Pregnancy is an especially important time for interventions to improve calcium intake through dietary changes or supplementation because of the role that calcium plays in pregnancy, fetal development and in preventing preeclampsia. While effective dietary and supplementation guidance requires supportive policy frameworks and implementation strategies to meaningfully change calcium intake, these recommendations serve as an important nutrition intervention—particularly in settings where fortification programs are absent.

For calcium, dietary guidance typically includes foods such as leafy green vegetables, dairy products, small whole fish with bones, and legumes that can support meeting recommended intake levels. The World Health Organization (WHO) recommends calcium supplementation for pregnant women in regions with inadequate calcium intake to reduce the risk of preeclampsia and related hypertensive disorders during pregnancy. Current WHO guidelines advise 1.5-2 g/day of calcium throughout pregnancy, though emerging research suggests potential benefits even at lower dosages.

Data Source

This visualization presents findings from a systematic review of national dietary and supplementation policies identified through comprehensive searches of antenatal care guidelines in government health websites and WHO policy databases. The analysis identified 34 countries that have established specific food-based recommendations designed to improve calcium intake for pregnant women as part of their maternal health guidance. Twenty-nine countries—predominantly high-income nations—have established guidelines recommending daily elemental calcium supplementation ranging from 0.5-2 grams during pregnancy.

Strategic Applications

This map enables stakeholders to understand the food-based recommendations and calcium supplementation policy landscape across countries and regions. When analyzed alongside calcium intake data and maternal health metrics, this visualization highlights critical policy gaps—particularly in low- and middle-income countries where calcium intake is frequently inadequate, and pregnancy complications occur at higher rates. This information provides essential context for prioritizing policy development and program implementation in high-need areas currently lacking official prenatal guidelines for improving calcium intake through diet and supplementation.

Further Reading

• Romero, I.B., Puchulu, M.B., Perez, S.M., White, C., Delgado, C., … & Cormick, C. (2025). National adoption of World Health Organization recommendations on calcium supplementation during pregnancy. SUBMITTED.
• Knight, F., Rana, Z. H., Cormick, G., Belizan, J., Gomes, F., Bourassa, M. W., … & Ferguson, E. L. (2023). Could local foods achieve recommended calcium intakes for nutritionally vulnerable populations in Uganda, Guatemala, and Bangladesh? Annals of the New York Academy of Sciences, 1525(1), 173-183. View full article
• Bourassa, M. W., Abrams, S. A., Belizán, J. M., Boy, E., Cormick, G., Quijano, C. D., … & Weaver, C. M. (2022). Interventions to improve calcium intake through foods in populations with low intake. Annals of the New York Academy of Sciences, 1511(1), 40-58. View full article
• World Health Organization. WHO recommendation: Calcium supplementation during pregnancy for the prevention of pre-eclampsia and its complications. Geneva: World Health Organization; 2018. View official guidelines
• Hofmeyr, G. J., Lawrie, T. A., Atallah, Á. N., & Torloni, M. R. (2018). Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database of Systematic Reviews, (10). View article
• Gomes, F., Ashorn, P., Askari, S., Belizan, J. M., Boy, E., Cormick, G., … & Bourassa, M. W. (2022). Calcium supplementation for the prevention of hypertensive disorders of pregnancy: current evidence and programmatic considerations. Annals of the New York Academy of Sciences, 1510(1), 52-67. View article

Last updated: 8/1/25