Calcium supplements are derivatives of natural products, such as oyster shell or bone. Some are marketed primarily as antacids. Calcium carbonate and phosphate preparations have the highest concentration of elemental calcium, about 40 percent. Calcium citrate contains 21 percent elemental calcium, and calcium lactate and gluconate contain 13 and 9 percent, respectively. Absorption of calcium citrate is 25 percent higher than that of calcium carbonate.
If
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Types
of calcium supplements
Calcium from carbonate and citrate are the most common forms of calcium
supplements. Calcium carbonate, the most cost-effective form, should be taken
with a meal to ensure optimal absorption. Calcium citrate can be taken without
food and is the supplement of choice for individuals with low gastric acid
levels or who are taking histamine-2 blockers or protein-pump inhibitors.
Calcium lactate and calcium gluconate are less concentrated forms of calcium and
are not practical oral supplements.
Calcium and osteoporosis
January 2007 - The Food and Drug Administration is proposing to allow new claims
on foods and dietary supplements containing calcium and Vitamin D to show their
potential to reduce the risk of osteoporosis. The proposed rule would allow
manufacturers to include new information on their food and supplement labeling
and to eliminate certain other information, described below. “This is important
information for all citizens,” said Robert E. Brackett, Ph.D., director of FDA’s
Center for Food Safety and Nutrition. “All persons lose bone with age, and the
loss can influence an individual's risk of developing osteoporosis. Maintenance
of an adequate intake of calcium and vitamin D in all stages of life can help
lower one’s risk.” Today’s action is part of FDA’s continued commitment to
helping consumers make informed and healthy food choices, and responds to a
health claim petition submitted by the Beverage Institute for Health and
Wellness, The Coca-Cola Company. The proposed rule would amend one of the first
health claims authorized in 1993 through the Nutrition Labeling and Education
Act of 1990 for the relationship between calcium intake and osteoporosis. The
proposal would amend this existing health claim by allowing for claims of a
reduced risk of osteoporosis with the consumption of both calcium and vitamin D.
The proposed rule also would eliminate certain requirements that were a part of
the required claim language in the existing calcium and osteoporosis health
claim. However, FDA is not changing its conclusion that there is still
significant scientific agreement to support claims for calcium intake and
reduced risk of osteoporosis. “Osteoporosis is a significant public health
problem, especially for women,” said Kathleen Uhl, MD, assistant commissioner of
FDA’s Office of Women’s Health. “This new labeling should assist consumers to
select foods - and women especially since women do the majority of food shopping
in the US - that provide adequate calcium and Vitamin D intake and hopefully
prevent the occurrence of osteoporosis in themselves and their family members.”
FDA’s decision to amend the existing health claim is based on the agency’s
review of the publicly available scientific evidence, which included the 2004
Surgeon General’s report on Bone Health and Osteoporosis and the 2000 NIH
Consensus Statement on Osteoporosis, Prevention, Diagnosis and Therapy.
Specifically, FDA is proposing to change the calcium and osteoporosis health
claim to: Add a claim for calcium and vitamin D together and a reduced risk of
osteoporosis. Shorten the claim language by: Dropping the reference to sex,
race, and age since the benefits apply to both sexes at all ages and race
categories. Dropping the need to identify the mechanism by which calcium reduces
the risk of osteoporosis. Dropping the requirement that the claim state that
there are limits to benefit of calcium intakes above 200% of the Daily Value.
In elderly women, adding vitamin D to regular calcium supplements
produces long-term improvements in hip bone density.
Food sources of Calcium
The NIH recommends milk and other
dairy products as a primary source of calcium. In addition, a variety of other
foods are excellent sources of calcium as well. Dark green, leafy vegetables and
foods with added calcium can be healthy ways to get enough calcium. By eating a
wide variety of foods with calcium, you can help make sure to get the calcium
you need each day.
Calcium Dosage recommendations
A high dietary calcium intake combined with vitamin D can increase bone
density and reduce fractures in older women and, probably, men. The Institute of
Medicine recommends that persons 19 to 50 years of age consume 1,000 mg per day
of calcium and that persons older than 50 years consume 1,200 mg per day. The
average American consumes less than 800 mg of calcium per day.
