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Medications Deplete
Nutrition in your body. Stay nutritionally healthy. You
will find that it is certainly worth the effort because you will
feel better and live longer.
Prescription Drugs Deplete Nutrients. Improve
your life style and make the personal changes that reduce or eliminate
Prescription Drugs.
Milk and Cheddar Cheese are excellent sources of
Calcium.
Plain Low Fat or Non-Fat Yogurt is among the best
sources of Calcium
Calcium
- If your body is not getting enough calcium from diet it will take what it
needs from your bones and teeth. Over time this process leads to osteoporosis a
crippling disease that can make bones brittle and susceptible to fracture.
Depleting Calcium from your bones occurs when your body is Acidic
Postmenopausal women have
special Calcium needs. Take quality Calcium Supplements and eat properly.
You will be healthier and you will enjoy your grandchildren.
Weight Management
for Children is important. Keep your children healthy and watch what they
eat.
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Drugs, Nutrient Depletion and Calcium
Let us begin by watching a video
that will help you better understand that there is a
relationship between drugs, their side effect caused by
nutritional depletion.
Dr. Cass
Explains about Drugs, Side Effects and Nutrition Depletion
Today, more than ever, consumers
over the age of 50 are on some type of Pharmaceutical drug
regimen. Many of these drugs deplete vital nutrients from
the body which may cause a new round of medical complications.
Women are a group of drug
consumers who should be especially concerned with Drug-Induced
Nutrient Depletion. Few women know that oral contraceptives
lower the levels of vital nutrients such as Vitamin B2, B6 and
B12, Vitamin C, Folic Acid, Magnesium and Zinc.
Drugs can alter the ability of
the body to digest, absorb, synthesize, transport, store,
metabolize or eliminate nutrients. This situation potentially
can cause Nutrient Depletion. Quite often, a patient is then
placed on additional medication to combat a new set of symptoms.
The cascading effect of such an approach to disease management
often leads to a reduction in the patient's quality of life.
Folic Acid is a nutrient that is
often depleted by drugs. Ross Pelton and James B LaValle claim
that it can be depleted by some 30 different types of drugs,
from Aspirin and magnesium containing antacids to stronger
medications such as anticonvulsants, cardiovascular drugs and
oral contraceptives. Some of the possible effects of Folic Acid
deficiency can include Megaloblastic anemia, birth defects,
elevated homocysteine levels, fatigue and even increased rates
of colon and colorectal cancer.
Without vitamins and minerals, our bodies cannot synthesize new
cells, build new tissues and produce the energy we need.
What Do Your Drugs Deplete?
Antacids deplete
- Calcium, Phosphate, Folic Acid, Potassium
Antibiotics
deplete - B vitamins and vitamin K.
Probiotics should also be taken
Anti-Diabetic Drugs
deplete - Vitamin B12, CoQ10, Folic Acid
Anti-Inflammatory Drugs
(includes Corticosteroids, NSAIDS). deplete - Calcium, Vitamin
D, Potassium, Zinc, Magnesium, Vitamin C, Folic Acid, Vitamin
B12, Selenium, Chromium, Vitamin A
Aspirin (Salicylates)/other
mild pain killers deplete -.Vitamin C, Calcium, Folic Acid,
Iron, Sodium, potassium, Pantothenic Acid (Vitamin B5)
Bronchodilators
deplete - Vitamin B6, Potassium
Cardiovascular Drugs
deplete - Zinc, Coenzyme Q10, Potassium, Calcium, Magnesium,
Phosphorus, Vitamin B1, Vitamin B6, Sodium, Vitamin C, Folic
Acid
Cholesterol Lowering Drugs
deplete- Coenzyme Q10, Vitamin E
Corticosteroids
deplete - ( see anti-inflammatory above)
Gout Medications
deplete - Vitamin B12, Sodium, Potassium, Beta-carotene,
Calcium, Phosphorus
HRT Medicine
(Hormone Replacement Therapy) deplete - Vitamin B6, Magnesium
Oral contraceptives
deplete - Folic Acid, Vitamins B1, B2, B3, B6, B12, Vitamin C,
Magnesium, Selenium, Zinc
Thyroid Medications
deplete - Iron
Ulcer Medications
deplete -Vitamin B12, Folic Acid, Vitamin D, Calcium, Iron,
Zinc, Protein
To ensure you are not becoming nutrient
deficient from your prescription medication, educate yourself
about what you are taking and how it may affect the vital
nutrients that enhance our lives.
