Overview

Calcium is a fundamental micronutrient critical for multiple aspects of human health, including bone development, pregnancy outcomes, and cardiovascular function. Despite its importance, approximately half of the world’s population consumes insufficient calcium. The risk is particularly acute in low- and middle-income countries, where average intakes often fall significantly below the recommended 800 – 1000 mg/day for adults. This widespread issue represents a major yet addressable public health challenge.

Data Source

Given the lack of nationally representative calcium intake data from dietary assessment surveys, here data from the Nutrient Balance Sheets (NBS) are used. The foundation of the data comes from the FAO Food Balance Sheets, which estimates domestic disappearance, or the total amount of food available at the retail level. In the NBS, total food supply was converted to calcium supply using USDA data and other sources. The amount of calcium apparently consumed was then calculated by accounting for losses in cereal processing of rice, wheat, maize, sorghum, and millet; accounting for food loss and waste at the levels of retail transport and home consumption; and finally, by accounting for nutrient losses through common forms of cooking and preparation. These estimates have been updated with 2022 data, based on the article by Lividini and Masters (2022).

Strategic Applications

The NBS only accounts for nutrients that originate from the agricultural food system. Nutrients that enter the food system through other routes including the water supply, large-scale food fortification, or from supplementation, are not captured in the NBS estimates. Therefore, this map serves as a powerful tool for identifying populations with critically low apparent calcium intake from the food supply, illustrating areas where nutritional interventions such as food fortification programs or targeted supplementation for pregnant women are yielding or could yield substantial health benefits. It is especially useful in comparing apparent intake across countries due to the standardized nature of the data and for countries that do not have data on calcium intake. When analyzed alongside health outcome data and existing policy frameworks, this visualization enables evidence-based decision-making for nutrition program planning, resource allocation, and policy development.

Further Reading

• Lividini, K., Masters, W.A. Tracing global flows of bioactive compounds from farm to fork in nutrient balance sheets can help guide intervention towards healthier food supplies. Nat Food 3, 703–715 (2022). View article
• Shlisky, J., Mandlik, R., Askari, S., Abrams, S., Belizan, J. M., Bourassa, M. W., … & Weaver, C. (2022). Calcium deficiency worldwide: prevalence of inadequate intakes and associated health outcomes. Annals of the New York Academy of Sciences, 1512(1), 10-28. View article
• Cormick, G., & Belizán, J. M. (2019). Calcium intake and health. Nutrients, 11(7), 1606. View article

Last updated: 8/1/25