Calcium: A Guide for Parents

Calcium is a mineral that helps build strong bones. Calcium is also necessary for many of your body’s functions, such as blood clotting and nerve and muscle function. During the teenage years (particularly ages 11–15), your daughter’s bones are developing quickly and are storing calcium so that her skeleton will be strong later in life. Nearly half of all bone is formed during these years. It’s important that your daughter gets plenty of calcium in her diet, because if the rest of the body doesn’t get the calcium it needs, it takes calcium from the only source that it has: the bones. This can lead to brittle bones later in life and broken bones at any time. Unfortunately, most teen girls actually do not get enough calcium in their diet.

What is osteoporosis?

Osteoporosis is a bone disease that causes bones to become fragile and more likely to break. It develops slowly and is usually caused by a combination of genetics and too little calcium in the diet. Osteoporosis can also lead to shortened height because of collapsing spinal bones and can cause a hunched back.

How do I know if my daughter is at risk?

Several factors can put a young person at risk for developing osteoporosis.

They include:

• Being white
• Being female
• Being underweight
• Having a family history of osteoporosis
• Having irregular periods
• Doing little or no exercise
• Not getting enough calcium in your diet
• Smoking
• Drinking large amounts of alcohol

How much calcium does my daughter need?

Children and teenagers between the ages of 9 and 18 should aim for 1,300 milligrams per day, which is about 4 servings of high-calcium food or drinks. Each 8-ounce glass of milk (whether 1%, 2%, or whole) and each cup of yogurt has about 300 milligrams of calcium. Adults 19 to 50 years of age should aim for 1,000 milligrams per day.

How do I know how much calcium is in the foods my daughter eats?

For foods that have a nutrition facts label, the amount of calcium in that food is required to be on the label.  At the bottom of the label, you will see four nutrients: Vitamin D, calcium, iron and potassium  Next to calcium will be a number indicating the amount (in mg) in a serving of that product.

What foods contain calcium?

You probably know that dairy foods such as milk and cheese are good sources of calcium, but did you know that tofu and beans contain calcium, too? Even if you don’t drink milk or eat cheese, you can get the calcium you need from other foods. See the list of high–calcium foods at the end of this guide.

What if my daughter is lactose intolerant?

If your daughter is lactose intolerant or has a milk allergy and can’t drink milk, there are plenty of other ways she can get enough calcium. These include drinking fortified soy milk, fortified orange juice, almond milk or lactose-free milk (the lactase enzyme that you are missing has been added into the milk). If she is lactose intolerant,  she may also take lactase enzyme tablets before eating dairy products to help digest the lactose sugar in the milk. Some people who are lactose intolerant can tolerate having small amounts of milk or other dairy products.  There are also certain cheeses, such as cheddar, that are naturally lactose-free.  If you have a milk allergy, it is important to talk with your health care provider about what you can eat or drink.

How can my daughter get more calcium in her diet?

Here are some meal ideas to increase calcium in your daughter’s diet:

Breakfast:

• Have a bowl of cereal with milk.
• Use milk instead of water when making oatmeal.
• Drink calcium-fortified orange juice.
• Make a healthy breakfast smoothie with a cup of milk or yogurt and a handful of frozen fruit.
• Add a slice of cheese to your bagel or English muffin. Most cheeses, except for cream cheese, are high in calcium.

Lunch:

• Choose milk instead of soda at school. If you don’t like plain milk, try chocolate or strawberry milk.
• Pack a yogurt with your lunch.
• Add cheese to your sandwich.

Snacks:

• Look for cereal bars or energy bars that contain calcium. Check the label to see if calcium is listed.
• Make hot cocoa with milk instead of water.
• Eat broccoli dipped in a veggie dip made with plain yogurt.
• Snack on cheese sticks or almonds.
• Have a Greek yogurt (it’s packed with protein) as an after-school snack.

Dinner:

• Have macaroni and cheese made with milk.
• Try chowder-style soups.
• Prepare canned tomato soup with milk instead of water.
• Add tofu or edamame to stir fries or soups.
• Include more beans (legumes) in your meals.
• Make lasagna or other pasta dishes with ricotta cheese.
• Top your pizza with cheese and vegetables.
• Have pudding made with milk or frozen yogurt for dessert.

What if my daughter just can’t get enough calcium in her diet?

It’s best for your daughter to try to meet her calcium needs by having calcium–rich foods and drinks, but some teens find it hard to fit in 4 servings of high–calcium foods daily. If she doesn’t like dairy foods, calcium fortified juice or soymilk, she may need a calcium supplement. Calcium carbonate (for example, Viactiv® or a generic chewable) and calcium citrate (for example, Citracal®) are good choices.

When choosing a supplement for your daughter, keep the following things in mind:

• Most calcium supplements have between 200 and 500 milligrams of calcium. Remember, her goal is 1,300 milligrams of per day.
• If she has to take more than one supplement per day, it is best to take them at different times of the day because the body can only absorb about 500 milligrams of calcium at a time.
• She shouldn’t count on getting all of her calcium from a multivitamin. Most basic multivitamin/mineral tablets have very little calcium in them.
• Look for a calcium supplement that has vitamin D added. Vitamin D helps the body absorb calcium.
• Avoid “oyster shell” or “natural source” calcium supplements. These may have lead or aluminum in them and are not recommended.
• Know that a dietitian or health care provider will be able to support her with recommendations on what supplement will best suit her needs.

Our health guides are developed through a systematic, rigorous process to ensure accuracy, reliability, and trustworthiness. Written and reviewed by experienced healthcare clinicians from Boston Children's Hospital, a Harvard Medical School teaching hospital and consistently ranked as a top hospital by Newsweek and U.S. News & World Report, these guides combine clinical expertise, specialized knowledge, and evidence-based medicine. We also incorporate research and best practices from authoritative sources such as the CDC, NIH, PubMed, top medical journals, and UpToDate.com. Clinical specialists and subject matter experts review and edit each guide, reinforcing our commitment to high-quality, factual, scientifically accurate health information for young people.