Calcium is the chemical element with symbol Ca and atomic number 20. Calcium is a soft gray alkaline earth metal, and is the fifth-most-abundant element by mass in the Earth's crust. As a major material used in mineralization of bone, teeth and shells, calcium is the most abundant metal by mass in many animals.
Calcium is an important component of a healthy diet and a mineral necessary for life.
Approximately 99 percent of the body's calcium is stored in the bones and teeth. The rest of the calcium in the body has other important uses, such as some exocytosis, especially neurotransmitter release, and muscle contraction.
Vitamin D is needed to absorb calcium.
Dairy products, such as milk and cheese, are a well-known source of calcium. Some individuals are allergic to dairy products and even more people, in particular those of non Indo-European descent, are lactose-intolerant, leaving them unable to consume non-fermented dairy products in quantities larger than about half a litre per serving. Others, such as vegans, avoid dairy products for ethical and health reasons.
Many good vegetable sources of calcium exist, including seaweeds such as kelp, wakame and hijiki; nuts and seeds like almonds, hazelnuts, sesame, pistachio; blackstrap molasses; beans (especially soybeans); figs; quinoa; okra; rutabaga; broccoli; dandelion leaves; kale.
Numerous vegetables, notably spinach, chard and rhubarb have a high calcium content, but they may also contain varying amounts of oxalic acid that binds calcium and reduces its absorption. The same problem may to a degree affect the absorption of calcium from amaranth, collard greens & chicory greens.
Dietary calcium supplements
Calcium supplements are used to prevent and to treat calcium deficiencies. Most experts recommend that supplements be taken with food and that no more than 600 mg should be taken at a time because the percent of calcium absorbed decreases as the amount of calcium in the supplement increases. Recommended daily calcium intake for adults ranges from 1000 to 1500 mg. It is recommended to take supplements with food to aid in absorption.
Vitamin D is added to some calcium supplements. Proper vitamin D status is important because vitamin D is converted to a hormone in the body, which then induces the synthesis of intestinal proteins responsible for calcium absorption.
- The absorption of calcium from most food and commonly used dietary supplements is very similar.
- Milk is an excellent source of dietary calcium for those whose bodies tolerate it because it has a high concentration of calcium and the calcium in milk is excellently absorbed.
- Calcium carbonate is the most common and least expensive calcium supplement. It should be taken with food. It depends on low pH levels for proper absorption in the intestine. While most people digest calcium carbonate very well, some might develop gastrointestinal discomfort or gas. Taking magnesium with it can help to avoid constipation. Calcium carbonate is 40% elemental calcium. 1000 mg will provide 400 mg of calcium. However, supplement labels will usually indicate how much calcium is present in each serving, not how much calcium carbonate is present.
- Antacids frequently contain calcium carbonate, and are a commonly used, inexpensive calcium supplement.
- Coral calcium is a salt of calcium derived from fossilised coral reefs. Coral calcium is composed of calcium carbonate and trace minerals.
- Calcium citrate can be taken without food and is the supplement of choice for individuals with achlorhydria or who are taking histamine-2 blockers or proton-pump inhibitors. Calcium citrate is about 21% elemental calcium. 1000 mg will provide 210 mg of calcium. It is more expensive than calcium carbonate and more of it must be taken to get the same amount of calcium.
- Calcium phosphate costs more than calcium carbonate, but less than calcium citrate. Microcrystalline Hydroxyapatite (MH) is one of several forms of calcium phosphate used as a dietary supplement. Hydroxyapatite is about 40% calcium.
- Calcium lactate has similar absorption as calcium carbonate, but is more expensive. Calcium lactate and calcium gluconate are less concentrated forms of calcium and are not practical oral supplements.
- Calcium chelates are synthetic calcium compounds, with calcium bound to an organic molecule, such as malate, aspartate, or fumarate. These forms of calcium may be better absorbed on an empty stomach. However, in general they are absorbed similarly to calcium carbonate and other common calcium supplements when taken with food. The "chelate" mimics the action that natural food performs by keeping the calcium soluble in the intestine. Thus, on an empty stomach, in some individuals, chelates might, in theory, be absorbed better.
A study investigating the effects of personal calcium supplement use on cardiovascular risk in the Women’s Health Initiative Calcium/Vitamin D Supplementation Study (WHI CaD Study) found a modestly increased risk of cardiovascular events, particularly myocardial infarction in postmenopausal women. A broad recommendation of calcium/vitamin D supplements is therefore not warranted.
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