Dairy products, calcium, and prostate cancer risk: a systematic review and meta-analysis of cohort studies. Poverty is also associated with a higher risk of inadequacy. Hypercalcemia and hypercalciuria can cause poor muscle tone, renal insufficiency, hypophosphatemia, constipation, nausea, weight loss, fatigue, polyuria, heart arrhythmias, and a higher risk of CVD mortality [1,4,48]. Hypercalcemia (serum levels greater than 10.5 mg/dL [2.63 mmol/L]) and hypercalciuria (urinary calcium levels higher than 250 mg/day in women and 275 mg/day in men) are rare in healthy people and usually result from cancer, primary hyperparathyroidism, and other conditions [1,4]. For example, the body absorbs about 36% of a 300 mg calcium dose and 28% of a 1,000 mg dose [16]. Report of the American College of Obstetricians and Gynecologists Task Force on Hypertension in Pregnancy. Table 2 provides a list of various foods and their calcium contents. For rickets and osteomalacia, the requirements for calcium and vitamin D appear to be interrelated in that the lower the serum vitamin D level (measured as 25-hydroxyvitamin D [25(OH)D]), the more calcium is needed to prevent these diseases [21]. This section focuses on six health conditions and diseases in which calcium might play a role: bone health in older adults, cancer, cardiovascular disease (CVD), preeclampsia, weight management, and metabolic syndrome. Each compound contains varying amounts of calcium referred to as elemental calcium. Cardiovascular disease
[, Kopecky SL, Bauer DC, Gulati M, Nieves JW, Singer AJ, Toth PP, et al. Menopause leads to bone loss because decreases in estrogen production reduce calcium absorption and increase urinary calcium loss and calcium resorption from bone [1]. Iron and calcium bioavailability of fortified foods and dietary supplements. Contribution of dietary supplements to nutritional adequacy in race/ethnic population subgroups in the United States. Food Chem Toxicol 2017;109:585-648. Cochrane Database of Systematic Reviews 2019. Effects were greatest in adults younger than 35 years and with doses higher than 1,500 mg/day calcium. The median dietary intake in the U.S. for women age 50 or older is 589-649 mg per day and 728-777 per day for men. [, Wallace RB, Wactawski-Wende J, O'Sullivan MJ, Larson JC, Cochrane B, Gass M, et al. Dairy products, such as cheese, milk and yogurt, Dark green leafy vegetables, such as broccoli and kale, Fish with edible soft bones, such as sardines and canned salmon, Calcium-fortified foods and beverages, such as soy products, cereal and fruit juices, and milk substitutes, Have lactose intolerance and limit dairy products, Consume large amounts of protein or sodium, which can cause your body to excrete more calcium, Are receiving long-term treatment with corticosteroids, Have certain bowel or digestive diseases that decrease your ability to absorb calcium, such as inflammatory bowel disease or celiac disease, Calcium carbonate (40% elemental calcium). [, Fairweather-Tait SJ, Teucher B. Calcium and vitamin D supplementation in osteoporosis. Some clinical trial evidence shows that supplements containing a combination of calcium and vitamin D can reduce the risk of fractures in older adults. [, Hidayat K, Chen GC, Zhang R, Du X, Zou SY, Shi BM, et al. [, Han D, Fang X, Su D, Huang L, He M, Zhao D, et al. But when the analysis was restricted to trials with 4,000 or more women, the effect was no longer statistically significant. Nutr Rev 2002;60:360-7. Net absorption of dietary calcium is as high as 60% in infants and young children, who need substantial amounts to build bone, but it decreases to about 25% in adulthood and continues to decline with age [1]. Testodren - Highest Rated Test Boosters for Men Over 50. Other calcium forms in supplements include calcium sulfate, ascorbate, microcrystalline hydroxyapatite, gluconate, lactate, and phosphate [14]. J Clin Endocrinol Metab 2019;104:3576-84. Just 2 ounces of cheese or 1 cup of milk, yogurt or calcium-fortified beverage contains 300 milligrams of calcium, about 30 percent of your daily requirement. [, Candelas G, Martinez-Lopez JA, Rosario MP, Carmona L, Loza E. Calcium supplementation and kidney