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CA8.8
Calcium Research
Likely helpsModerate safety
117 peer-reviewed studies
What the evidence says
Likely helps
Calcium appears to help in 18 of 20 studies with measurable effects — the evidence leans clearly favourable.
Most evidence is from high-quality meta-analyses and randomised trials published 2015–2026 with a typical study size of 4,500 participants.
Based on 117 studies · 54 meta-analyses · 16 RCTs · 2,573,531 total participants
Confidence
High
What the studies found
18helped2unclear· 97 more without graded effect data
By outcome
Bone healthSupports bone mineral density and skeletal strength · 8-12 weeks
Likely helps89 studies
Women's healthMay help manage menopausal symptoms like hot flashes and mood changes · 4-8 weeks · May help reduce menstrual discomfort and PMS symptoms · 1-3 cycles · Provides essential nutrients for healthy pregnancy · Ongoing
Energy & fatigueAdequate calcium supports efficient muscle and nerve function · 4-8 weeks
Too few graded studies2 studies
InflammationCalcium + vitamin D co-supplementation may reduce inflammatory biomarkers · 8-12 weeks
Too few graded studies1 study
Endurance & exercise performance
Too few graded studies1 study
Anemia & hematology
Too few graded studies1 study
By the numbers
Pulled from 60 studies with measurable effects
Likely real effects
100%
across studies
People studied
2574k
typical study: 4500 people
Strongest designs
70
54 pooled, 16 randomised
Showed benefit
90%
18/20 studies
How long studies ran
3+ months
1
Populations Studied
Pregnant women6
General population5
Adults4
Individuals with metabolic conditions2
Active research area
98 studies in the last 5 years · Latest meta-analysis: 2026
201520202026
1Meta-Analysisn=902 · large study2026
Based on absolute risk reductions and thresholds considered clinically meaningful, this review found little to no benefits from use of calcium, vitamin D, or combined supplementation on the prevention of fractures and falls.
Massé O et al. · BMJ (Clinical research ed.) (2026)
Participants in most of the trials were community dwelling (87%) and not at high risk of fractures or falls (73%).
Based on absolute risk reductions and thresholds considered clinically meaningful, this review found little to no benefits from use of calcium, vitamin D, or combined supplementation on the prevention of fractures and falls.
4All-fracture riskMeta-AnalysisCited 247×n=51,419 · very large study2019
Supplementation with vitamin D plus calcium was associated with significantly decreased all-fracture risk, but neither vitamin D alone nor calcium alone was associated with reduced fracture risk.
Yao P et al. · JAMA Network Open (2019)
Noticeable benefit
← WorseNo effectBetter →
Meta-analysis of 11 randomized clinical trials with 51,419 participants
Vitamin D + calcium combination reduced overall fracture risk by 6%
Calcium alone was not associated with fracture risk reduction
5Bone mineral densityMeta-AnalysisCited 252×n=15,000 · very large study2015
Increasing calcium intake from dietary sources or by taking calcium supplements produces small non-progressive increases in BMD, which are unlikely to lead to a clinically significant reduction in risk of fracture.
Tai V et al. · BMJ (2015)
Barely noticeable benefit
← WorseNo effectBetter →
Meta-analysis of 59 RCTs of calcium supplementation and 6 studies of dietary calcium
Calcium supplementation increased total body BMD by 0.6-1.8%
Effects were similar for dietary and supplemental calcium
Therefore, although these findings suggest a protective role of calcium-rich diets, well-designed prospective and interventional studies are warranted to clarify whether this relationship is causal.
Gonnelli S et al. · Nutrients (2026)
Noticeable benefit
← WorseNo effectBetter →
Random-effects meta-analyses pooled fully adjusted odds ratios (ORs) and 95% confidence intervals (CIs) comparing the highest versus lowest intake categories.
Supporting these countries in developing calcium-based interventions to address this nutrient gap has the greatest likelihood to improve health outcomes, especially for mothers and their infants.
Bourassa MW et al. · Annals of the New York Academy of Sciences (2026)
Epidemiological data and modeled estimates on preterm births, maternal hypertensive disorders, and bone fractures were also incorporated to highlight areas with the greatest potential need for improved calcium intake.
Country typologies were created based on the risk of adverse health outcomes and the presence of policies or guidelines for calcium interventions.
