greens as there is in one cup of cow's milk, it is easy to see why groups of people who do not drink cow's milk still have strong bones and teeth.
The recommended level of calcium for adults age 19-50 years and men 51-70 is 1000 mg per day2. An intake of 1200 mg of calcium is recommended for women over 51 and for men over 702. Some studies 3-5, although not all 3-5, have shown that older adults with a high calcium intake have stronger bones and a lower fracture risk. There are a limited number of studies of vegans, most of which find low bone density as well as low calcium intakes 7,8. One study 9 where vegans had calcium intakes close to recommended levels found that calcium was well absorbed from a vegan diet.
Our Vegan Food Guide (page 198 of Simply Vegan) indicates good sources of calcium from several food groups. By choosing the suggested number of servings of calcium-rich foods daily, vegans should meet calcium needs. Table 2 shows several menus that contain more than 1000 mg of calcium.
Tofu is commonly recommended as a good source of calcium. Actually, the amount of calcium in tofu depends on the coagulating agent used to precipitate the soy protein in the process of making tofu. Calcium sulfate and nigari (magnesium chloride) are two commonly used agents. The agent used will be listed on the label under ingredients. Tofu that is prepared with calcium sulfate will contain more calcium than tofu made with nigari.
The amount of calcium in tofu varies from brand to brand. To calculate how much calcium is in the tofu you buy, look at the label. Calcium content will be listed as percent of the Daily Value. Since the current Daily Value for calcium is 1000 mg, multiply the percent Daily Value by 10 to get the amount of calcium (in milligrams) in one serving. For example, tofu with 10% Daily Value for calcium would have 100 mg of calcium in one serving.
The area of protein's effect on bones remains uncertain. Some studies show that diets that are high in protein, especially animal protein, do cause increased losses of calcium in the urine 10 and may even in-crease fracture risk 11,12. These effects of protein may be especially important in those with low calcium intakes 13. Other studies suggest that a higher protein intake is needed to promote calcium absorption 14, reduce the risk of fracture 15, and increase bone density 16,17. Until further evidence is available, vegans should strive to meet calcium recommendations and to have adequate, but not excessive, amounts of protein.
Other factors in bone health include sodium and physical activity. Sodium increases calcium losses with 5 to 10 mg of calcium lost with each gram of salt eaten 18. Reducing sodium intake can reduce calcium losses. Regular weight-bearing exercise such as walking, running, or aerobic dance is recommended to promote strong, healthy bones. Besides helping strengthen bones, exercise can also improve balance and flexibility, both important factors in preventing and recuperating from falls.
Table 1: Calcium Content of Selected Vegan Foods
|Blackstrap molasses||2 Tbsp||400|
|Collard greens, cooked||1 cup||357|
|Tofu, processed with
|Calcium-fortified orange juice||8 ounces||300|
|Soy or ricemilk, commercial,
|Commercial soy yogurt, plain||6 ounces||80-250|
|Turnip greens, cooked||1 cup||249|
|Tofu, processed with nigari*||4 ounces||80-230|
|Kale, cooked||1 cup||179|
|Soybeans, cooked||1 cup||175|
|Okra, cooked||1 cup||172|
|Bok choy, cooked||1 cup||158|
|Mustard greens, cooked||1 cup||152|
|Broccoli, cooked||1 cup||94|
|Almond butter||2 Tbsp||86|
|Soy milk, commercial, plain||8 ounces||80|
*Read the label on your tofu container to see if it is processed with calcium sulfate or nigari.
Note: Oxalic acid, which is found in spinach, rhubarb, chard, and beet greens binds with the calcium in those foods and reduces its absorption. These foods should not be considered good sources of calcium. Calcium in other green vegetables, like kale, collard greens, Chinese mustard greens, and Chinese cabbage flower leaves is well absorbed1,19. Fiber appears to have little effect on calcium absorption except for the fiber in wheat bran that does have a small effect20.
Sources: Composition of Foods. USDA Nutrient Data Base for Standard Reference, Release 18, 2005 and Manufacturer's information.
Table 2: Sample Menus Providing More Than 1000 milligrams of Calcium
|1 serving Cindy's Light
and Fluffy Pancakes (p. 23)
|1 cup Calcium-Fortified Soy milk||300|
|1 serving Hummus on Pita Bread (p. 27)||178|
|6 Dried Figs||68|
|1/4 cup Almonds||89|
|1 serving Scrambled Tofu and
Bok Choy over Brown Rice (p. 96)
|1 serving Green Salad and
Tangerine Dressing (p. 39)
|1 serving Chocolate Pudding (p. 114)||92|
|1 serving Tropical Fruit Smoothie (p. 16)||102|
|1 Toasted Bagel with||89|
|2 Tbsp Almond Butter||86|
|1 serving Mini Pizzas (p. 34)||235|
|1 serving Creamed Spinach (p. 68)||121|
|1 serving Lemon Rice Soup (p. 46)||82|
|1 serving Tofu Squash Burgers (p. 102)||135|
|1 cup Steamed Broccoli||94|
|1 serving Chocolate Pudding (p. 114)||92|
Page numbers refer to recipes in the book Simply Vegan: Quick Vegetarian Meals.
Additional foods should be added to these menus to provide adequate calories and to meet requirements for nutrients besides calcium.
There are factors that increase the risk of osteoporosis and that cannot be changed. These include small frame size, female gender, aging, heredity, being Caucasian or of Asian or Latino descent, early menopause, and prolonged immobilization. Other factors like cigarette smoking, excessive alcohol, physical inactivity, and inadequate calcium and vitamin D (see Simply Vegan Chapter on Vitamin D) are under our control. Vegans of all ages can promote bone health by consuming enough calcium and protein, getting adequate vitamin D, limiting use of sodium, and getting regular exercise, especially weight-bearing exercise.
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Sellmeyer DE, Stone KL, Sebastian A, et al. A high ratio of dietary animal to vegetable protein increases the rate of bone loss and the risk of fracture in postmenopausal women. Am J Clin Nutr 2001;73:118-22.
Meyer HE, Pedersen JI, Loken EB, et al. Dietary factors and the incidence of hip fracture in middle-aged Norwegians. A prospective study. Am J Epidemiol 1997;145:117-23.
Kerstetter JE, O'Brien KO, Caseria DM, et al. The impact of dietary protein on calcium absorption and kinetic measures of bone turnover in women. J Clin Endocrinol Metab 2005;90:26-31.
Munger RG, Cerhan JR, Chiu BC. Prospective study of dietary protein intake and risk of hip fracture in postmenopausal women. Am J Clin Nutr 1999;69:147-52.
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Promislow JH, Goodman-Gruen D, Slymen DJ, et al. Protein consumption and bone mineral density in the elderly: the Rancho Bernardo Study. Am J Epidemiol 2002;155:636-44.
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Weaver CM, Heaney RP, Nickel KP, et al. Calcium bioavailability from high oxalate vegetables: Chinese vegetables, sweet potatoes, and rhubarb. J Food Sci 1997;62:524-525.
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|This article originally appeared in the book Simply Vegan: Quick Vegetarian Meals by Debra Wasserman. Nutrition section by Reed Mangels Ph.D., R.D. (ISBN 0-931411-30-0)|
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