stone risk in osteoporosis: a systematic literature review. Other excellent sources of calcium include calcium-fortified orange juice, cranberry juice or soymilk. [, Li P, Fan C, Lu Y, Qi K. Effects of calcium supplementation on body weight: a meta-analysis. Age-related bone loss can also occur in men and lead to osteoporosis, but fracture risk tends to increase in older men about 5 to 10 years later than in older women [1]. Obstet Gynecol 2013;122:1122-31. Manufacturers are responsible for ensuring that supplements are safe and claims are truthful. Calcium intake and mortality from all causes, cancer, and cardiovascular disease: the Cancer Prevention Study II Nutrition Cohort. Your body needs calcium to build and maintain strong bones. PLoS One 2020;15:e0235042. [, Aune D, Navarro Rosenblatt DA, Chan DS, Vieira AR, Vieira R, Greenwood DC, et al. Endocrine 2020;69:485-95. [, Pletz MW, Petzold P, Allen A, Burkhardt O, Lode H. Effect of calcium carbonate on bioavailability of orally administered gemifloxacin. Age can also affect absorption of dietary calcium [1,4]. For the maximum absorption, no more than 500 mg of calcium should be taken in a single dose. The recommended upper limit for calcium is 2,500 mg a day for adults 19 to 50. Unlike teeth, bone undergoes continuous remodeling, with constant resorption and deposition of calcium into new bone [4]. [, World Health Organization. Calcium - General Range: 1000 mg to 1300 mg daily. [, Zhao JG, Zeng XT, Wang J, Liu L. Association between calcium or vitamin D supplementation and fracture incidence in community-dwelling older adults: a systematic review and meta-analysis. [, Heine-Broring RC, Winkels RM, Renkema JM, Kragt L, van Orten-Luiten AC, Tigchelaar EF, et al. Which of the following categories include the majority of the elements? Calcium supplement use is associated with less bone mineral density loss, but does not lessen the risk of bone fracture across the menopause transition: data from the Study of Women's Health Across the Nation. The effects of vitamin D, K and calcium co-supplementation on carotid intima-media thickness and metabolic status in overweight type 2 diabetic patients with CHD. Write the VHDL code for an S-R flip-flop with a rising-edge clock. [, Reyes-Garcia R, Mendoza N, Palacios S, Salas N, Quesada-Charneco M, Garcia-Martin A, et al. Adequate Intake (AI): Intake at this level is assumed to ensure nutritional adequacy; established when evidence is insufficient to develop an RDA. [, Hofmeyr GJ, Betran AP, Singata-Madliki M, Cormick G, Munjanja SP, Fawcus S, et al. Calcium also plays an important role in other bodily functions. Approximately what percentage of body weight consists of minerals? Calcium has the potential to interact with certain medications, and several types of medications might adversely affect calcium levels. This equals two servings of calcium-rich foods, such as dairy or foods and beverages fortified with calcium. What is the daily recommended dosage of calcium for female athletes? In a meta-analysis of eight cross-sectional studies and two prospective cohort studies in 63,017 participants aged 20 years and older, 14,906 participants developed metabolic syndrome [94]. Other forms of calcium in supplements include gluconate and lactate. A Cochrane review included 27 RCTs of calcium supplements during pregnancy in 18,064 women to prevent hypertensive disorders and related problems [78]. Usual Adult Dose for Osteoporosis. [, Nappo A, Sparano S, Intemann T, Kourides YA, Lissner L, Molnar D, et al. Am J Clin Nutr 2012;96:735-47. Independent associations of dairy and calcium intakes with colorectal cancers in the Adventist Health Study-2 cohort. [, Keum N, Aune D, Greenwood DC, Ju W, Giovannucci EL. Although diet is the best way to get calcium, calcium supplements may be an option if your diet falls short. Similarly, in a follow-up study an average of 55 months after administration of 1,200 mg/day calcium, 1,000 IU (25 mcg)/day vitamin D3, or both for 3 to 5 years in 1,121 participants, supplements had no effect on risk of recurrent adenomas [55]. In people with low levels of stomach acid, the solubility rate of calcium carbonate is lower, which could