Office of Dietary Supplements •
National
Institutes of Health
Introduction
Calcium, the most abundant mineral in the body, is found in some
foods, added to others, available as a dietary supplement, and
present in some medicines (such as antacids). Calcium is required
for muscle contraction, blood vessel expansion and contraction,
secretion of hormones and enzymes, and transmitting impulses
throughout the nervous system. The body strives to maintain constant
concentrations of calcium in blood, muscle, and intercellular
fluids, though less than <1% of total body calcium is needed to
support these functions.
The remaining 99% of the body's calcium supply is stored in the
bones and teeth where it supports their structure. Bone itself
undergoes continuous remodeling, with constant resorption and
deposition of calcium into new bone. The balance between bone
resorption and deposition changes with age. Bone formation exceeds
resorption in growing children, whereas in early and middle
adulthood both processes are relatively equal. In aging adults,
particularly among postmenopausal women, bone breakdown exceeds
formation, resulting in bone loss that increases the risk of
osteoporosis over time.
Recommended Intakes
Intake recommendations for calcium and other nutrients are provided
in the Dietary Reference Intakes (DRIs) developed by the Food and
Nutrition Board (FNB) at the Institute of Medicine of the National
Academies (formerly National Academy of Sciences). DRI is the
general term for a set of reference values used for planning and
assessing the nutrient intakes of healthy people. These values,
which vary by age and gender, include:
- Recommended Dietary Allowance (RDA): average daily level of
intake sufficient to meet the nutrient requirements of nearly
all (97%-98%) healthy individuals.
- Adequate Intake (AI): established when evidence is
insufficient to develop an RDA and is set at a level assumed to
ensure nutritional adequacy.
- Tolerable Upper Intake Level (UL): maximum daily intake
unlikely to cause adverse health effects.
The FNB established AIs for the amounts of calcium required to
maintain adequate rates of calcium retention and bone health in
healthy people. They are listed in Table 1 in milligrams (mg) per
day.
Table 1: Adequate Intakes (AIs) for Calcium [1]
| Age |
Male |
Female |
Pregnant |
Lactating |
| Birth to 6 months |
210 mg |
210 mg |
|
|
| 7-12 months |
270 mg |
270 mg |
|
|
| 1-3 years |
500 mg |
500 mg |
|
|
| 4-8 years |
800 mg |
800 mg |
|
|
| 9-13 years |
1,300 mg |
1,300 mg |
|
|
| 14-18 years |
1,300 mg |
1,300 mg |
1,300 mg |
1,300 mg |
| 19-50 years |
1,000 mg |
1,000 mg |
1,000 mg |
1,000 mg |
| 50+ years |
1,200 mg |
1,200 mg |
|
|
mg = milligrams
Sources of Calcium
Food
Milk, yogurt, and cheese are rich sources of calcium and are the
major food contributors of this nutrient to people in the United
States. Nondairy sources include vegetables, such as Chinese
cabbage, kale, and broccoli. Most grains do not have high amounts of
calcium unless they are fortified; however, they contribute calcium
to the diet because they do have small amounts and people consume
them frequently. Foods fortified with calcium include many fruit
juices and drinks, tofu, and cereals. Selected food sources of
calcium are listed in Table 2.
