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Adrienne Bitar explains why the form of calcium matters just as much as the amount.
If you’ve been diagnosed with osteopenia or osteoporosis, chances are someone has told you to “take calcium.”
But the real question isn’t simply whether you need calcium—it’s what kind of calcium your body can actually use.
In this episode of Stronger Bones Lifestyle, I sat down with Adrienne Bitar, food studies scholar and co-founder of Seen Nutrition, to discuss one of the biggest sources of confusion in bone health: calcium supplementation. Our conversation challenged some of my own long-held concerns about calcium supplements—because not all calcium is created equal.
Calcium Is Essential—but It Needs to Reach Your Bones
About 99% of the calcium in your body is stored in your bones and teeth. When your diet doesn’t provide enough, your body withdraws it from your bones to support essential functions like muscle contraction, nerve signaling, and heart function.
That’s why adequate calcium intake matters—but getting enough isn’t the whole story. The goal isn’t simply swallowing calcium. The goal is helping it become available to your body.
Food First
One of my favorite parts of this conversation was learning more about the “food matrix.” Foods naturally contain vitamins, minerals, and cofactors that work together to support absorption. Rather than isolating a single nutrient, whole foods provide a complete package.
Adrienne explained that dairy naturally contains calcium along with magnesium, phosphorus, zinc, copper, and other minerals that may help improve calcium’s bioavailability. This reinforces something I teach often: whenever possible, start with food.
Why the Form Matters
Many common calcium supplements use calcium carbonate or calcium citrate. Adrienne explained that calcium carbonate, in particular, may contribute to digestive discomfort for some people, including bloating, constipation, and gas.
She also discussed why fortified foods aren’t always the same as foods that naturally contain calcium. Understanding where your calcium comes from—and how your body absorbs it—can help you make more informed choices.
My Takeaway
I’ve always encouraged women to get their calcium from food whenever possible. This conversation reinforced that philosophy while introducing a food-based option designed to bridge the gap when dietary intake isn’t enough.
As always, remember that calcium is just one piece of healthy bones. Strong bones also depend on healthy digestion, movement, hormones, sleep, stress management, protein intake, and reducing inflammation. Bone health is never about one nutrient—it’s about supporting the whole body.
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Frequently Asked Questions (FAQs)
Oxalates, also known as oxalic acid, are naturally occurring compounds found in many plants, vegetables, and fruits. They are part of a plant’s defense mechanism against predators and can be found in high concentrations in foods like spinach, rhubarb, beets, nuts, chocolate, tea, and certain beans.
Regarding bone health, oxalates can bind to minerals such as calcium in the gut, forming calcium oxalate. This compound is not easily absorbed by the body, meaning the calcium that could have been utilized for bone strengthening is instead excreted. This process can potentially lead to lower calcium availability for bone health, which can be particularly concerning for individuals at risk of osteoporosis or other bone-related issues.
However, for most women, dietary oxalates do not pose a significant threat to bone health, especially if their diet is balanced with enough calcium and they do not have a history of kidney stones.
Your gut is crucial for stronger bones for several reasons:
- Nutrient Absorption: The gut is where most nutrient absorption occurs. For bones to be healthy and strong, they need a variety of nutrients, particularly calcium, phosphorus, magnesium, and vitamin D. A healthy gut efficiently absorbs these essential nutrients from your diet and facilitates their transportation to the bones.
- Gut Microbiome and Bone Health: Research has shown that the gut microbiome (the community of bacteria living in your intestines) can influence bone density. Certain gut bacteria help in producing short-chain fatty acids (SCFAs) like butyrate, which have been shown to promote bone health. SCFAs can enhance the absorption of minerals necessary for bone strength and play a role in reducing inflammation, which can negatively affect bone health.
- Hormone Regulation: The gut helps regulate hormones that are involved in bone metabolism, including insulin, thyroid hormones, and sex hormones like estrogen. For example, estrogen is vital for bone density, and gut health can influence estrogen levels through the enterohepatic circulation, where estrogens are processed in the liver and intestines.
- Reducing Inflammation: Chronic inflammation, which can stem from poor gut health, is linked to many conditions that compromise bone strength, such as osteoporosis. A healthy gut helps to reduce systemic inflammation, protecting bones from inflammatory damage.
- Immune System Modulation: The majority of the immune system is located in the gut. An imbalance in the immune system can lead to autoimmune conditions, some of which affect the bones. Maintaining gut health helps to ensure the immune system works correctly, protecting against autoimmune reactions that could impact bone health.
In essence, maintaining a healthy gut contributes significantly to stronger bones by ensuring the effective absorption of vital nutrients, regulating hormones, reducing inflammation, and supporting a healthy immune system. Therefore, a diet rich in bone-healthy nutrients, prebiotics, and probiotics, along with lifestyle factors that promote gut health, is key to maintaining strong bones.