reduce the absorption of calcium from calcium carbonate supplements unless they are taken with a meal [3]. [, Chung M, Tang AM, Newberry SJ. Some scientists have questioned these findings because of the lack of statistical power (the studies were designed to detect differences in bone health measures, not cancer incidence), details from the investigators on the study sample and randomization procedures [45,46]. However, the quality of this evidence was low. Recommended Dietary Allowance (RDA): Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%98%) healthy individuals; often used to plan nutritionally adequate diets for individuals. [, Brunner RL, Wactawski-Wende J, Caan BJ, Cochrane BB, Chlebowski RT, Gass ML, et al. Antimicrob Agents Chemother 2003;47:2158-60. For example, a meta-analysis of 8 RCTs in 30,970 adults older than 50 years found that 500 to 1,200 mg/day calcium and 400 to 800 IU/day (10 to 20 mcg/day) vitamin D supplementation for 1 to 7 years reduced the risk of total fractures by 15% and hip fractures by 30% [37]. You may opt-out of email communications at any time by clicking on WHO Recommendation: Calcium Supplementation During Pregnancy for Prevention of Pre-eclampsia and Its Complications. Includes a variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), nuts, seeds, and soy products. Vitamin D with calcium supplementation and risk of atrial fibrillation in postmenopausal women. All-cancer incidence and mortality. See how much you need and how to get it. But one large clinical trial did find that calcium supplements reduce cancer risk. Accessed Oct. 18, 2020. Ann Intern Med 2017;166:686-7. Bone remodeling is required to change bone size during growth, repair damage, maintain serum calcium levels, and provide a source of other minerals [4]. https://www.consumerlab.com/aboutcl.asp. For the most part, the observational evidence does not show that increasing calcium intakes reduces the risk of fractures and falls in older adults. In children with rickets, the growth cartilage does not mineralize normally, which can lead to irreversible changes in the skeletal structure [1]. For additional information on calcium and weight management, see the health professional fact sheet on weight loss. Maturitas 2018;107:7-12. High calcium intakes might also increase the risk of CVD (see section on CVD in "Calcium and Health" section above) [39,62,67,69,70] and prostate cancer (see "Other Cancers" in "Calcium and Health" section above for more details) [57,58], although not all studies confirm these findings. National Institutes of Health. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Long-term use of lithium (Eskalith, Lithobid), a treatment for bipolar disorder, can lead to hypercalcemia, and use of both lithium and calcium supplements could increase this risk [107]. Higher dietary calcium intakes are associated with reduced risks of fractures, cardiovascular events, and mortality: a prospective cohort study of older men and women. Accessed Oct. 18, 2020. 200. For more information about building a healthy dietary pattern, refer to the Dietary Guidelines for Americans and the U.S. Department of Agricultures MyPlate. Absorption of calcium as the carbonate and citrate salts, with some observations on method. Calcium intake from diet and supplements and the risk of coronary artery calcification and its progression among older adults: 10-year follow-up of the Multi-Ethnic Study of Atherosclerosis (MESA). Magnesium is necessary for calcium absorption. Some observational evidence links higher calcium intakes with lower risk of metabolic syndrome. Calcium plus vitamin D supplementation and height loss: findings from the Women's Health Initiative Calcium and Vitamin D clinical trial. [, American College of Obstetricians and Gynecologists Task Force on Hypertension in Pregnancy. Sulfur is a derivative of what two essential amino acids? hydroxide, which is also called lye. For instance, if you have a health condition that causes excess calcium in your bloodstream (hypercalcemia), you should avoid calcium supplements. Nutr Cancer 2011;63:827-41. [, Moore-Schiltz L, Albert JM, Singer ME, Swain J, Nock NL. [, Huncharek M, Muscat J, Kupelnick