IMPORTANCE OF CALCIUMIMPORTANCE OF CALCIUM

Dr. Betty J. Larson, LRD, FADA

Concordia College

Moorhead, MN 56562

Impact ofCalcium

Osteoporosis

Blood Pressure Control

(Calmodulin)

Blood Clotting(thromboplastin)

BoneCalcification

Prevention

Tooth

Formation

MuscleContraction

Nerve Impulse transmission

Calcium and HypertensionCalcium and Hypertension

When animals are deprived of calcium blood pressure increases.

Increasing calcium in animals lowers blood pressure or lessens the development of high blood pressure.

Hypertension is more prevalent in populations with a low calcium intake.

Calcium and HypertensionCalcium and Hypertension

Osteoporotic women have a 2-3 fold increase in hypertension.

Increasing calcium decreases blood pressure. McCarron (1999) demonstrated that men with

higher blood pressure levels also had lower bone mineral density and bone mineral content.

DASH diet demonstrated that a low fat diet rich in dairy, fruits and vegetables could significantly reduce blood pressure.

Journal of the American Journal of the American College of NutritionCollege of Nutrition (1999). (1999). 18(5):373S-412S.18(5):373S-412S.

Calcium in the Prevention of Kidney Stones Dairy Foods Prevent Colon Cancer Vitamin D and Calcium Prevent Breast

Cancer Calcium Control of Blood Pressure Implications for Osteoporosis Implications for weight management

PMSPMS

Daily consumption of 1,200 mg of calcium may decrease some adverse side effects of PMS including psychological symptoms, food craving, and water retention

Dairy’s Role in Weight Dairy’s Role in Weight ManagementManagement

Calcium may play an important role in the regulation of energy metabolism and may result in a reduction of body fat and an acceleration of weight and fat loss during caloric restriction. Dairy sources of calcium may have a substantially greater effect than supplemental or fortified sources.

Increasing dietary calcium or dairy intake may reduce future weight gain.

Nutrients found in dairy, including calcium, may contribute to the reduction of body weight, body fat and insulin resistance syndrome.

Increasing calcium intakes to recommended levels may reduce the incidence of overweight and obesity by 60-80% in a population.

Low daily calcium intake was associated with greater body fat and body weight, particularly in women.

Benefit of Dairy FoodsBenefit of Dairy Foods

Dairy foods provide calcium, vitamin A, thiamin, riboflavin, B12 , magnesium, and phosphorus.

Milk provides vit D CLA

Calcium SourcesCalcium Sources Calcium content is highest in dairy products One 8-ounce glass of skim milk contains about

300 mg which supplies about 1/3 of the RD for an adult

Equivalent dairy foods are 1.5 oz of cheese, 1 c yogurt, 1.75 c of ice cream

Other good sources include fish with small bones such as sardines, canned salmon, dark green leafy vegetables (broccoli, kale, turnip greens), tofu, legumes, nuts, fortified OJ or fortified cereals

DV for calcium is 1,000 mg

Dietary Calcium Intake of Dietary Calcium Intake of Females in mg – 75% of F do Females in mg – 75% of F do not consume the AI for calciumnot consume the AI for calcium

0

200

400

600

800

1000

1200

1400

age1-2

age3-5

age12-14

15-17

18-24

25-34

35-44

45-54

55-64

Intake

Ideal

Factors that Enhance Calcium Factors that Enhance Calcium AbsorptionAbsorption

Acid Normal GI Motility Calcium-Phosphorus Ratio Vitamin D Need for Calcium Lactose PTH

Factors that Hinder Calcium Factors that Hinder Calcium AbsorptionAbsorption

Inadequate Vitamin D Intake Alkaline Conditions Impaired GI Motility Imbalance in Calcium:Phosphorus Ratio Excess Intake of Iron, Zinc, or Magnesium Phytic or Oxalic Acid

Calcium and SodiumCalcium and Sodium

Excess sodium can increase calcium excretion

For every 500 mg increase in urinary sodium excretion there is about a 10 mg increase in urinary calcium loss.

Calcium, Protein, and Calcium, Protein, and ExerciseExercise

Excessive protein intake may lead to calcium excretion. About 1 mg of calcium is lost for every gram of protein consumed.

Intense exercise may increase urinary loss of calcium

Coffee, alcohol and calciumCoffee, alcohol and calcium

High intakes of coffee and alcohol may increase calcium loss from the body

Up to five cups of coffee and moderate alcohol consumption appear to have little effect on calcium balance

If Blood Calcium is Too LowIt will be a signal to ParathyroidGland to secrete Parathormone

Viamin D raisescalcium absorptionin the gut

PTH & Vitamin Dpromote kidneyreabsoprtion ofcalcium

PTH & Dstimulatecalcium releasefrom bone

BioavailabilityBioavailability

Calcium absorption from broccoli, cabbage and kale is good, but the calcium content per serving is much less than that for milk