Table 2: Selected Food Sources of Calcium
| Food |
Milligrams (mg) per
serving |
Percent DV* |
| Yogurt, plain, low fat, 8
ounces |
415 |
42 |
| Sardines, canned in oil,
with bones, 3 ounces |
324 |
32 |
| Cheddar cheese, 1.5 ounces |
306 |
31 |
| Milk, nonfat, 8 ounces |
302 |
30 |
| Milk, reduced-fat (2% milk
fat), 8 ounces |
297 |
30 |
| Milk, lactose-reduced, 8
ounces** |
285-302 |
29-30 |
| Milk, whole (3.25% milk
fat), 8 ounces |
291 |
29 |
| Milk, buttermilk, 8 ounces |
285 |
29 |
| Mozzarella, part skim, 1.5
ounces |
275 |
28 |
| Yogurt, fruit, low fat, 8
ounces |
245-384 |
25-38 |
| Orange juice,
calcium-fortified, 6 ounces |
200-260 |
20-26 |
| Tofu, firm, made with
calcium sulfate, ˝ cup*** |
204 |
20 |
| Salmon, pink, canned, solids
with bone, 3 ounces |
181 |
18 |
| Pudding, chocolate, instant,
made with 2% milk, ˝ cup |
153 |
15 |
| Cottage cheese, 1% milk fat,
1 cup unpacked |
138 |
14 |
| Tofu, soft, made with
calcium sulfate, ˝ cup*** |
138 |
14 |
| Spinach, cooked, ˝ cup |
120 |
12 |
| Ready-to-eat cereal,
calcium-fortified, 1 cup |
100-1,000 |
10-100 |
| Instant breakfast drink,
various flavors and brands, powder prepared with water, 8
ounces |
105-250 |
10-25 |
| Frozen yogurt, vanilla, soft
serve, ˝ cup |
103 |
10 |
| Turnip greens, boiled, ˝ cup |
99 |
10 |
| Kale, cooked, 1 cup |
94 |
9 |
| Kale, raw, 1 cup |
90 |
9 |
| Ice cream, vanilla, ˝ cup |
85 |
8.5 |
| Soy beverage,
calcium-fortified, 8 ounces |
80-500 |
8-50 |
| Chinese cabbage, raw, 1 cup |
74 |
7 |
| Tortilla, corn,
ready-to-bake/fry, 1 medium |
42 |
4 |
| Tortilla, flour,
ready-to-bake/fry, one 6" diameter |
37 |
4 |
| Sour cream, reduced fat,
cultured, 2 tablespoons |
32 |
3 |
| Bread, white, 1 ounce |
31 |
3 |
| Broccoli, raw, ˝ cup |
21 |
2 |
| Bread, whole-wheat, 1 slice |
20 |
2 |
| Cheese, cream, regular, 1
tablespoon |
12 |
1 |
* DV = Daily Value. DVs were developed by the U.S. Food and Drug
Administration to help consumers compare the nutrient contents among
products within the context of a total daily diet. The DV for
calcium is 1,000 mg for adults and children aged 4 and older. Foods
providing 20% of more of the DV are considered to be high sources of
a nutrient, but foods providing lower percentages of the DV also
contribute to a healthful diet.
The U.S. Department of Agriculture’s Nutrient Database provides a
comprehensive list of foods containing
calcium list of foods.
** Calcium content varies slightly by fat content; the more fat, the
less calcium the food contains.
*** Calcium content is for tofu processed with a calcium salt. Tofu
processed with other salts does not provide significant amounts of
calcium.
In its food guidance system, MyPyramid, the U.S. Department
of Agriculture recommends that persons aged 9 years and older eat 3
cups of foods from the milk group per day. A cup is equal to 1 cup
(8 ounces) of milk, 1 cup of yogurt, 1.5 ounces of natural cheese
(such as Cheddar), or 2 ounces of processed cheese (such as
American).
Dietary supplements
The two main forms of calcium in supplements are carbonate and
citrate. Calcium carbonate is more commonly available and is both
inexpensive and convenient. Both the carbonate and citrate forms are
similarly well absorbed, but individuals with reduced levels of
stomach acid can absorb calcium citrate more easily. Other calcium
forms in supplements or fortified foods include gluconate, lactate,
and phosphate. Calcium citrate malate is a well-absorbed form of
calcium found in some fortified juices. The body absorbs calcium
carbonate most efficiently when the supplement is consumed with
food, whereas the body can absorb calcium citrate equally
effectively when the supplement is taken with or without food.
