A good diet is only one of the building blocks for healthy bones, which also includes exercise and avoiding certain risk factors for osteoporosis.
Adults need 700mg of calcium a day. You should be able to get all the calcium you need by eating a varied and balanced diet.
Good sources of calcium include:
• milk, cheese, and other dairy foods
• green leafy vegetables, such as broccoli, cabbage, and okra, but not spinach
• soya beans
• plant-based drinks (such as soya drink) with added calcium
• bread and anything made with fortified flour
• fish where you eat the bones, such as sardines and pilchards
Although spinach contains a lot of calcium, it also contains oxalate, which reduces calcium absorption, and it is therefore not a good source of calcium.
Adults need 10 micrograms (400 International Units or IU) of vitamin D a day.
It's difficult to get all the vitamin D we need from our diet, and we get most of our vitamin D from the action of the sun on our skin.
From late March/April to the end of September, you can make vitamin D from sunlight by having short daily periods of sun exposure without sunscreen. However, everyone should consider taking a daily vitamin D supplement during the autumn and winter when we cannot make vitamin D from sunlight.
For babies and children, see vitamins for children.
Some groups of the population are at greater risk of not getting enough vitamin D, and the Department of Health and Social Care recommends that these people should take a daily 10 microgram (400IU) vitamin D supplement all year round.
These groups are:
• people who are not often outdoors, for example if they are frail, housebound or living in a care home
• people who usually wear clothes that cover up most of their skin when outdoors
• people with dark skin such as those of African, African-Caribbean or south Asian origin
Good sources of vitamin D:
• oily fish, such as salmon, sardines and mackerel
• egg yolks
• fortified foods, such as some fat spreads and breakfast cereals
If you've been diagnosed with osteoporosis, your doctor may prescribe calcium and vitamin D supplements as well as osteoporosis drug treatments if they have concerns that your calcium intake may be low.
Women lose bone more rapidly for a number of years after the menopause when their ovaries almost stop producing oestrogen, which has a protective effect on bones.
There are no specific calcium or vitamin D recommendations for the menopause, however a healthy balanced diet, including calcium, summer sunlight and vitamin D supplements, will help slow down the rate of bone loss.
Non-vegans get most of their calcium from dairy foods (milk, cheese, and yoghurt), but vegans will need to get it from other foods.
Good sources of calcium for vegans include:
• fortified soya, rice, and oat drinks
• soya beans
• calcium-set tofu
• sesame seeds and tahini
• brown and white bread (in the UK calcium is added to white and brown flour by law)
• dried fruit such as raisins, prunes, figs and dried apricots
The vegan diet contains little, if any, vitamin D without fortified foods or supplements but, for everyone, sunlight on the skin in spring and summer is the main source of vitamin D. Remember to cover up or protect your skin before it starts to turn red or burn.
Other vegan sources of vitamin D are:
• fortified fat spreads, breakfast cereals and plant-based drinks such as soya drink (with vitamin D added)
During pregnancy and when breastfeeding, women who follow a vegan diet need to make sure they get enough vitamins and minerals for their child to develop healthily.
If you're bringing up your baby or child on a vegan diet, you need to ensure they get a wide variety of foods to provide the energy and nutrients they need for growth.
Too much vitamin A
Some research has suggested a link between too much vitamin A and an increased risk of bone fractures. As a precaution, people who regularly eat liver (a rich source of vitamin A) are advised not to eat liver more than once a week or take supplements containing retinol (a form of vitamin A usually found in foods that come from animals).
People at risk of osteoporosis, such as postmenopausal women and older people, are advised to limit their retinol intake to no more than 1.5mg (1,500 micrograms) a day by eating less liver and liver products and avoiding supplements containing retinol (including those containing fish liver oil).
Santegra’s product Camosten™ contains calcium and vitamin D.