Curious if you’re getting enough calcium during pregnancy, or why you even need it? Find out, plus get answers to the most google’d questions about calcium in pregnancy, along with the best foods to make sure you get the calcium you need.
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Table of Contents
– What is Calcium and Why Do I Need It?
– Calcium in Pregnancy
– What Calcium Needs to be Effective
– How Do I Know if I’m Getting Enough Calcium
– High Calcium Foods
– Calcium in a Dairy Free Pregnancy
– Don’t Count on Spinach for Calcium
– Should I Take a Calcium Supplement in Pregnancy?
– How to Pick a Calcium Supplement
What is Calcium and Why Do I Need It?
Calcium is a mineral that your body needs to circulate blood, move muscles, release hormones, carry messages from your brain to other parts of your body and build teeth and bones. (1)
If you don’t get enough calcium for your body to perform as it should, your body will pull it from your bones. (1) As a result, your bones will weaken.
Since you can’t produce calcium on your own, you have to get it from your diet, or a supplement.
Calcium in Pregnancy
Calcium performs the same in pregnancy.
The recommended daily intake (RDI) for calcium in an adult is 1000mg each day. For pregnant women, the recommended daily intake to prevent severe deficiency is 1300mg, but the recommendation for an optimal level is 1462mg. (2)
Interstingly, when pregnant, your ability to absorb calcium doubles. (3)
What Calcium Needs to Absorb Properly
Calcium needs Vitamin D, Vitamin K2 and magnesium to be effective.
Vitamin D helps your body absorb calcium.
It is the only vitamin that is not obtained primarily through diet. In other words, 90% of your Vitamin D comes from sun exposure. (3)
Pregnant women are normally deficient in Vitamin D, and the darker your skin is, the harder it is for your body to produce it from the sun. That means that women with darker pigmented skin need longer sun exposure each day to produce enough Vitamin D. (3)
The best and most efficient way to get Vitamin D is to spend 10 to 30 minutes in the sun everyday in the midday; longer for darker pigmented skin.
Vitamin K2 is majorly important because it tells calcium where to go in your body. (3)
Dairy is the best source for Vitamin K2, and fermented dairy is even better. Fermented dairy products have more Vitamin K2 due to their probiotics.
Fermented dairy products include buttermilk, sour cream, yogurt, most cheeses, aged cheeses, kefir, koumiss, acidophilus milk, cultured milk and new yogurts containing Bifidobacteria. (5)
Magnesium helps balance the distribution of calcium between your body’s soft tissues and bones.
A lack of magnesium causes the calcium you intake to store in your soft tissues and not your bones, possibly causing arthritis and osteoporosis. (6)
Great sources for magnesium are nuts and seeds (pumpkin seeds, almonds, sunflower seeds, cashews, etc.), leafy greens (spinach, kale, collard greens, etc.), avocados, legumes (black and kidney beans, edamame, etc.), dark chocolate, salmon, milk, topical magnesium oil, Epsom salt baths and more. (3) (7)
How Do I Know if I’m Getting Enough Calcium
According to a 2010 study, the standard American diet (mostly non-healthy) comes fairly close to the daily amount of calcium needed. (3)
Easy answer – if you’re eating more real food than heavily processed food, and eating dairy, it’s safe to assume that you’re meeting your daily calcium needs.
There are many non-dairy calcium sources, and if you don’t consume dairy products, you may want to make an effort to eat more of these non-dairy calcium rich foods (chart below).
High Calcium Foods
This food chart lists the best sources for calcium from highest to lowest, and only foods with doses high enough to be notable. Other foods have calcium but in very small amounts, meaning you’d have to overeat just to get half of the calcium you need.
Pay particular attention to the foods with a heart and star because they contain the other vitamins and minerals that calcium needs to absorb properly.
Calcium in a Dairy Free Pregnancy
If you avoid dairy products, you may want to ask your doctor about your calcium, Vitamin D, Vitamin K2 and magnesium levels. Vitamin D, Vitamin K2 and magnesium all assist your body in absorbing calcium properly, (3) and if you avoid the main sources of calcium (dairy products) you want to make sure that the calcium you are eating is enough and effectively stored.
