The nurse tells a client in her first trimester to increase her daily intake of calcium to 1,200 mg during pregnancy. The client dislikes milk. Which dietary adjustment should be recommended?

• A. Increase organ meats in the diet.
• B. Eat more green, leafy vegetables.
• C. Add molasses and whole-grain breads to the diet.
• D. Choose more fresh citrus and other fruits daily.

Answer: (B)

Calcium is essential for fetal bone development and maternal bone health, and the goal here is to reach about 1,200 mg daily without relying on milk. Green leafy vegetables are among the best non-dairy calcium sources and can contribute meaningful amounts when eaten regularly. Varieties like kale, collard greens, and bok choy provide calcium that the body can absorb well, making them an effective way to boost intake. Spinach, while high in calcium, isn’t as reliable because the calcium is less available due to absorption issues, so it’s not as helpful for meeting the target.

Other options mentioned offer only small amounts of calcium and don’t reliably help reach 1,200 mg daily. For example, organ meats are not a major calcium source, and molasses with whole-grain bread or citrus fruits don’t supply calcium in quantities sufficient to meet the requirement. So increasing consumption of green leafy vegetables is the most beneficial dietary adjustment in this scenario. If needed, fortified foods or supplements can be added to ensure the daily goal is met, with attention to vitamin D for better calcium absorption.