B. Colorectal cancer risk and dietary intake of calcium, vitamin D, and dairy products: a meta-analysis of 26,335 cases from 60 observational studies. Heaney RP, Dowell MS, Barger-Lux MJ. For breast cancer, observational studies have had mixed findings on whether higher calcium intakes are associated with a lower risk. The recommended daily allowances (RDA) for calcium are: Boys 9-18: 1300 mg Men 19-70: 1000 mg Men 71+: 1200 mg Girls 9-18: 1300 mg Women 19-50: 1000 mg Women 51+: 1200 mg Of course, more isn't always better - excessive supplement intake has been tied to potential cardiovascular events. Nutrients 2021;13:368. U.S. Pharmacopeial Convention. As with the evidence on the link between increased calcium intakes and reductions in BMD loss, the findings of research on the use of calcium supplementation to prevent fractures in older adults are mixed. Older adults may need fewer calories to maintain their weight, since they. 260. Preeclampsia is defined as hypertension and proteinuria or thrombocytopenia during pregnancy, usually after 20 weeks gestation [74]. Geneva: World Health Organization; 2013. Calcium. Ann Intern Med 2016;165:867-8. In contrast, several prospective cohort studies and RCTs have shown that calcium supplements increase the risk of CVD. However, in women, the CVD mortality rate was 16% lower with supplemental calcium intakes of 1,000 mg/day than with no supplemental calcium intakes. Evidence Research on use of folate and oral folic acid supplements for specific conditions shows: Birth defects. Calcium supplementation for prevention of primary hypertension. The effect of calcium plus vitamin D on risk for invasive cancer: results of the Women's Health Initiative (WHI) calcium plus vitamin D randomized clinical trial. Dietary supplement use and colorectal cancer risk: a systematic review and meta-analyses of prospective cohort studies. Nutr Cancer 2009;61:47-69. Dietary supplements verification program. information highlighted below and resubmit the form. https://www.dietaryguidelines.gov/2020-advisory-committee-report. Check food and supplement labels to monitor how much total calcium you're getting a day and whether you're achieving the RDA but not exceeding the recommended upper limit. In addition, when 132,823 adults (mean age 63 years) were followed for an average of 17.5 years, the risk of CVD mortality was 22% higher in men with calcium supplement intakes of 1,000 mg/day or more than in those not taking calcium supplements [47]. Over time, these changes lead to decreased bone mass and fragile bones [1]. Men and women over age 70 should increase their uptake to 800 IU daily, which also can be obtained from supplements or vitamin D-rich foods such as egg yolks, saltwater fish, liver, and fortified milk. Declining levels of estrogen in women during menopause and for approximately 5 years afterward lead to rates of bone resorption that are higher than rates of bone formation, resulting in a rapid decrease in bone mass [7]. 21 likes, 6 comments - Online Nutrition & Training (@livefit_nutritionandhealth) on Instagram: "Feeling super tired and drained, can't explain why . Almost all (98%) calcium in the body is stored in the bones, and the body uses the bones as a reservoir for, and source of, calcium to maintain calcium homeostasis [1]. [, Wongdee K, Rodrat M, Teerapornpuntakit J, Krishnamra N, Charoenphandhu N. Factors inhibiting intestinal calcium absorption: hormones and luminal factors that prevent excessive calcium uptake. They also recommended a screening test for women . Nondairy sources include canned sardines and salmon with bones as well as certain vegetables, such as kale, broccoli, and Chinese cabbage (bok choi). Furthermore, women who met the RDA for calcium for adults (1,000 to 1,200 mg/day, depending on age) had an 18% lower risk of metabolic syndrome, but the association was not statistically significant in men who met the RDA for calcium. Can zinc supplements help treat hidradenitis suppurativa? 