Calcium supplements contain varying amounts of elemental calcium.
For example, calcium carbonate is 40% calcium by weight, whereas
calcium citrate is 21% calcium.
The percentage of calcium absorbed depends on the total amount of
elemental calcium consumed at one time; as the amount increases, the
percentage absorption decreases. Absorption is highest in doses ≤500
mg. So, for example, one who takes 1,000 mg/day of calcium from
supplements might split the dose and take 500 mg at two separate
times during the day.
Some individuals who take calcium supplements might experience gas,
bloating, constipation, or a combination of these symptoms. Such
symptoms can often be resolved by spreading out the calcium dose
throughout the day, taking the supplement with meals, or changing
the brand of supplement used.
Medicines
Because of its ability to neutralize stomach acid, calcium carbonate
is found in some over-the-counter antacid products, such as Tums®
and Rolaids®. Depending on its strength, each chewable pill or
softchew provides 200 to 400 mg of calcium. As noted above, calcium
carbonate is an acceptable form of supplemental calcium, especially
for individuals who have normal levels of stomach acid.
Calcium Intakes and Status
Many Americans do not ingest recommended amounts of calcium from
food. Approximately 44% of boys and 58% of girls aged 6–11 fell
short in 1994–1996, as did 64% of boys and 87% of girls aged 12–19
years and 55% of men and 78% of women aged 20 years or older,
according to the nationwide Continuing Survey of Food Intakes of
Individuals [10]. The
National Health and Nutrition Examination Survey 1999-2000 found
that average calcium intakes were 1,081 and 793 mg/day for boys and
girls ages 12-19 years, respectively; 1,025 and 797 mg/day for men
and women 20-39 years; and 797 and 660 mg/day for men and women ≥60
years. Overall, females are less likely than males to get
recommended intakes of calcium from food.
Not all calcium consumed is actually absorbed in the gut. Among the
factors that affect its absorption are the following:
- Amount consumed: the efficiency of absorption decreases as
the amount of calcium consumed at a meal increases.
- Age: net calcium absorption is as high as 60% in infants and
young children, who need substantial amounts of the mineral to
build bone. Absorption decreases to 15%-20% in adulthood and
continues to decrease as people age; this explains the higher
recommended calcium intakes for ages ≥51 years
- Vitamin D intake: this nutrient, obtained from food and
produced by skin when exposed to sunlight of sufficient
intensity, improves calcium absorption.
- Other components in food: phytic acid and oxalic acid, found
naturally in some plants, bind to calcium and can inhibit its
absorption. Foods with high levels of oxalic acid include
spinach, collard greens, sweet potatoes, rhubarb, and beans.
Among the foods high in phytic acid are fiber-containing
whole-grain products and wheat bran, beans, seeds, nuts, and soy
isolates. The extent to which these compounds affect calcium
absorption varies. Research shows, for example, that eating
spinach and milk at the same time reduces absorption of the
calcium in milk. In contrast, wheat products (with the exception
of wheat bran) do not appear to have a negative impact on
calcium absorption. For people who eat a variety of foods, these
interactions probably have little or no nutritional consequence
and, furthermore, are accounted for in the overall calcium DRIs,
which take absorption into account.
Some absorbed calcium is eliminated from the body in urine, feces,
and sweat. This amount is affected by such factors as the following:
- Sodium, potassium, and protein intakes: high intakes of
sodium and protein increase calcium excretion. Adding more
potassium to a high-sodium diet might help decrease calcium
excretion, particularly in postmenopausal women.
- Caffeine intake: this stimulant in coffee and tea can
modestly increase calcium excretion and reduce absorption . One
cup of regular brewed coffee, for example, causes a loss of only
2-3 mg of calcium. Moderate caffeine consumption (1 cup of
coffee or 2 cups of tea per day) in young women has no negative
effects on bone.
