Calcium and Vitamin D After 50: Needs, Food Sources and Supplement Evidence

Recommended intakes

The U.S. National Institutes of Health Office of Dietary Supplements lists the recommended dietary allowance for calcium as 1,200 mg per day for women aged 51 and older and men aged 71 and older, and 1,000 mg for men aged 51 to 70. For vitamin D it is 600 IU (15 mcg) for ages 51 to 70 and 800 IU (20 mcg) from age 71. These totals include food and supplements.

Food first

Dairy foods, fortified plant milks, canned fish with bones, tofu set with calcium and leafy greens such as kale provide calcium. Vitamin D comes from oily fish, egg yolks, fortified foods and sunlight exposure.

What the evidence says about supplements

In 2018 the U.S. Preventive Services Task Force reviewed supplements for preventing a first fracture. It recommended against daily supplementation with 400 IU or less of vitamin D and 1,000 mg or less of calcium in community-dwelling postmenopausal women, finding no net benefit. It found the evidence insufficient for higher doses and for men and premenopausal women. It also found supplementation increases kidney stones, a small harm, and recommended against vitamin D to prevent falls in community-dwelling adults 65 and older.

These conclusions do not apply to people with osteoporosis, vitamin D deficiency, a history of fracture or higher fall risk. Those people may need supplements, so follow your clinician's advice.

Practical tips

Add up what you get from food before supplementing. Calcium is absorbed better in smaller amounts, so split larger supplement doses. Do not exceed the tolerable upper limits without medical advice: 2,000 mg per day for calcium and 4,000 IU for vitamin D at this age. Ask whether a blood test for vitamin D makes sense for you.

Pair it with exercise

Weight-bearing and muscle-strengthening exercise remain central for bone health alongside nutrition and any prescribed treatment.