Is a ‘healthy diet’ and a ‘calcium‐rich diet’ the same thing?

Screen Shot 2020-03-04 at 07.17.19.pngYu et al., JHND Early View Unknown


In the present study, we aimed to (i) examine perceptions of achieving calcium and vitamin D recommended dietary allowance (RDA) and (ii) determine how participants talked about food in relation to RDA recommendations.


Participants aged ≥50 years who were prescribed osteoporosis medication and received two modes of bone health education were eligible. Relying on a qualitative description design, we interviewed participants 1 month after they had attended an education session and received a self‐management booklet. Calcium and vitamin D intakes were estimated by in‐depth questions about diet and supplements and compared with perceptions of achieved RDA levels. Interview transcripts were analysed based on an analytic hierarchical process.


Forty‐five participants (29 reporting previous fragility fractures) were included. Calcium and vitamin D RDA appeared to be potentially achieved by 64% and 93% of participants, respectively, primarily because of reliance on supplements. Few participants talked about vitamin D in relation to food intake and 49% of participants were unclear about the calcium content of food. Most considered that a healthy diet was equivalent to a calcium‐rich diet. We noted no differences in our findings in the subset of individuals with fragility fractures.


Despite reporting a prescription for osteoporosis medication and receiving bone health education, a substantial number of individuals appeared to have sub‐optimal calcium levels. This may be attributed to the challenge of achieving RDA with diet alone and the misconception of a healthy diet as a calcium‐rich diet.

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