Got milk? If you grew up in the ‘90s, you probably did. Across the U.S., kids and teens were nudged by ads featuring milk-mustached celebrities to drink up as a way to grow big and strong. This was a strategy to save the struggling milk industry, sure. But it was also a way to encourage the intake of the bone-building mineral calcium and vitamin D. The benefits of this duo don't end when growth spurts do, though; women in the menopause transition may want to boost their consumption, too.
What calcium and vitamin D do for the body
The most abundant mineral in the body, calcium plays a major part in hardening and strengthening bone. That's because bones are made of calcium salts — mixtures of that mineral with others like iron and magnesium.
Calcium also helps with regulation of muscles, nerves, and the cardiovascular system. But even though it's integral to so many functions, our bodies can't actually make any of it. That means it needs to come from food and drinks, or supplements when necessary. If we don't get enough, the body starts taking it from our own bones, like some campy horror story. Over time, this makes bones weaker.
In order for calcium to do its job, though, it needs a nutrient wingman. Vitamin D helps the calcium we get from food and drinks to absorb into the body, and it also improves functioning of the immune system, lowers inflammation, and supports muscle health.
For adults, too little vitamin D can contribute to osteoporosis, a disease that makes bones brittle and weakened. Unlike calcium, though, the body can make vitamin D — but there's a catch. The main way this process occurs is from sunlight. When ultraviolet rays strike the skin, it triggers vitamin D creation.
Why calcium and vitamin D are crucial during menopause?
If you don’t get enough calcium and vitamin D, your bones become brittler — and menopause hormones compound the weakening.
"Estrogen helps slow the natural breakdown of bone, and it supports the activity of cells that build bone," says Dr. Rachael Lopez, M.D., OB/GYN and medical director of women's services at MemorialCare Saddleback Medical Center's Women's Health Pavilion in Laguna Hills, CA. “So, when estrogen levels drop during menopause, bone loss speeds up, raising the risk of osteoporosis."
This bone disease involves loss of bone mineral density and bone strength, which means your risk of fractures is significantly increased. Osteoporosis is the most prevalent cause of fractures in postmenopausal women, and can lead to bone breaks even from minor falls or normal stressors like bending or lifting — even coughing could cause fractures for those with this condition.
How much calcium and vitamin D should you get?
The recommended daily allowance of calcium for women older than 50 is 1,200 mg daily — that’s 200 mg more than what’s recommended for women 19-50, and 100 mg less than what's advised for preteens and adolescents. (They need more as their bones develop and strengthen.)
For vitamin D, adults 19-70 should get 600 IU (international units) a day, while those over age 70 should be getting at least 800 IU per day.
For perspective, per the USDA’s database, 8 ounces of nonfat milk offers about 325 mg of calcium and 108 IU of vitamin D (if fortified).
Top food sources for calcium
It may be the most widely known, but milk isn’t the only source of calcium. You can get your fill from a variety of foods:
- Yogurt (plain, low fat): 415 mg per 8 oz
- Tofu (firm, calcium-set): 253 mg per half-cup
- Canned sardines: 325 mg per 3 oz
- Kale (raw, chopped): 24 mg per cup
Some foods are also fortified with calcium, meaning that it's added as part of the manufacturing process. Examples include:
- Soymilk: 299 mg per cup
- Orange juice: 349 mg per cup
Sources of vitamin D
Getting enough of this vitamin can be tricky because unless you're eating or drinking a food or beverage that's fortified, not many foods naturally contain vitamin D. Some kinds of fish like salmon, trout, tuna, and mackerel have some of the vitamin, but the majority of vitamin D in the body comes from sunlight exposure.
In terms of how much sun you need, that can depend on degree of skin pigmentation, weather conditions, season, and where you live, according to Michael Holick, M.D., professor of medicine at Boston University Chobanian and Avedisian School of Medicine and director of the Vitamin D, Skin and Bone Research Laboratory. For example, UV radiation is more intense near the equator, so if you live in those areas, you would need less time in the sun for the benefits.
In general, though, you only need about 10 to 20 minutes of sunshine per day for your daily dose, and where you get those rays matters. “It’s best to get sun on your shoulders, arms, or legs instead of your back or face since those can increase cancer risk,” he says. After your brief exposure, he suggests using sunscreen for the rest of your time outside.
When to consider supplements
If you aren’t getting enough calcium and vitamin D, you may want to consider supplements. "Ideally, you'd want to get what you need from food, but supplements can help fill in the gaps," says Ali McGowan, R.D., a Boston-based dietitian at Sprout Out Loud. "Many women fall short through food alone, especially if they avoid dairy or get limited sun exposure.”
For calcium, look for a supplement that contains calcium carbonate and provides 500 mg/day. For vitamin D, you’ll want 10 mcg that’s paired with K2. While vitamin D helps the calcium get absorbed, vitamin K2 helps the calcium get into bones. Look for third-party tested brands with seals from NSF or USP, and always check with your healthcare provider first before taking something new.
How to maximize absorption
Vitamin D is fat-soluble, so taking your vitamin D supplement with meals that include some fat — like eggs, avocado, or salmon — can help your body absorb it better, suggests McGowan.
"Calcium is easier to absorb in smaller amounts, so it’s helpful to spread it out through the day with snacks and meals," she adds. "That might look like yogurt in the morning, cheese with lunch, or a smoothie with fortified plant-based milk in the afternoon. Try not to pair calcium with high amounts of caffeine, which can block its absorption."
When to talk to your doctor
Many women with low levels of calcium or vitamin D may not have obvious symptoms at first, but there are some signs, says Lopez. Low calcium can lead to issues like muscle cramps, tingling in the fingers and toes, and brittle nails. When you have low vitamin D levels, this can show up as fatigue, muscle aches, or general weakness.
"Talk to your doctor about bone loss due to menopause, even if you don’t have symptoms," she advises. A simple blood test can check your vitamin D levels, and your provider can recommend a supplement plan if needed.
For guidance navigating your specific nutritional needs during menopause, join WeightWatchers for Menopause. You’ll be able to meet with a registered nutritionist who can help you prioritize the nutrients most important to your goals.
The bottom line
Calcium and vitamin D are important for everyone, but they're especially crucial for women who are going through menopause or are postmenopausal because reductions in estrogen can affect bone health — and supporting better bones through this mineral-vitamin duo can help to mitigate those effects.
This content is for informational purposes only and does not constitute medical advice, diagnosis or treatment. It should not be regarded as a substitute for guidance from your healthcare provider.