- Alcohol intake: alcohol intake can affect calcium status by
reducing its absorption and by inhibiting enzymes in the liver
that help convert vitamin D to its active form. However, the
amount of alcohol required to affect calcium status and whether
moderate alcohol consumption is helpful or harmful to bone is
unknown.
- Phosphorus intake: the effect of this mineral on calcium
excretion is minimal. Several observational studies suggest that
consumption of carbonated soft drinks with high levels of
phosphate is associated with reduced bone mass and increased
fracture risk. However, the effect is probably due to replacing
milk with soda rather than the phosphorus itself.
- Fruit and vegetable intakes: these foods, when metabolized,
shift the acid/base balance of the body towards the alkaline
by producing bicarbonate, which reduces calcium loss.
Metabolic acids produced by diets high in protein and cereal
grains, for example, cause bone to release minerals such as
calcium and phosphates and alkaline salts that neutralize the
excess acid. In one experiment, women ≥50 years of age who took
supplements of bicarbonate showed significant reductions in
calcium excretion, indicating reduced bone resorption.
Calcium Deficiency
Inadequate intakes of dietary calcium from food and supplements
produce no obvious symptoms in the short term. Circulating blood
levels of the nutrient, for example, are tightly regulated.
Hypocalcemia results primarily from medical problems or treatments,
including renal failure, surgical removal of the stomach, and use of
certain medications (such as diuretics). Symptoms of hypocalcemia
include numbness and tingling in the fingers, muscle cramps,
convulsions, lethargy, poor appetite, and abnormal heart rhythms. If
left untreated, calcium deficiency leads to death.
Groups
at Risk of Calcium Inadequacy
Although frank calcium deficiency is uncommon, dietary intakes of
the nutrient below recommended levels might have health consequences
over the long term. The following groups are among those most likely
to need extra calcium.
Postmenopausal women
Menopause leads to bone loss because decreases in estrogen
production both increase bone resorption and decrease calcium
absorption. Annual decreases in bone mass of 3%-5% per year
frequently occur in the first years of menopause, but the decreases
are typically less than 1% per year after age 65. Increased calcium
intakes during menopause do not completely offset this bone loss.
Hormone replacement therapy (HRT) with estrogen and progesterone
helps increase calcium levels and prevent osteoporosis and
fractures. Estrogen therapy restores postmenopausal bone remodeling
to the same levels as at premenopause, leading to lower rates of
bone loss, perhaps in part by increasing calcium absorption in the
gut. However, because of the potential health risks associated with
HRT use, several medical groups and professional societies recommend
that postmenopausal women consider using medications, such as
bisphosphonates, instead of HRT to prevent or treat osteoporosis. In
addition, consuming adequate amounts of calcium in the diet might
help slow the rate of bone loss in all women.
Amenorrheic women
and the female athlete triad
Amenorrhea, the condition in which menstrual periods stop or fail to
initiate in women of childbearing age, results from reduced
circulating estrogen levels that, in turn, have a negative effect on
calcium balance [1].
Amenorrheic women with anorexia nervosa have decreased calcium
absorption and higher urinary calcium excretion rates, as well as a
lower rate of bone formation than healthy women.
The "female athlete triad" refers to the combination of disordered
eating, amenorrhea, and osteoporosis. Exercise-induced amenorrhea
results in decreased bone mass. In female athletes and active women
in the military, low bone-mineral density, menstrual irregularities,
certain dietary patterns, and a history of prior stress factors are
associated with an increased risk of future stress fractures. Such
women should consume adequate amounts of calcium.
Individuals with lactose
intolerance
Lactose intolerance refers to symptoms (such as bloating,
flatulence, and diarrhea) that occur when one consumes more lactose,
the naturally occurring sugar in milk, than the enzyme lactase
produced by the small intestine can hydrolyze into its component
monosaccharides, glucose and galactose. The symptoms vary, depending
on the amount of lactose consumed, history of consumption of
lactose-containing foods, and type of meal. Approximately 25% of
U.S. adults have a limited ability to digest lactose, including 85%
of Asians, 50% of African Americans, and 10% of Caucasians.