4-6% In general, daily mineral requirements are correlated with what? NHANES data from 2007 to 2014 show that the risk of inadequate calcium intakes (less than 800 to 1,100 mg) is 11.6% higher among adults aged 50 and older in households earning less than $20,000 per year than other households [20]. The amount increases to 1,200 mg per day for women over the age of 50 and men over the age of 71. Modern Nutrition in Health and Disease. They are based on observational evidence from the WHI showing a link between higher intakes of supplemental calcium (1,000 mg/day for 7 years) and a greater risk of kidney stones [96,97]. [, Khan B, Nowson CA, Daly RM, English DR, Hodge AM, Giles GG, et al. Different types of calcium supplements have different costs. Cochrane Database of Systematic Reviews 2015. For children aged 2-19, mean daily intakes of calcium from foods and beverages range from 965 to 1,015 mg [ 18 ]. After an average of 7 years, risk of cancer mortality did not differ between groups. Calcium citrate is absorbed equally well when taken with or without food and is a form recommended for individuals with low stomach acid (more common in people over 50 or taking acid blockers), inflammatory bowel disease or absorption disorders. Symptoms can be alleviated by switching to a supplement containing a different form of calcium, taking smaller calcium doses more often during the day, or taking the supplement with meals. In the bones Sulfur is a derivative of what two essential amino acids? An earlier systematic review and meta-analysis of 10 RCTs in 24,787 women also found that calcium supplementation (1,500 to 2,000 mg/day) reduced the risk of preeclampsia by 38% and, in women at increased risk of any hypertensive disorder of pregnancy, by 58% [79]. Br J Nutr 2015;114:924-35. [, Jackson RD, LaCroix AZ, Gass M, Wallace RB, Robbins J, Lewis CE, et al. The Supplement Facts label on calcium supplements is helpful in determining how much calcium is in one serving. Br J Nutr 2006;95:539-45. However, they contribute to calcium intakes, even though they contain small amounts of calcium, because people consume them frequently [1]. Net absorption of dietary calcium is also reduced to a small extent by intakes of caffeine and phosphorus and to a greater extent by low status of vitamin D [9-11]. J Obstet Gynaecol Can 2014;36:416-41. Review/update the In the typical American diet, approximately 30% of the phosphorous comes from which food source? [, Liu C, Kuang X, Li K, Guo X, Deng Q, Li D. Effects of combined calcium and vitamin D supplementation on osteoporosis in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials. Calcium supplements can interact with many different prescription medications, including blood pressure medications, synthetic thyroid hormones, bisphosphonates, antibiotics and calcium channel blockers. An analysis of data on 132,823 participants in the Cancer Prevention Study II Nutrition Cohort, who were followed for an average of 17.5 years, found no association between total dietary and supplemental calcium intakes and risk of cancer-related death or death from lung, colorectal, breast, or prostate cancer in men or women [47]. Because of its ability to neutralize stomach acid, calcium carbonate is contained in some over-the-counter antacid products, such as Tums and Rolaids. An observational study found an association between higher calcium intakes and lower prevalence of overweight or obesity in 6,696 children (51% male, mean age 6 years) in eight European countries, of whom 2,744 were re-examined 6 years later [86]. Mayo Clinic College of Medicine and Science, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Graduate Medical Education, Mayo Clinic School of Continuous Professional Development, Mayo Clinic on Incontinence - Mayo Clinic Press, NEW Mayo Clinic on High Blood Pressure - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Financial Assistance Documents Minnesota, Nutritional Supplements at Mayo Clinic Store. Vitamin D, calcium, or combined supplementation for the primary prevention of fractures in community-dwelling adults: US Preventive Services Task Force Recommendation Statement. J Clin Endocrinol Metab 2012;97:614-22. For a general overview of Calcium, see our consumer fact sheet on Calcium. Implications for implementing national strategies of calcium fortification.
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