The Vital Link Between Calcium and Bone Strength

Calcium builds your skeleton, but calcium alone will not protect it. Your body cannot absorb calcium without adequate vitamin D — and vitamin D deficiency is remarkably common in India, with pooled estimates of roughly 67% across age groups and 70–90% among adult women. That combination is why bone loss is often well advanced before anyone notices. Indian diets also tend to be high in phytates, which further reduce how much calcium the gut takes up. The ICMR-National Institute of Nutrition raised the recommended calcium intake for Indian adults to 1,000 mg per day in its 2020 revision, and 1,200 mg for adults over 60. Bone is living tissue that is constantly rebuilt, so intake matters at every age — not only after a fracture. The practical takeaway is simple: pair calcium with vitamin D, and start before symptoms appear.

How much calcium do Indian adults need?

The ICMR-National Institute of Nutrition sets Recommended Dietary Allowances specifically for Indian bodies and dietary patterns. The 2020 revision raised adult calcium intake from 600 mg to 1,000 mg per day, with 1,200 mg per day for men and women aged 60 and over.

That increase was significant. Many people still work from the older figure and assume they are meeting their needs when they are not.

Why is vitamin D essential for calcium to work?

Vitamin D is what allows your intestine to absorb calcium and your bones to deposit it. Without enough of it, a high calcium intake simply passes through you.

This is where India has a genuine problem. Pooled prevalence of vitamin D deficiency sits around 67% across age groups, and studies of adult women report 70–90%. The drivers are well documented: limited sun exposure from indoor work, air pollution reducing UVB, naturally darker skin requiring longer exposure, clothing that covers most of the body, and low dietary intake.

A calcium supplement without vitamin D is doing only part of the job.

Who is most at risk of low bone density?

Women after menopause lose bone mass rapidly as oestrogen falls. One hospital-based Indian study found osteoporosis in around half of postmenopausal women assessed, with bone mineral density correlating positively with both vitamin D and calcium status.

Women from around age 30, when peak bone mass has been reached and gradual decline begins. People who avoid dairy, whether by preference or lactose intolerance. Anyone with limited sun exposure. Older adults, whose absorption efficiency declines with age.

What are the warning signs?

Bone loss is often called silent because it usually has no symptoms until a fracture occurs. Possible indicators of low calcium status include frequent muscle cramps, brittle nails, dental problems and tingling in the fingers — but none is diagnostic, and all have other causes.

A DEXA scan measures bone mineral density directly and is the reliable answer. A blood test can check vitamin D status.

How can you get more calcium from food?

Milk, curd and paneer remain the most concentrated sources. Beyond dairy: ragi (finger millet) is exceptionally calcium-rich and a staple in several Indian cuisines, along with sesame seeds, almonds, amaranth, drumstick leaves and other dark leafy greens, and fish eaten with bones.

Phytates in wholegrains and legumes reduce absorption somewhat. Soaking, sprouting and fermenting all help — which is part of why traditional Indian preparation methods work as well as they do.

When should you consider a supplement?

Food first is the sensible order. A supplement makes sense when dietary intake is consistently short, after menopause, if you avoid dairy, or if a test has shown low bone density or low vitamin D.

Two practical notes. Calcium is absorbed better in doses of around 500 mg or less, so splitting a larger daily amount works better than taking it all at once. And calcium competes with iron for absorption — if you take both, separate them by a couple of hours.

References

1. ICMR-National Institute of Nutrition. Nutrient Requirements for Indians — Recommended Dietary Allowances, 2020. nin.res.in/rdabook/brief_note.pdf
2. Prevalence of osteoporosis and osteopenia in an apparently healthy Indian population: a cross-sectional retrospective study. pmc.ncbi.nlm.nih.gov/articles/PMC6362954
3. Associations of bone health biomarkers and bone mineral density with dietary intakes in vitamin D deficient women. Scientific Reports. pmc.ncbi.nlm.nih.gov/articles/PMC12680615

A note on medical advice

This article is general information, not a diagnosis or treatment plan. Excess calcium can cause kidney stones and interfere with the absorption of other minerals. If you are pregnant, breastfeeding, taking prescription medication, or managing kidney disease or a thyroid condition, speak to your doctor before starting a calcium supplement.