[Not intended as medical advice, see your doctor for that. I don't know your situation at all, which may preclude some of the ideas here, especially if you are taking any kind of long term medication, which I am not. Likewise, see a Nutritionist for nutritional advice targeted to you.]
Back in 2017, a friend of mine in her 50's got osteoporosis and started a treatment program. For a few years she had to take Fosamax, which helps make weak bones more rigid but also can make them more brittle than normal if you take it too long. The best thing is to reach the point where you don't need Fosamax any more in a few years and from then on get the proper nutrients every day for normal bone remodeling which will, over time, restore full bone normality. Fosamax is a band-aid you don't want to keep wearing.
This made me start thinking about my bones and took a look at the Recommended Daily Allowance for Calcium. I was shocked to see that it was 1,000mg for adults and 1200 mg for seniors. I thought I was getting plenty of calcium from (then) 2 cups yogurt, but that was less than half of the RDA. And not much else in my diet had calcium. My multivitamin didn't add much. So, I started supplementing calcium with a single 330-500 mg Calcium/Magnesium tablet every day to fill the gap.
Visiting my sister and brother-in-law in 2019, my attorney brother-in-law noticed my supplements, and gave me a scathing critique. "You should not be supplementing calcium," he said. "You'll get atherosclerosis. You'll get kidney stones."
I replied, "You only get those things if you are out-of-balance somehow. Meeting your minimum daily calcium requirement is not out-of-balance, it's in balance." I could not change his mind at all. He was highly opposed to supplements almost in principle (as it seems many doctors I've known have been).
I was very concerned about him that since he is lactose intolerant and avoids dairy altogether (except 2 cups of special ice cream with lactase for lactose intolerant people) he was not getting enough calcium. And my sister too, who did have small pieces of cheese with her salads but less ice cream. They were both already in their 70's and starting to look like they were rapidly shrinking. I've tried and tried to get my sister to consider supplementing calcium but it's never happened so far. She'd have to face her husband's disapproval for one thing. And for another, she doesn't like to do anything technical, like calculating the calcium supplementation required, preferring to leave everything technical to her husband.
Nine years later now they both look extremely shrunken. My sister has constant neck and back pain and her neck has become flexible. Her two upper front teeth simply broke off one day and she had to get a partial dental. The shrinking is not just in statue but in depth.
Everywhere I go I see elderly people who look like they do now. I doubt any of them are getting enough calcium. Few seem to even be aware that seniors need more calcium than adults and how much that is. (BTW, this is a well known fact that most US seniors are not getting enough calcium.)
Retrospectively I now blame lack of calcium for my short stature. In freshman year of high school, a friend of mine convinced me that drinking milk was for babies, and I quit doing so. I really didn't have other significant sources of calcium in my diet then. I didn't regularly eat yogurt or ice cream. That was surely bad advice.
*****
Doing this can get a little more complicated than people might like. You should not take simply take supplements having the RDA for calcium. You need to figure out the gap between your diet and the recommended amount for your age, and then fill just that gap. You don't want to get too more more calcium than the RDA because then you could get kidney stones, etc.
But there is some slack here. You can have somewhat more than the RDA without issues, so long as you stay below the upper limits. It's when you go past the upper limits that you could get the kidney stones, etc. The upper limits are a bit more complicated since they vary for young people, pregnant mothers, adults below 51, and adults above 51. For non-pregnant adults under 51 the upper limit is 2500mg and for adults over 51 it is 2000mg. Thus the range for eldery people is the most narrow: from 1200mg recommended to 2000 mg upper limit.
It's not really hard to do, though it takes a little time and arithmetic. Nowadays you can simply ask your favorite search engine for the calcium in any kind and quantity of food. You could probably even get it to add up the calcium in a long list of foods that constitutes what you eat in a given day. I do the adding up myself.
Better than using a search engine is actually looking at the Nutrition Facts on any labeled product. Then you get the exact numbers for the specific products you are eating (though lots of fresh foods are not so labeled--there you need to use the search engine).
I wrote everything down on an index card with columns for calcium, protein, and sodium. It's a worthwhile exercise to do at least once, I wish I had the time to do it every day.
I don't recommend the example below as an ideal diet for anyone, even me. I'm more interested in showing the method of adding up the calcium including everything. This just happens to be what I ate yesterday.
As far as the diet below is concerned, it "breaks" some nominal rules, like 2 tbsps peanut butter max (I generally try to keep it under 3 tbsps but yesterday I had no other reasonable snacks available) and possibly even the saturated fat calories. Anyway the most recent research seems to show that dairy and peanut butter saturated fats are actually somewhat protective, but the saturated fat dogmas haven't been updated to reflect this. Yesterday I didn't get any of the most dangerous saturated fats, those from red meats, but sometimes I do have 3-4 oz lean steak instead of chicken, which still wouldn't be very much.
I have never had a bad A1C measurement but recently I've become very focused on keeping it low because I believe it is actually the number one factor in heart and other diseases for elderly people.*** You will note that there's very little sugar in my diet now. I do use orange juice but only in the very tiniest amount for flavoring. I eat a tiny bit of sugar and a tiny piece of chocolate. I need the artificially flavored electrolyte drinks right now because I have diarrhea from taking an antibiotic.** I didn't have any fruit mainly because that's not compatible with current diarrhea. Normally I'd eat a fresh apple or banana. On nutrition focused friend of mine thinks its pointless to eat fruit at all but I find the fiber beneficial.
