Robert P. Opportunity knocks As the awareness and incidence of osteoporosis continues to grow, so does the need for calcium-fortified products.
Ideally, most nutritionists recommend foods, especially lowfat dairy products, as the best source of calcium. Americans are consuming an average of only 1. To pique consumer interest, manufacturers can flag fortified products. Choosing the best calcium form for food fortification depends on a number of technical considerations, such as bioavailability, solubility, taste, palatability, stability and effects on the final product, as well as cost and consumer preference. Generally, organic salts citrate, gluconate and lactate have better bioavailability than inorganic calcium salts phosphate and carbonate.
But many factors influence the actual calcium absorbed by an individual, including other items in the diet and the calcium level consumed, intestinal conditions, calcium status, and age. Vitamin D and magnesium enhance absorption. Inorganic salts tend to be less expensive. At high levels, they have a higher likelihood of imparting a chalky mouthfeel.
Reading the labels with an eye toward cost and convenience may help you sift through your options. While products that yield a high amount of calcium may seem to be the best bet at first blush, they may not serve you best. Because your body has difficulty absorbing more than mg of calcium at a time, more of the mineral may go to waste.
So, while you may think that you've met your daily requirements by taking that 1,mg calcium pill, you may actually be only halfway to your target. Calculate your cost per serving based on how many tablets or chews the package contains, and consider whether you might find it inconvenient to take several tablets a day. Here are some final tips for choosing and taking calcium supplements as found in the Harvard Special Health Report Osteoporosis: A guide to prevention and treatment :. As a service to our readers, Harvard Health Publishing provides access to our library of archived content.
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Get helpful tips and guidance for everything from fighting inflammation to finding the best diets for weight loss Stay on top of latest health news from Harvard Medical School. Recent Blog Articles. Too much or too little calcium, whether through diet or supplements, could be problematic for these individuals. In this article, we briefly discuss daily human calcium requirements, types of calcium supplements, nutritional considerations of calcium, and problems with too little or too much calcium intake.
The two main forms of calcium supplements are carbonate and citrate. Calcium supplements contain several different kinds of calcium salts. Each salt contains varying amounts of elemental calcium. In addition, some calcium supplements are combined with vitamin D or magnesium. Product labels should be read carefully and the supplement ingredients checked to see which form and amount of calcium are present in the product. This information is important if a person has any health or dietary concerns.
The daily requirement of calcium depends on age and sex. People should not take more than 1, mg of calcium a day in supplement form unless instructed by a doctor or dietitian.
On average, the majority of Americans get between mg and mg of calcium daily through diet alone. It is now known that vitamin D calciferol has a big role in calcium absorption. The requirements increase with age because older skin produces less vitamin D. These recommendations have since increased, as discussed below. Conditions associated with calcium deficiency include hypoparathyroidism, achlorhydria, chronic diarrhea, vitamin D deficiency, steatorrhea, sprue, pregnancy and lactation, menopause, pancreatitis, renal failure, alkalosis, and hyperphosphatemia.
Administration of certain drugs e. People who follow vegan diets, have lactose intolerance and limit dairy products, eat large amounts of protein or sodium, have osteoporosis, have undergone long-term treatment with corticosteroids, or have certain bowel or digestive diseases that decrease their ability to absorb calcium, such as inflammatory bowel disease or celiac disease, are also at risk for low calcium intake.
In these situations, calcium supplements may help people meet their calcium requirements. Some other natural sources of calcium are coral calcium and oyster shell calcium.
Coral calcium is a form of calcium carbonate that comes from fossilized coral sources. The human body undergoes a natural process known as chelating , in which it combines calcium with another material e. Coral calcium is also used in maxillofacial surgery and bone grafting. Calcium and Vitamin D: A major role of vitamin D is to help the body absorb calcium and maintain bone density.
For this reason, some calcium supplements are combined with vitamin D. This vitamin is available in two forms, vitamin D 2 ergocalciferol and vitamin D 3 cholecalciferol. The D 2 form of the vitamin has a shorter shelf life compared to the D 3 form. A few foods are known to have small amounts of vitamin D, such as canned salmon with bones and egg yolks.
Vitamin D can also be acquired from fortified foods and produced naturally through sun exposure. Calcitriol Rocaltrol is the biologically active form of vitamin D that is used to treat and prevent low levels of calcium in the blood of patients whose kidneys or parathyroid glands are not functioning normally.
This vitamin provides major protection from osteoporosis and pathologic calcification of the arteries and soft tissues—a major known consequence of aging. Vitamin K 2 is found in animals and bacteria, including beneficial probiotic bacteria from the gastrointestinal tract.
Antibiotics interfere with normal growth of healthy bacteria and impact vitamin K 2 production. Although vitamin D 3 has been known as the bone vitamin because it puts the osteocalcin gene into action and acts swiftly on bones, the slower-acting vitamin K 2 has been recognized as being just as important for bone maintenance. The human skeleton is fully replaced every 8 to 10 years with good, dense bone, and these two vitamins play a large role in the process.
The oral osteoporosis treatment dose of vitamin K 2 is 45 mg a day. Elemental Calcium: Elemental calcium is what the body absorbs for bone growth and other health benefits; therefore, the actual amount of calcium in the supplement is very important. The label on calcium supplements is helpful in determining how much calcium is contained in one serving number of tablets. Supplement Choice: Some people cannot tolerate certain calcium supplements owing to side effects such as gas, constipation, and bloating.
One may need to try a few different brands or types of calcium supplement to find the one that he or she can tolerate best. In general, calcium carbonate is the most constipating supplement, but it contains the highest amount of calcium and is the least expensive. Calcium phosphate does not cause gas or constipation, but it is more expensive than calcium carbonate.
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