Lactose-intolerant individuals are at risk of calcium inadequacy if
they avoid dairy products.
Depending on the degree of lactose intolerance, some people with
this condition might be able to consume moderate amounts of lactose,
such as that present in 8 ounces of milk or in two 8-ounce glasses
taken at different meals. Other options to reduce symptoms include
drinking milk with a meal, inducing some adaptation by regularly
eating foods with lactose daily for 2-3 weeks, or eating aged
cheeses (such as Cheddar and Swiss with little lactose), yogurt
(whose live active cultures aid in lactose digestion), or
lactose-reduced or lactose-free milk. To ensure adequate calcium
intakes, lactose-intolerant individuals can also choose nondairy
food sources of the nutrient or take a calcium supplement.
Vegetarians
Vegetarians might absorb less calcium than omnivores because they
consume more plant products containing oxalic and phytic acids. On
the other hand, some vegetarian diets contain less protein than
typical omnivore diets, which reduces calcium excretion. Lacto-ovo
vegetarians (who consume eggs and dairy) and nonvegetarians have
similar calcium intakes. However, vegans, who eat no animal
products, might not obtain sufficient calcium because of their
avoidance of dairy foods. It is difficult to assess the impact of
vegetarian diets on calcium status because of the wide variety of
eating practices.
Calcium and Health
Many claims are made about calcium's potential benefits in health
promotion and disease prevention and treatment. This section focuses
on several areas in which calcium is or might be involved: bone
health and osteoporosis; blood pressure regulation and hypertension;
cancers of the colon, rectum, and prostate; kidney stones; and
weight management.
Bone health and
osteoporosis
Bones increase in size and mass during childhood and adolescence,
reaching peak bone mass around age 30. The greater the peak bone
mass, the longer one can delay serious bone loss with increasing
age. Everyone should therefore consume adequate amounts of
calcium and vitamin D throughout childhood, adolescence, and early
adulthood.
Osteoporosis, a disorder characterized by porous and fragile bones,
is a serious public health problem for more than 10 million U.S.
adults, 80% of whom are women. (Another 34 million have osteopenia,
or low bone mass, which precedes osteoporosis.) Osteoporosis is
associated with fractures of the hip, vertebrae, wrist, pelvis,
ribs, and other bones. An estimated 1.5 million fractures occur each
year in the United States due to osteoporosis.
When calcium intake is low or ingested calcium is poorly absorbed,
bone breakdown occurs as the body uses its stored calcium to
maintain normal biological functions. Bone loss also occurs as part
of the normal aging process, particularly in postmenopausal women
due to decreased amounts of estrogen. Many factors increase the risk
of developing osteoporosis, including being female, thin, inactive,
or of advanced age; smoking cigarettes; drinking excessive amounts
of alcohol; and having a family history of osteoporosis.
Various bone mineral density (BMD) tests are available. The T-score
from these tests compares an individual's BMD to an optimal BMD
(that of a healthy 30-year old adult). A T-score between +1 and -1
indicates normal bone density, -1.0 to -2.5 indicates low bone mass
(osteopenia), and lower than -2.5 osteoporosis.
Although osteoporosis affects individuals of all races, ethnicities,
and both genders, women are at highest risk because their skeletons
are smaller than those of men and because of the accelerated bone
loss that accompanies menopause. Adequate intakes of calcium and
vitamin D as well as regular exercise (both weight-bearing such as
walking, running, and activities where one's feet leave and hit the
ground and work against gravity, as well as resistance exercises
such as calisthenics and that involve weights) are critical to the
development and maintenance of healthy bones throughout the life
cycle.
In 1993, the U.S. Food and Drug Administration authorized a health
claim related to calcium and osteoporosis for foods and supplements.
In January 2010, this health claim is expanded to include vitamin D.