OsteoporosisOsteoporosis

Porous Bones Back Pain Spontaneous Fracture Loss of Height Dowager’s Hump

Dowager’s HumpDowager’s Hump

Osteoporosis PreventionOsteoporosis Prevention

Adequate Calcium Intake Increased Exercise Adequate Vitamin D Intake Avoid Excessive Protein Intake, Alcohol,

Fiber and Cigarettes Resources for health professionals on

calcium www.nationaldairycouncil.org

Calcium Content of FoodCalcium Content of Food Broccoli: 36 mg per 1/2

cup Sardines: 324 mg per 3 oz Milk: 316 mg per cup Pork & Beans: 77 mg per

1/2 cup Cheddar Cheese: 305 mg

per 1 1/2 oz Almonds: 80 mg per 2

Tbs

Calcium SupplementsCalcium Supplements Consumers Union notes that most people absorb

calcium from different preparations equally well and recommends pills that deliver calcium at the lowest price.

Over age 50 may do better with chewable calcium-carbonate

Check label for calcium content per tablet – range from 50-600 mg.

Best choice a tablet with about 200 mg with snacks or small meals – gastric acidity and slower transit time in the gut may enhance absorption

Calcium ToxicityCalcium Toxicity

NEVER FROM FOODS Excess Vitamin D with Calcium Supplements Symptoms include abnormal heart contractions,

constipation, development of kidney stones May interfere with absorption of key minerals

notably iron and zinc Supplements without food may contribute to

oxalate stones in the kidney

Osteoporosis in SportsOsteoporosis in Sports

Concern about disturbed calcium metabolism in young ahtletes in endurance or weight control sports.

Female Athlete Triad – disordered eating, amenorrhea, osteoporosis

Restrictive diets and excessive exercise may affect hormone status including the hypothalamus and pituitary glands resulting in reduced levels of estrogen.

Athletic AmenorrheaAthletic Amenorrhea

Amenorrheic athletes were found to have significantly less bone mineral content in the spine and other bones, including the femur.

Increased dietary calcium may be useful in maintaining bone but limited research.

Four glasses of skim milk provide 1200 mg of calcium.

Other nutrients such as protein, magnesium, zinc, copper, iron, fluoride and vitamins A, C, D, and K are also required for bone metabolism.

How can you get your peers to How can you get your peers to consume adequate calcium?consume adequate calcium?

2001 jingle to “Here comes Santa Claus”

Here comes calcium, here comes calcium right down mineral lane. Bones growing stronger, blood clotting faster don’t deny your calcium need. Calcium everyone, not just anyone, oh what a wonderful thing. Broccoli, Sardines, Milk and Pork & Beans, drink your calcium today.

PhosphorusPhosphorus Phosphorus is part of ATP for energy processes Bones and Teeth Acid-Base balance Lipids contain phosphorus as part of their

structure in phospholipids Phospholipids are major components of cell

membranes Important for muscle contraction in ATP and PCr Glucose also needs to be phosphorylated in order

to enter glycolysis to produce energy

Phosphorous is found inPhosphorous is found in

Animal Protein Meat, seafood Eggs

Milk Cheese

Processed foods such as soda pop Nuts, dried beans and peas, grain products

PhytatePhytate

Phosphorus is part of phytate that might diminish absorption of minerals like calcium, iron, zinc and copper by forming insoluble phosphate salts in the intestine.

Recommended calcium phosphorus ratio is 2:1 calcium to phosphorus or 1:1.

Too much phosphorus might impair calcium abosrption

IntakeIntake

Deficiency of phosphorus is very rare – recovering alcoholics or with excess antacids

PhosFuel –phosphorus to enhance exercise performance but in the past 50 years most research has discredited use of phosphorus supplementation on athletic performance and they may create imbalance with calcium. It may have a limited impact on perceived exertion.

MagnesiumMagnesium Involved in over 300 enzyme systems A major role is to act as a catalyst in the reaction that adds

the last phosphate to ATP Acts together with calcium in muscle contraction and blood

clotting; while calcium promotes the process, magnesium inhibits the process.

Helps prevent dental decay by holding calcium, in the tooth. Helps prevent bone fragility PART OF AN ENZYME NECESSARY FOR GLUCOSE

METABOLISM IN THE MUSCLE AND FOR GLUCONEOGENESIS.

Magnesium RequirementMagnesium Requirement Almost 3 of every 4 Americans do not meet need Found in chocolate, nuts, seafood, green leafy

vegetables, black beans, and whole grain products. ½ cup of shrimp or cooked spinach contains about

20% of the RDA A glass of skim milk has 10% of the RDA Hard water may contain up to 20 mg of

magnesium/liter Some bottled waters may have over 100 mg/liter UL is 350 mg FROM SUPPMENTS – not an issue

with food as absorption varies from food 25-60%

Magnesium DeficiencyMagnesium Deficiency

Can develop with prolonged diarrhea, use of diuretics or excess alcohol

Symptoms include apathy, muscle weakness, muscle twitching and tremor, muscle cramps (particularly in the feet) and cardiac arrhythmias

Lack of Mg may contribute to increased blood pressure

No data available on the benefit of magnesium supplements for athletic performance.

Excess Mg may cause nausea, vomiting, diarrhea