Supporting these countries in developing calcium-based interventions to address this nutrient gap has the greatest likelihood to improve health outcomes, especially for mothers and their infants.
9National adoption of WHO calcium supplementation recommendationsSystematic Review2025
Most of these guidelines were from upper middle- or high-income countries (19, 65.5%), whereas in countries where this recommendation is most needed, there is a lack of published calcium supplementation recommendations during pregnancy.
Romero IB, Puchulu MB, Perez SM, White C, Rana ZH, Bourassa MW, Delgado C, Belizán JM, Salva F, Cormick G. · Annals of the New York Academy of Sciences (2025)
Most of these guidelines were from upper middle- or high-income countries (19, 65.5%), whereas in countries where this recommendation is most needed, there is a lack of published calcium supplementation recommendations during pregnancy.
Our objective was to evaluate the global adoption of the World Health Organization (WHO) recommendation for calcium supplementation during pregnancy to prevent pre-eclampsia.
Each WHO member state's Ministry of Health website, Google, and WHO databases were searched, between January and July 2024, to identify national antenatal care guidelines.
10skeletal muscle mass indexMeta-Analysisn=349 · medium study2025
Conclusions: ST in older people with osteosarcopenia conditions increases SMMI, MIHS, and protein intake.
Hernandez-Martinez J, Branco BHM, Vasquez-Carrasco E, Cid-Calfucura I, Herrera-Valenzuela T, Guzmán-Muñoz E, Delgado-Floody P, Concha-Cisternas Y, Valdés-Badilla P. · Nutrients (2025)
Likely real
Hedge's g effect sizes were calculated for the abovementioned variables for the meta-analysis.
Seven overall and two subgroup meta-analyses showed significant increases in skeletal muscle mass index (SMMI; p < 0.01), maximal isometric handgrip strength (MIHS; p = 0.03), and protein intake ( p = 0.03).
There were no significant differences in bone mineral density (BMD), body fat percentage (BFP), gait speed, and calcium intake.
Further large-scale prospective cohort investigations are needed to obtain stronger and more accurate results.
Nematbakhsh R, Rouhani P, Saneei P. · Obesity reviews : an official journal of the International Association for the Study of Obesity (2025)
Combining 24 effect size from 17 investigations (15 cross-sectional and two cohort studies) with 74,720 participants and 18,200 cases showed that highest versus lowest level of dietary Ca intake was related to 23% significant decreased odds of MetS (OR = 0.77; 95% CI: 0.66, 0.89).
Linear dose-response analysis of estimates from 12 investigations showed that each 100 mg/day increment in dietary Ca intake was associated with 3% marginally significant decreased odds in MetS (OR = 0.97; 95%CI: 0.93, 1.01).
According to this meta-analysis, the likelihood of MetS was significantly lower in adults with higher level of dietary calcium intake.
This study shows that calcium supplements are associated with a significant reduction in the risk of preeclampsia and gestational hypertension and a trend toward better maternal and fetal-related outcomes.
Jaiswal V et al. · Current problems in cardiology (2024)
The Pooled analysis of primary outcome shows that calcium supplements reduce the risk of preeclampsia by 49% (OR, 0.51(95%CI: 0.40-0.66), P<0.001), and reduce the risk of gestational hypertension by 30% (OR, 0.70 (95%CI: 0.58-0.85)), P<0.001) compared to placebo.
This study shows that calcium supplements are associated with a significant reduction in the risk of preeclampsia and gestational hypertension and a trend toward better maternal and fetal-related outcomes.
Our results do not support the isolated or combined use of calcium and vitamin D supplementation in healthy premenopausal women as a public health intervention to improve BMD in the total hip or lumbar spine, and therefore it is unlikely to have a benefit for the prevention of fractures (vertebral and non-vertebral).
Méndez-Sánchez L et al. · The Cochrane database of systematic reviews (2023)
Calcium alone supplementation does not reduce or increase the withdrawals in the trials (risk ratio (RR) 0.78, 95% CI 0.52 to 1.16; I2 = 0%; 4 studies, 261 participants: moderate-certainty evidence).
These studies reported lumbar spine BMD as a mixture of MDs and percent of change and we were unable to pool the results.
Vitamin D alone supplementation does not reduce or increase withdrawals for any reason between groups (RR 0.74, 95% CI 0.46 to 1.19; moderate-certainty evidence).
