For long term care dietitians, it is common to see residents who are considered a fall risk. The resident may have an unsteady gait, weakness, or forget they need help with activities of daily living or ADLs. Maintaining their bone health is very important for preventing fractures because a fractured hip or femur often sets the course for further life-threatening health complications.

It is widely known that calcium is a major component in keeping bones healthy and that dairy products are rich sources of calcium. But, how can residents reach the recommendation of 1200mg/day of calcium if they are sensitive to dairy or say “I’ve never been a milk drinker”?

Good news! There are other foods besides dairy that naturally contain calcium. Plant sources include beans such as pinto, red, and white. Almonds are a good source of calcium as are vegetables such as bok choy, kale, broccoli, and spinach (think dark greens). However. there are other components in spinach and almonds that make the calcium less available to our bodies. Spinach is high in calcium, but it also is high in oxalates which interfere with the availability of calcium. Therefore the best plant sources are bok choy, kale, and broccoli because it only takes between one and two cups to match the amount of bioavailable calcium that is found in 1 cup of milk. As preliminary studies suggest, it may be because vitamin K helps with calcium absorption, and conveniently bok choy, broccoli, and kale are also high in vitamin K.

Canned fish with the bones like salmon and sardines are also excellent natural sources of calcium and because they are high in protein and natural vitamin D, the calcium is easily and readily absorbed.

A lot of foods are also fortified with calcium like orange juice and non-dairy milk alternatives such as soy milk, almond milk, and rice milk. Tofu not only contains some natural calcium from the soybean, but some varieties are set in calcium sulfate, increasing its calcium content. While these aren’t necessarily as bioavailable as natural sources, they can contribute to one’s total calcium intake.

As always a varied diet is best for covering the scope of our nutrient needs, calcium included. So remember not to overlook what a sausage, bean and kale soup; a delicious bok choy and tofu stir-fry; a beautiful side of steamed broccoli; or a salmon burger can offer to bone health.