Taking calcium with food in dosages
of 500 mg or less increases absorption. Calcium preparations must be dissolved
before they can be absorbed; the absorption rate for calcium is about 20 to 30
percent. The absorption of calcium supplements differs by preparation. Foods
such as spinach, rhubarb and wheat bran can decrease calcium absorption. Calcium
can interfere with absorption of iron, zinc, bisphosphonates and tetracycline.
Absorption also requires adequate doses of vitamin D. The recommended daily
intake of vitamin D is 200 IU for adults younger
than 50 years and 600 IU for those older than 70 years. Vitamin D
supplementation is especially important in elderly persons because skin
synthesis and absorption of vitamin D may be impaired.
Calcium and vitamin D intake can reduce
bone fracture.
Calcium side effects
The most common adverse effects of calcium supplements are
constipation, intestinal bloating and excess
gas. Adverse effects occur most frequently with calcium carbonate. Switching
preparations or increasing fluid intake may relieve symptoms. Patients who form
calcium-containing stones are generally advised not to take calcium supplements.
However, a low intake of calcium can aggravate the risk of stone formation by
increasing absorption and urinary excretion of oxalate. Calcium is best taken
during meals.
It's important to take the right balance of calcium and phosphorous, so
your body absorbs the nutrients properly. Based on a bone mineral content
study, calcium with phosphorous is five times better utilized by the body
than calcium carbonate. Enzymatic Therapy's Calcium gives you more calcium
and vitamin D than drinking 3 glasses of whole milk, without the fat and
calories. It's the easy way to keep your bones healthy and strong.
Osteoporosis affects middle-aged and older persons. A lifetime of regular
exercise and a healthy diet that includes calcium builds and maintain good
bone health and may reduce the risk of osteoporosis late in life. Daily
intakes above 2,000 mg are not likely to provide any additional benefits
to bone health.
From Supplement Research
Update newsletter - reprinted with permission
Did you see this worrisome headline in the news recently? "Older
women who take calcium supplements to maintain bone strength may have an
increased risk of heart attack." Researchers at the University of Auckland
in New Zealand evaluated 1,400 healthy post-menopausal women for a period
of five years. Half were given a daily calcium supplement and half were
given a placebo. Participants received either 1 gram of elemental calcium
daily as the citrate (Citracal) or identical placebo. They were asked to
take two tablets (each containing 200 mg calcium) before breakfast and
three in the evening. After five years, to their surprise, the researchers
found heart attacks were more common in the women taking the calcium
supplements.
Comments: Many women take calcium supplements to prevent
osteoporosis. Calcium supplements elevate blood calcium levels possibly
accelerating vascular calcification. Doctors and patients are now
presented with a very difficult challenge. At what level of calcium
supplement intake do the benefits of osteoporosis prevention or treatment
outweigh the possible risks of kidney stones and heart attacks? I would
like to see a few more studies regarding the role of calcium supplements
and heart attack rate. Perhaps the results of this study were a fluke and
other studies may not find the same association. Assuming that there is
such an association, recommending calcium supplements for post menopausal
women for osteoporosis prevention becomes quite difficult. I don't have
absolute answers on this issue, but, for the time being, a reasonable
balance would be to reduce one's calcium intake from supplements. If you
are taking 1,200 mg a day, you may wish to drop to 800 or 1,000 mg. If you
are taking 800 a day, you may wish to drop to 600 mg. Discuss with your
doctor and both of you could come to a mutually satisfying decision
regarding the appropriate dosage in your particular case. Different
doctors and scientists are likely to have different interpretations and
suggestions.
Calcium questions
Q. Does Calcium and Magnesium have to be taken at night as the last thing
before bed for them to be absorbed into the body? I have read this in
many
articles and I need to know for sure.
A. Calcium and magnesium can be taken any time of day. They don't
have to be taken at night.
Q. Can you tell me about calcium glucarate?
A. See
calcium d glucarate info here. You can buy
Calcium-d-glucarate here.
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