This review is to present an overview of the latest research progress, existing problems and research prospects in the field of peptide-mineral complexes and to provide a more comprehensive theoretical basis for their exploitation in food industry.
Tian Q et al. · Critical reviews in food science and nutrition (2023)
Peptides with small molecular weight are more likely to chelate metals, and carboxyl, amino groups and nitrogen, oxygen, sulfur atoms in the side chain, which can provide lone-pair electrons to combine with metallic ions.
Unidentate, bidentate, tridentate, bridging and α mode are regarded as common chelating modes.
Moreover, the stability of peptide-mineral complexes in the gastrointestinal tract and possible transport pathways were summarized.
15Calcium homeostasis in neuronal demiseSystematic Review2023
From this perspective, therapeutic interventions to safely restore Ca2+ homeostasis would mitigate the excessive activation of neuronal destruction pathways and, therefore, are expected to have promising neuroprotective potential.
Griffioen G · International journal of molecular sciences (2023)
These core pathophysiological processes and elevated cytosolic Ca2+ levels comprise a self-enforcing feedforward cycle inevitably spiralling toward high levels of cytosolic Ca2+.
Ageing impacts mitochondrial function indiscriminately of the neuronal cell type and, therefore, contributes to the feedforward cycle of pathophysiology development seen in all age-related NDDs.
However, further investigation is required to fully understand its range of health impacts and define optimal intake levels.
Pop MS et al. · Nutrients (2023)
Emerging evidence suggests that calcium-rich mineral water might have a role in body weight management, though further research is needed.
The review identifies several areas requiring additional research, such as the potential interaction between calcium-rich mineral water and other dietary components, the effects on populations with specific health conditions, and the long-term effects of consumption.
In conclusion, natural calcium-rich mineral waters show promise as a readily accessible and bioavailable sources of dietary calcium, potentially beneficial for a broad range of individuals.
In conclusion, along with exercise and dietary support, nutraceuticals, such as vitamin D, calcium, vitamin K, and natural agonists of irisin or testosterone, can serve as promising future therapeutic alternatives.
Kim YC et al. · Nutrients (2023)
Vitamin K, specifically menaquinone-4 (MK-4), improves mitochondrial function and reduces muscle damage.
Irisin is a hormone secreted during exercise that enhances oxidative metabolism, prevents insulin resistance and obesity, and improves bone quality.
Low-glycemic-index diets and green cardamom are potential methods for managing sarcopenic obesity.
18Urolithiasis risk with vitamin D and calcium supplementationSystematic Review2023
Finally, we share with the reader our pragmatic algorithm for handling the urolithiasis risk in patients who have strong indications to be prescribed vitamin D and calcium supplementations.
Messa P et al. · Nutrients (2023)
Patients with urolithiasis, and particularly those with hypercalciuria, frequently have a marked reduction of bone mineral content up to the levels of osteoporosis, with a significant increase in bone fracture risk.
Despite the clinical and practical relevance of this issue, the evidence on this topic is scarce and contradictory.
Therefore, some concerns exist about how and whether to prescribe such supplements to a patient with a history of kidney stones.
20colorectal adenoma recurrence riskRCTn=2,259 · very large study2023
The findings of this secondary analysis of a randomized clinical trial suggest that individuals with the DBP2 isoform-encoding rs4588*A allele may particularly benefit from vitamin D3 and/or calcium supplementation for colorectal adenoma prevention.
Gibbs DC et al. · JAMA oncology (2023)
No clear effect
← WorseNo effectBetter →
Of the 2259 participants randomized (mean [SD] age, 58 [6.8] years; 1033 [64%] men), 1604 non-Hispanic White participants (chosen to avoid population stratification bias) were included in the analysis.
Among those with the DBP2 isoform (rs4588*AC or AA), the RRs (95% CI) for adenoma recurrence were 0.84 (0.72-1.00) with vitamin D3 relative to no vitamin D3, 0.83 (95% CI, 0.70-0.99) with calcium relative to no calcium, and 0.76 (95% CI, 0.59-0.98) with both agents relative to neither agent.
Among DBP2 homozygotes (rs4588*AA), the RR for adenoma recurrence was 0.57 (95% CI, 0.31-1.08) with both agents relative to neither agent.