Food / Calcium
1 oz Orange Juice (mixed with no sugar Citrucel) 2 mg
4 large slices Dave's White Bread 80 mg
4 tablespoons all natural peanut butter 36 mg
7/8 cup Chobani Nonfat Greek Yogurt 225 mg
1 scoop whey isolate 105 mg
Centrum for Men 50+ 210 mg
2 Ultima Electrolyte Drinks 94 mg
3 oz cooked chicken breast 10 mg
3 oz Protein Pasta 0 mg
8oz can no salt added green beans 40 mg
2/3 11.5oz can low sodium V8. 33 mg
2 Tbsps Olive Oil 2 mg
1 Tbsp Heavy Cream 10 mg
7 cups RO water (coffee, mixes, ice) 7 mg
(Local Tap Water would be 105-140 mg)
1/2 cup Low Sodium Marinara Sauce. 20 mg
1/5 oz (one tiny square*) Chocolate w nuts 4 mg
3/4 tsp Sugar (in whey drink) 0 mg
Before calcium powder: 876 mg calcium
1 tsp Calcium/Magnesium powder 267 mg
I was a bit below calcium target, but not far. I was a bit too conservative when measuring out the Calcium/Magnesium powder. I didn't actually know how the numbers were going to work out. Going forwards, I think I may use the 1 1/2 tsp suggested amount.
That powder was my calcium supplement yesterday (sometimes I take a 333mg pill instead, which would have put me just slightly over 1200 mg). But I'll explain below why I think the powder is better than nearly all the pills.
The total 'supplements' contribution to my calcium was 567 mg (multivitamin, electrolyte drinks, calcium/magnesium powder). Almost half. And that's in spite of eating slightly more than the standard serving of yogurt and about as much calcium as most people in US eat.
I love to have a spaghetti dinner every day and I think that's fine with exact portion control (pasta is weighed on my scale) protein pasta and low sodium marinara. Pasta itself is zero sodium (and I put no salt in the water) which helps stay within optimal sodium. I do aim to cut back the extra two pieces of regular bread and peanut butter but it was the only snack I had available to go with my whey drink in the afternoon yesterday. Today I had the low sodium Ezekiel bread with the lightest rub of peanut butter possible. Going forwards, I plan to use low sodium Ezekiel Bread for snacking, with less peanut butter, and so reduce the daily peanut butter to 3 tablespoons or less.
Good calcium supplements (including pills and powders) are are sold with Magnesium included because you need to have calcium and magnesium in balance. The recommended balance for calcium:magnesium is 2:1, so many pills have this exact ratio.
But it actually doesn't make sense if most of your other calcium comes from dairy, because dairy products are 10:1, the supplement should try to bring that back into balance. So a 1:1 calcium magnesium supplement powder makes sense for me whose other calcium comes mostly from dairy.
The 1:1 Calcium Magnesium powder I get (NOW) is also made with citrates, which are more easily absorbed than the calcium supplements made with carbonates. Most calcium magnesium pills are made with carbonates. Adding it to my whey isolate drink makes it seem less watery and more like milk.
(* It wasn't long enough ago that I couldn't help myself but to eat a whole 3.5 oz bar of chocolate every day. My recent near death experience with pneumonia and dehydration has made me a different and better behaving person now, and hopefully from here on.)
(** The day I started taking electrolytes the situation dramatically improved. It's as if part of the problem was the interplay between the anal and urinal sphincters, which are connected, and of course are connected to the nervous system and all of its electrolytes.)
(*** From NIH published research I've read, the biggest risk factor for heart disease in elderly is in insulin resistance, aka type 2 diabetes, not in fats****, anyway. The saturated fat dogmas haven't been updated to reflect this. Lots of my thin elderly friends on lowfat diets are still taking statins, which I wonder about, then stuffing themselves with candy. I think they should be more focused on insulin resistance, as I am. I quit taking statins when I retired and could do my own low fat cooking instead of eating at Chinese buffets and steak bars every day. When that happened, I started noticing that statins made me feel weak My doctor wanted me to continue statins anyway, perhaps a different one, looking at my BMI category, she said my LDL was still a few points short of target. I don't think BMI reflects my stocky and above-average muscular body style correctly, I see Percent Body Fat, as I get on my biometric scale, a better indication of how much excess fat I have, which is as I understand it the relevant factor for heart disease. I have always done better on percent body fat than BMI, and as of right now I am no longer even "obese". Right now I can't seem to find the very impressive NIH published research I read last year on insulin resistance vs hyperlipidemia that put insulin resistance on top for elderly people while discounting hyperlipidemia a lot, but there is much research and writing that makes a similar case that can be easily found, such as https://www.optimalwellnessmd.com/blog/uncategorized/atherosclerosis-is-it-due-to-lipids-insulin-or-inflammation which mentions many studies.)
(****It bugs me no end that most people have come to regard low density lipoproteins (the entities, not the LDL relative blood measurement) as diseased. In truth, low density lipoproteins are the essential lubricant the body needs like an engine needs motor oil. You could not live without them. High density lipoproteins are like the oil additive that keep it flowing smoothly under different conditions. You can have too high HDL--when it keeps the low density lipoproteins from doing their job.)
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