Model health claims include the following: "Adequate calcium
throughout life, as part of a well-balanced diet, may reduce the
risk of osteoporosis" and "Adequate calcium and vitamin D as part of
a healthful diet, along with physical activity, may reduce the risk
of osteoporosis in later life".
Blood pressure and hypertension
Several clinical trials have demonstrated a relationship between
increased calcium intakes and both lower blood pressure and risk of
hypertension, although the reductions are inconsistent. The authors
of a systematic review of the effects of calcium supplements for
hypertension found any link to be weak at best, largely due to the
poor quality of most studies and differences in methodologies. Other
observational and experimental studies suggest that individuals who
eat a vegetarian diet high in minerals (such as calcium, magnesium,
and potassium) and fiber and low in fat tend to have lower blood
pressure.
The Dietary Approaches to Stop Hypertension (DASH) study was
conducted to test the effects of three different eating patterns on
blood pressure: a control "typical" American diet; one high in
fruits and vegetables; and a third diet high in fruits, vegetables,
and low-fat dairy products. The diet containing dairy products
resulted in the greatest decrease in blood pressure, although the
contribution of calcium to this effect was not evaluated. Additional
information and sample DASH menu plans are available on the National
Heart, Lung, and Blood Institute Web site (http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/index.htm).
Cancer of the colon and rectum
Observational and experimental studies on the potential role of
calcium in preventing colorectal cancer provide mixed results.
Several studies have found that higher intakes of calcium from foods
(low-fat dairy sources) and/or supplements are associated with a
decreased risk of colon cancer.
Supplementation with calcium carbonate has led to reductions in the
risk of adenoma (a nonmalignant tumor) in the colon, a precursor to
cancer even as long as 5 years after the person stopped taking the
supplement. In two large prospective epidemiological trials, men and
women who consumed 700-800 mg per day of calcium had a 40%-50% lower
risk of developing left-side colon cancer.
But other observational studies have found the associations to be
inconclusive. In the Women's Health Initiative, a clinical trial
involving 36,282 postmenopausal women, daily supplementation with
1,000 mg of calcium and 400 IU of vitamin D3 for 7 years
produced no significant differences in the risk of invasive
colorectal cancer compared to placebo. Given the long latency period
for colon cancer development, long-term studies are needed to
understand whether calcium intakes affect colorectal cancer risk.
Cancer of the prostate
Several epidemiological studies have found an association between
calcium intakes of 600 mg or more per day, intakes of more than 2.5
servings of dairy foods, or both and an increased risk of developing
prostate cancer. However, others have found only a weak
relationship, no relationship, or a negative association between
calcium intake and prostate cancer risk. The authors of a
meta-analysis of prospective studies concluded that high intakes of
dairy products and calcium might slightly increase prostate cancer
risk. Additional research is needed to determine whether a man's
risk of prostate cancer is affected by the amount of dairy products
or calcium consumed.
Kidney stones
Kidney stones in the urinary tract are most commonly composed of
calcium oxalate. In the Women's Health Initiative clinical trial,
postmenopausal women who consumed 1,000 mg of supplemental calcium
and 400 IU of vitamin D per day for 7 years had a higher risk of
kidney stones than subjects taking a placebo. Other studies,
however, have found that high dietary calcium intakes decrease this
risk. For most individuals, other risk factors for kidney stones,
such as high intakes of oxalates from food and low intakes of fluid,
appear to play a bigger role than calcium.
Weight management
Several studies have linked higher calcium intakes to lower body
weight or less weight gain over time. Two explanations have been
proposed. First, high calcium intakes might reduce calcium
concentrations in fat cells by decreasing the production of two
hormones (parathyroid hormone and an active form of vitamin D) that
increase fat breakdown in these cells and discourage fat
accumulation. Secondly, calcium from food or supplements might bind
to small amounts of dietary fat in the digestive tract and prevent
its absorption. Dairy products, in particular, might contain
additional components that have even greater effects on body weight
than their calcium content alone would suggest.