Dairy Free (Vegan) High Calcium Foods
Avoiding dairy doesn’t mean you can’t get an adequate amount of calcium each day. This food chart shows calcium-rich vegan foods from highest to lowest.
Additional high calcium dairy free foods that aren’t vegan are sardines and salmon, canned with bones.
Don’t Count on Spinach for Calcium
A common misconception is that spinach is a great source of calcium. Though it has a decent amount of calcium, it’s extremely high in oxalates. Oxalates prevent the absorption of calcium.
This is the case with a few foods, most common are spinach, rhubarb, beet greens and almonds.
Though these foods are great nutritionally, they shouldn’t be counted as a source of calcium. (11)
Should I Take a Calcium Supplement in Pregnancy?
Calcium supplementation is likely unnecessary if you eat dairy products.
As stated above, the common North American diet gets a decent amount of calcium each day. On top of that, your prenatal vitamin likely includes Vitamin D. Take a look at the label.
Add in the fact that your absorption of calcium doubles during pregnancy and there’s little chance that you’re lacking calcium.
If you want optimal calcium levels, or if you’re deficient in calcium, consider a calcium supplement and discuss it with your healthcare team.
How to Pick a Calcium Supplement
Your body has trouble absorbing more than 500mg of calcium at a time, so there’s no need to purchase a calcium supplement with a dose higher than 500mg.
Look at the label at the type of calcium: is it calcium carbonate or calcium citrate?
Calcium carbonate has twice as much calcium by weight as calcium citrate, should be taken with food and has been linked to constipation and bloating. Viactiv Calcium Chews, Os-Cal, and Tums are supplements with calcium carbonate.
Calcium citrate has half as much calcium by weight as calcium carbonate (meaning you may need to take more pills to reach the desired dose), can be taken on an empty stomach and is better absorbed by your body. Citracal and GNC Calcimate Plus 800 are supplements with calcium citrate. (12)
If you take tetracycline antibiotics, iron or zinc supplements, or levothyroxine, take them 3+ hours from the calcium supplement to avoid negative interactions.Harvard Health
To prevent severe deficiency, the recommended daily intake (RDI) of calcium while pregnant is 1000mg. For optimal function and fetal growth, the RDI is 1462mg.
There are no obvious signs of a lack of calcium in the short term because the body maintains calcium levels in the blood by taking it from your bones. Severe calcium deficiency symptoms are numbness and tingling in the fingers, convulsions, and abnormal heart rhythms. These symptoms are almost always in people with serious health problems or who are undergoing certain medical treatments. Long term effects are low bone mass (osteopenia) and increased risks of osteoporosis and bone fractures. (9)
If you don’t get enough calcium, your body pulls it from your bones because they hold the most calcium in the body. As a result, your bones weaken and the chances for arthritis, bone fractures and osteoporosis increase. Deficient calcium is also associated with hypertensive disorders and increased chances of preeclampsia in pregnant women.
Yes: low calcium can affect a fetus even through adolescence and adulthood, causing stunted growth, reduced bone density and an increased chance of osteoporosis. Low calcium in pregnant women is associated with hypertensive disorders and increased chances of preeclampsia. Since calcium is pulled from bones when there is a lack in consumption, the mother’s bones weaken as a result, and she is at greater risk for preeclampsia and hypertensive disorders. (8)
The foods with the highest calcium per serving are dairy milks, yogurts and cheeses (not so high in soft cheeses). Often, juices and plant-based milks are fortified with calcium. Dairy-free high calcium sources are sardines, canned salmon, winged and white beans, kale, collard greens, tofu/edamame, whey protein and chia seeds.
The easiest way to increase calcium in pregnancy is to consume more dairy milk, yogurt or cheese. Calcium is highest and best absorbed from those dairy products. For dairy free, try sardines, canned salmon, kale, collard greens, broccoli rabe, winged and white beans, chia seeds, tofu/edamame, whey protein or calcium fortified milks or juices.
