Are you wondering where to get calcium as a vegan? Especially if you have had bariatric surgery you may be worried about whether or not you’re getting enough calcium. In this article I am going to share with you how much calcium is needed each day after bariatric surgery and a list of 19 vegan calcium foods to help you meet your calcium needs. You’ll also learn about how to find out if you have a calcium deficiency.
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Why is Calcium Important?
Calcium is a very important component of your bones and teeth. It also helps with muscle function, nerve transmission, and the action of blood vessel contraction and dilation. Read more about calcium here.
Calcium is mostly stored in your bones and your body will use your bones as a source of calcium if you’re not eating enough as calcium. This is because calcium is needed for the body functions listed above.
How Much Calcium is Needed?
After bariatric surgery, your calcium needs vary depending on which procedure you had.
If you had the roux-en-Y gastric bypass or sleeve gastrectomy, you need 1200-1500 mg calcium each day.
If you had the biliopancreatic diversion with duodenal switch, your calcium needs are higher at 1800-2400 mg calcium each day.
Which Type of Calcium is Recommended?
After bariatric surgery, calcium citrate is the recommended form of calcium to take in supplement form, because it is best absorbed. Calcium citrate is absorbed better when less acid is present in the stomach, such as after bariatric surgery.
You can take calcium citrate with or without food and it will still absorb well.
Calcium carbonate is the second choice for calcium supplementation after bariatric surgery.
Take calcium carbonate with food to help it absorb better.
How to Take Calcium Supplements
You should divide your calcium supplement doses after bariatric surgery. Your body absorbs a larger percentage of the calcium supplements when you take them in smaller doses.
You should divide your calcium intake into 500-600 mg doses or less, spread throughout the day.
You should also avoid taking calcium supplements with iron supplements. Even if you’re not taking a separate iron supplement, your multivitamin with minerals will typically have iron in it.
Why is Calcium a Concern for Vegans?
You may be extra concerned about calcium as a vegan. This is because many foods that you traditionally thought about to get calcium, such as dairy products, are no longer part of your diet.
There are also differences in how much calcium is absorbed from non-dairy calcium sources. Sometimes a higher percentage of calcium is absorbed from non-dairy sources and sometimes it is a lower percentage.
For example, 27% of the calcium in dairy milk is absorbed by the body, whereas only 5% of the calcium in spinach is absorbed. About 50% of the calcium in broccoli is absorbed by the body.
Factors that Decrease Absorption From Vegan Calcium Foods
Oxalic acid and phytic acid decrease absorption of calcium from foods because they form indigestible salts with the calcium. Foods that are high in calcium, but also high in one of these compounds include rhubarb, Swiss chard, and sweet potatoes.
Why is Calcium a Concern After Bariatric Surgery?
After bariatric surgery, there are several reasons why you may be concerned about calcium. Firstly, the amounts and types of foods that you can eat will change. Your stomach is smaller so you can’t eat as much as you used to. You may also have trouble tolerating all the foods that you used to eat.
Secondly, the absorption of calcium is altered after bariatric surgery. This is due to your stomach producing less acid, which affects calcium absorption. Read more on this from the ASMBS here.
How to Tell if You’re Getting Enough Calcium
There are some lab tests that your doctor can order to determine if you have a calcium deficiency.
Ionized Calcium Level or Serum Calcium Level (blood tests)
These lab tests are recommended to be tested before surgery and every 3-6 months for the first year after surgery. Then after that they should be checked yearly. Typically your doctor will only check one or the other.
It is important to remember though that even if these labs come back normal that doesn’t mean that you’re taking in enough calcium each day. This is because your body tightly regulates how much calcium is in your blood when you can be low in calcium in other areas (such as your bones).
If calcium levels drop in the bloodstream, parathyroid hormone signals the bones to release calcium into the bloodstream.
DXA (dexa) Scan
A DXA scan is recommended every two years after bariatric surgery to assess your bone mineral density. It can also indicate if there are changes over time to your bone density.
A DXA scan is part of the monitoring that is done after bariatric surgery that could indicate that if you’re not eating enough calcium if you have decreases in your bone density.
Symptoms of a Calcium Deficiency
If you were to have a calcium deficiency, sometimes there are physical signs and symptoms, but most of the time you would not have symptoms.
Symptoms that could occur with a calcium deficiency are bone pain, or muscle weakness, or leg cramping.
Vegan Calcium Foods
As a vegan you may not know where to get calcium in your diet besides supplements.
Here is a list of vegan calcium foods to add calcium to your diet as a vegan:
- Tofu (calcium set), firm (House FoodsⓇ)
- 130 mg for a 3 ounce serving
- Click here for a yummy tofu recipe!
- Tempeh (LightlifeⓇ)
- 87 mg for a 3 ounce serving
- TVP (Bob’s Red MillⓇ)
- 62 mg for a ¼ cup serving
- Legumes (Navy Beans)
- 60 mg for ½ cup serving
- Soy Milk (fortified)
- 300 mg for 1 cup serving
- Almond Milk (fortified)
- 450 mg for 1 cup serving
- Orange Juice (fortified)
- 350 mg for 1 cup serving
- 70 mg for 1 ounce serving
- Sesame Seeds
- 276 mg for 1 ounce serving
- 42 mg for 1 cup chopped
- Bok Choy
- 73 mg for 1 cup chopped
- Collard Greens
- 83 mg for 1 cup chopped
- 53 mg for 1 cup chopped
- Mustard Greens
- 64 mg for 1 cup chopped
- Sweet Potato
- 57 mg for 1 medium sweet potato
- Turnip Greens
- 104 mg for 1 cup chopped
- 52 mg for 1 medium orange
- Dried Figs
- 54 mg for 4 figs
- Butternut Squash
- 42 mg for 1/2 cup cooked
Calcium can be a concern for both vegans and people who have had bariatric surgery. If you are a vegan that has had bariatric surgery you might be extra concerned. This article has given you information and ideas for vegan calcium foods to give you confidence as a vegan to meet calcium needs after bariatric surgery.
1. National Institutes of Health. Office of Dietary Supplements – Calcium. Nih.gov. Published March 26, 2020. Accessed April 12, 2022. https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/
2. Parrott J, Frank L, Rabena R, Craggs-Dino L, Isom KA, Greiman L. American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient 2016 Update: Micronutrients. Surgery for Obesity and Related Diseases. 2017;13(5):727-741. doi:10.1016/j.soard.2016.12.018
3. Kim J, Nimeri A, Khorgami Z, El Chaar M, Lima AG, Vosburg RW. Metabolic bone changes after bariatric surgery: 2020 update, American Society for Metabolic and Bariatric Surgery Clinical Issues Committee position statement. Surgery for Obesity and Related Diseases. Published online September 2020. doi:10.1016/j.soard.2020.09.031
4. Harvard School of Public Health. Calcium. The Nutrition Source. Published October 19, 2020. https://www.hsph.harvard.edu/nutritionsource/calcium/
Ashley Krautkramer, RD, CSOWM, CD, CDCES is a vegan and bariatric nutrition expert with more than six years of experience. She is a board certified specialist in obesity and weight management.