Despite these findings, the results from clinical trials have been
largely negative. For example, a meta-analysis of 13 randomized
controlled trials concluded that neither calcium supplementation nor
increased dairy product consumption has a statistically significant
effect on weight reduction. A more recent clinical trial found
dietary supplementation with 1,500 mg/day of calcium (from calcium
carbonate) for 2 years to have no clinically significant effects on
weight in overweight and obese adults as compared with placebo. Any
apparent effects of calcium and dairy products on weight regulation
and body composition are complex, inconsistent, and not well
understood.
Health Risks from Excessive Calcium
Excessively high levels of calcium in the blood known as
hypercalcemia impair kidney function, and lead to reduced absorption
of other essential minerals, such as iron, zinc, magnesium, and
phosphorus. However, hypercalcemia rarely results from dietary or
supplemental calcium intake and is most commonly associated with
hyperparathyroidism, advanced cases of cancer or excessive intakes
of vitamin D from supplements at doses of 50,000 IU/day or higher.
The Tolerable Upper Intake Levels (ULs) for calcium established by
the Food and Nutrition Board are listed in Table 3.
Table 3: Tolerable Upper Intake Levels (ULs) for Calcium [1]
| Age |
Male |
Female |
Pregnant |
Lactating |
| Birth to 12 months |
None established |
None established |
|
|
| 1-13 years |
2,500 mg |
2,500 mg |
|
|
| 14-50 years |
2,500 mg |
2,500 mg |
2,500 mg |
2,500 mg |
| 51+ years |
2,500 mg |
2,500 mg |
|
|
mg = milligrams
Calcium and Healthful Diets
According to the 2005 Dietary Guidelines for Americans,
"nutrient needs should be met primarily through consuming foods.
Foods provide an array of nutrients and other compounds that may
have beneficial effects on health. In certain cases, fortified foods
and dietary supplements may be useful sources of one or more
nutrients that otherwise might be consumed in less than recommended
amounts. However, dietary supplements, while recommended in some
cases, cannot replace a healthful diet."
Interactions with Medications
Calcium supplements have the potential to interact with several
types of medications. This section provides a few examples.
Individuals taking these medications on a regular basis should
discuss their calcium intake with their healthcare providers.
Calcium can decrease the absorption of the following drugs when
taken together: biphosphonates (to treat osteoporosis), the
fluoroquinolone and tetracycline classes of antibiotics,
levothyroxine, phenytoin (an anticonvulsant), and tiludronate
disodium (to treat Paget's disease).
Thiazide-type diuretics can interact with calcium carbonate and
vitamin D supplements, increasing the risks of hypercalcemia and
hypercalciuria. Both aluminum- and magnesium-containing antacids
increase urinary calcium excretion. Mineral oil and stimulant
laxatives decrease calcium absorption. Glucocorticoids, such as
prednisone, can cause calcium depletion and eventually osteoporosis
when they are used for months.
The Dietary Guidelines for Americans describe a healthy
diet as one that:
- Emphasizes a variety of fruits, vegetables, whole grains,
and fat-free or low-fat milk and milk products:
- Many dairy products, such as milk, cheese, and yogurt,
are rich sources of calcium. Some vegetables provide
significant amounts of calcium, as do some fortified cereals
and juices.
-
- Includes lean meats, poultry, fish, beans, eggs, and nuts.
- Tofu made with calcium salts is a good source of calcium, as
are canned sardines and salmon with soft bones.
- Is low in saturated fats, trans fats, cholesterol, salt
(sodium), and added sugars.
- Low- and nonfat dairy products provide amounts of
calcium that are roughly similar to the amounts in their
full-fat versions.
-
- Stays within your daily calorie needs.
Get yourself and your family started here with a
program that makes sense and please stay in touch. Your health is
important to us so please make it important to you. Remember
"The Time is Always Now."
Sincerely,
Bob Fox
Robert S. Fox, Nutritional Consultant
Email:
KLATOOGORT@aol.com
Phone: 201-944-7757 Off - 201-362-5619 Cell
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