Because Vitamin D, Vitamin K2 and magnesium all work closely for the proper absorption of calcium, it would benefit you to have those levels tested to see exactly where the issue lies in your lack of calcium. As a vegan, sufficient calcium may be hard to obtain, in which case a calcium supplement can help increase your intake in pregnancy.
Taking a calcium supplement during pregnancy is OK but likely not necessary since it’s easy to get a good amount of calcium even in a non-healthy diet. Calcium supplementation is more likely necessary for dairy free persons. Always consult your physician before taking a supplement.
Food sources are the best sources of calcium for pregnancy, and dairy is the very best because your body absorbs that calcium easily.
Since severe calcium deficiency isn’t common in pregnancy, if you’re looking to supplement, you don’t need one with a ton of calcium. The amount in your prenatal vitamin is likely enough to get you to an adequate level. Your body has trouble absorbing more than 500mg of calcium at a time.
Take a calcium supplement at any time of the day is fine, but if you take iron or zinc supplements, tetracycline antibiotics, or levothyroxine, take the calcium 3+ hours from these to prevent negative interactions.
Adequate calcium is most important in the third trimester when the fetus’ skeleton develops rapidly.
The foods with the highest calcium per serving are dairy milks, yogurts and cheeses (not so high in soft cheeses). Often, juices and plant-based milks are fortified with high amounts of calcium. Dairy-free high calcium sources are sardines, canned salmon, winged and white beans, kale, collard greens, broccoli rabe, tofu/edamame, whey protein and chia seeds.
You cannot increase calcium in your bones naturally. Calcium must be obtained through a food or supplement.
Increase your calcium level by eating more calcium rich foods like dairy, fermented dairy products and leafy greens, but also have your calcium, Vitamin D, Vitamin K2 and magnesium levels checked to see where you’re lacking in the calcium absorption process.
Dairy milk has the highest amount of calcium occurring naturally. Calcium fortified juices and (dairy free) milks sometimes have more calcium per serving; however, calcium in dairy products is better absorbed than calcium in any other food, supplement or fortification.
Diary free calcium sources worth mentioning are calcium fortified juices and plant-based milks, sardines, canned salmon, winged and white beans, kale, collard greens, broccoli rabe, tofu/edamame, whey protein and chia seeds.
Dried figs and fresh oranges are the only notable fruits for calcium. Dried figs have more calcium per ounce than oranges, but they both have less than 10% of the recommended daily intake (RDI) of calcium in one serving. Two dried figs contain 65mg of calcium, and one orange has 55mg of calcium.
Collard greens is the vegetable with the most calcium at 36% of the recommended daily intake (RDI) for every 8 ounces frozen.
The best form of calcium to take is calcium carbonate because it has the highest percent of calcium by weight; 40%. Side effects include constipation and bloating. Viactiv Calcium Chews, Os-Cal, and Tums are supplements with calcium carbonate.
One that is 500mg or less in a daily dose. Other factors, like the form and type of calcium all differ based on personal needs.
In pregnancy you need 1300mg of calcium per day to prevent severe deficiency, but 1462mg of calcium per day for an optimal level. Calcium can only come through your diet or a supplement: it can’t be produced by your body. The highest sources of calcium are dairy products, but there are other comparable non-dairy sources as well (see graphics).
A standard American diet is likely just short in calcium intake, so adding one or two high calcium foods each day would be beneficial. However, loading up on calcium isn’t the answer because your body can absorb only 500mg at a time, and calcium needs Vitamin K2, Vitamin D and magnesium to absorb properly.
2. The Best Prenatal Vitamins in 2020
3. Real Food for Pregnancy
4. Total Usual Calcium and Vitamin D Intakes in the U.S.
5. Cultured Dairy Foods
6. Magnesium: A Key to Calcium Absorption
8. Hypocalcemia in Pregnancy
9. Calcium Fact Sheet
10. Calcium Foods
11. Calcium Absorption