We’ve been reminded of the importance of keeping our bones strong and healthy by way of marketing campaigns (like Got Milk?) since childhood. But by now, we’ve also learned that getting enough calcium into our diets is a little more nuanced than just chugging a glass of milk in the morning.

According to Caroline Cederquist, MD, a board-certified physician and founder and chief medical officer of BistroMD, age is a key contributing factor that impacts someone’s calcium needs. This is worth noting, as studies have deemed osteoporosis—an imbalance between bone resorption and bone production—the “silent disease of the 21st century” due to its severity, chronicity, and progression in many postmenopausal women and older adults. We caught up with Dr. Cederquist, who shared how your calcium needs change as you age and how to gradually shift your lifestyle accordingly to meet these evolving recommendations.

How do your calcium needs change as you age, according to an MD

While calcium is often associated with strong bones and teeth, it’s also an essential mineral and electrolyte vital for overall health. “Calcium is a vital mineral for maintaining nerve functioning, muscle contractions, blood clotting, and even a regular heartbeat,” Dr. Cederquist says. Much like hydration levels, the amount of calcium the body requires tends to ebb and flow throughout your life.

According to Dr. Cederquist, the most significant changes to your calcium requirements will come during childhood and once again during later adulthood. “Calcium needs change throughout the lifespan due to the natural changes our bodies experience. While needs increase steadily to support the growing body from birth to teenage years, needs gently decrease in young adulthood,” Dr. Cederquist says.

But similar changes begin to occur again as folks reach later adulthood. “Calcium requirements start increasing again for women after 50—due to menopause—and men after 70 to preserve bone strength and lower the risk of osteoporosis and subsequent injuries,” Dr. Cederquist says.

“Calcium requirements start increasing again for women after 50—due to menopause—and men after 70 to preserve bone strength and lower the risk of osteoporosis and subsequent injuries,” Dr. Cederquist says.

This means that calcium intake levels will also need to be adjusted to address these normal changes. “As the body is growing, particularly from birth to age 18, calcium needs steadily increase up to 1,300 milligrams per day, then reduce to 1,000 milligrams per day,” Dr. Cederquist says. Meanwhile, she recommends that women aged 50 and older consume 1,200 milligrams per day due to hormonal changes caused by menopause. And folks aged 70 and older should also increase their calcium intake to about 1,200 milligrams to support bone health.

Signs that your calcium needs are changing

According to Dr. Cederquist, several factors can contribute to changes in the amount of calcium one requires. “There are many risks that can increase calcium deficiency, inadequate calcium intake and/or absorption, which may be due to consuming a dairy-free diet based on choice, a dairy allergy, or lactose intolerance. Certain medications, deficiencies of other nutrients such as vitamin D, and menopause can also increase the risk of calcium deficiencies,” Dr. Cederquist says.

However, to avoid calcium deficiency, Dr. Cederquist recommends the general rule of thumb is to stay vigilant and acknowledge the changes that come at main milestones like after your teenage years, after turning 50 for women, and 70 for men.

If you are experiencing a calcium deficiency, you might experience a few physical symptoms. “While not everyone experiences calcium deficiency symptoms, someone may experience muscle spasms, numbness and tingling in their extremities, and fatigue. Neurologic symptoms, heart issues, bone fractures, and seizures are signs and symptoms of a more severe calcium deficiency,” Dr. Cederquist says.

How to consume sufficient amounts of calcium

Dr. Cederquist recommends consuming calcium-rich food sources to help maintain sufficient levels of the mineral. This includes eating foods like milk and dairy products. However, if you’re following a dairy-free diet, there are plenty of additional plant-based calcium options available, like collard greens, kale, corn that’s undergone nixtamalization, and broccoli, to name a few. However, if you cannot consume a calcium-rich diet, it’s best to speak with a medical specialist about alternative options to best match your personal needs.

In order to reap the most benefits of calcium, Dr. Cederquist recommends always pairing calcium and vitamin D together. “You can also boost how much calcium your body absorbs by pairing those foods with vitamin D, whether it be obtained from the sun, diet, and/or supplementation,” she says. Another great booster for calcium is by augmenting its benefits with resistance training that helps support healthier bones.

On the flip side, despite the importance of calcium, Dr. Cederquist notes that it is possible to consume too much. “Calcium is not flushed out readily like other nutrients, which can lead to build-up in the bloodstream and cause hypercalcemia,” she says. “While high calcium levels are rare in generally healthy people, it can result in individuals with an underlying condition such as cancer. If calcium builds in the bloodstream above normal levels, a condition known as hypercalcemia, people are more at risk for weight loss, kidney stones, renal insufficiency, heart arrhythmias, and heart disease, amongst other health issues,” she says.

Sources of calcium-rich foods (in milligrams):

Fruits & Veggies:

• Cooked collard greens: 134 mg per 1/2 cup
• Cooked napa cabbage: 79 mg per 1/2 cup
• Dried figs: 61 mg per 1/4 cup
• Oranges: 60 mg per 1 medium
• Cooked kale: 47 mg per 1/2 cup
• Cooked broccoli: 31 mg per 1/2 cup

Protein Sources:

• Raw tofu prepared with calcium sulfate: 434 mg per 1/2 cup
• Canned sardines: 351 mg per 3.75 oz can
• Cooked soybeans: 261 mg per 1 cup
• Cooked white beans: 81 mg per 1/2 cup
• Shrimp: 77 mg per 3 oz
• Cooked pinto beans: 39 mg per 1/2 cup
• Cooked red beans: 25 mg per 1/2 cup

Additional Food Sources:

• Fortified cereal: upwards of 1000 mg per 3/4-1 cup serving
• Fortified orange juice: 350-500 mg per 1 cup
• Sesame seeds: 351 mg per 1/4 cup
• Fortified plant milks: 100-300 mg per 8 oz serving
• Fortified instant oatmeal: 140 mg per 1 packet

An RD shares supplements for women’s health: