What are the Benefits of Calcium Pills

Calcium: how much do we really need?

Dipl. Oec. troph. Karin Maier

Over nine million packs Calcium supplements go over the counters of German pharmacies every year. There are also offers from drugstores and supermarkets. The fear of osteoporosis and the advertising of the pharmaceutical companies make many people resort to an extra portion every day. Do we really need that much of the mineral, or can an excessive intake of calcium even be harmful?

Calcium: important for bones, teeth and more

Calcium is of the greatest importance for the human organism. Together with phosphorus, it is the most important building material for bones and teeth. 99 percent of all calcium in our body is in these hard tissues. The rest is dissolved in blood and tissue. The calcium ions fulfill vital tasks there: They are crucial for blood clotting, the excitability of nerve and muscle cells and stabilize the cell walls.

As message transmitters within the cells, they also activate numerous enzymes. Because calcium ions are required for many processes in the body, the organism keeps the calcium level in the blood within very narrow limits. This is achieved through a complex interplay of various hormones, primarily parathyroid hormone, vitamin D hormone (calcitriol) and calcitonin. Estrogens, androgens, thyroid and growth hormones, cortisol and insulin are also involved. If too little calcium is supplied, the organism falls back on its emergency reserve, the bone tissue. Then, under the influence of parathyroid hormone, calcium ions are released from the bones to prevent the blood level from falling. In this way, bone substance is lost in the event of a persistent lack of calcium.

Preventing calcium deficiency - how much calcium is necessary?

On average, we excrete 300 milligrams of calcium every day in urine, stool and sweat. This loss must be compensated for through food. The German Nutrition Society recommends 500 milligrams of calcium per day for infants and 900 for adults. People with an increased need should consume more: adolescents in the growth phase and pregnant women 1200 milligrams and breastfeeding women even 1300 milligrams daily. These recommendations take into account that the body only absorbs 20-40 percent of the calcium it contains from a mixed diet. The use of the mineral is therefore by no means optimal. How much we actually ingest depends on several factors: age, gender, current calcium requirement, hormonal balance and the composition of the food promote or inhibit calcium absorption. For example, infants absorb 75 percent of the minerals from breast milk, and men generally utilize dietary calcium better than women. Certain substances in plants such as phytic and oxalic acid form poorly soluble complexes with calcium and impair absorption.

An important partner of calcium: vitamin D.

Vitamin D plays the decisive role in the absorption of calcium, without which it is not possible to absorb it as required. Few foods, such as butter and oily fish, make a contribution to vitamin D supply. Exceptionally, in the case of vitamin D, humans are not exclusively dependent on food: the vitamin is formed in the skin from a precursor formed in the body when there is sufficient sunlight. The actual active form of the vitamin, the vitamin D hormone, is then produced in the kidneys. The hormone causes a protein to be formed in the intestinal wall, which transports the calcium ions from the intestine into the blood. If there is a vitamin D deficiency, less calcium is absorbed, with serious consequences for bone mineralization. If children do not take in enough vitamin D or do not produce enough vitamin D, this leads to bone deformation, known as rickets.

Ratio of calcium and phosphorus

The ratio of calcium and phosphorus in the diet is also important for good calcium utilization. Phosphorus or phosphate is absorbed up to 60 percent and is superior to calcium in this respect. If significantly more phosphate than calcium is consumed, the phosphate content of the blood increases. As the body tries to maintain a balanced calcium-phosphorus ratio in the blood, it mobilizes calcium from the bones to compensate for the imbalance. In addition, the absorption of calcium is reduced by having a lot of phosphate in the diet. The phosphate content of food should therefore not be significantly higher than that of calcium. This is not a problem with a balanced, natural diet. However, due to today's eating habits with a lot of meat and sausage, ready-made products and soft drinks, more phosphate is often consumed than calcium.

1000 mg calcium are contained in:

100 g whole wheat pasta
30 g parmesan cheese
250 g broccoli
20 g poppy seeds
100 ml buttermilk

1000 mg calcium
or 200 g yogurt
30 g almonds
200 g whole wheat bread
35 g Emmentaler
200 g fennel

1000 mg calcium

With the right food selection, it is not a problem, even without tablets, to the recommended amount of around one gram of calcium daily get. Even an increased need can be met with food and suitable drinks.

Calcium from pills or through food?

You take easily soluble calcium salts, acidulants, sugar substitutes and sweeteners, a little color and aroma - and the mineral tablet is ready. Calcium carbonate, lactate or gluconate are often used, with a rate of absorption of 30 percent. Fortified fruit juices usually contain calcium citrate malate, which is somewhat more readily available due to its acidity. Sorbitol, a sugar substitute found in many sweets, on the other hand, reduces the utilization of calcium and causes stomach cramps and diarrhea in some people. To get enough calcium, you don't have to have that much chemistry.

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Milk and dairy products such as yoghurt and kefir are the most important sources of calcium in our diet, with a content of around 120 milligrams per 100 grams. At the same time, other ingredients such as lactose, vitamin D, lactic acid and proteins promote the absorption of the mineral. The bioavailability from these foods is therefore very good at 30 percent. The same applies to cheese, which, depending on how it is made, can contain up to 1200 milligrams of calcium per 100 grams. Hard and semi-hard cheeses are particularly rich in calcium. Plant-based foods also make a contribution to the calcium supply, which can be quite considerable with a targeted selection of calcium-rich vegetables. The mineral is generally used less well from plants; the resorption rate is usually below 20 percent. Plant substances such as oxalic and phytic acid from vegetables, cereals and seeds also reduce the availability. Another liquid calcium source should not be underestimated - mineral water. Calcium is here in ionized form, in which the organism can easily absorb it. From a content of 150 milligrams per liter, mineral water can be called calcium-rich.

Calcium supply for vegans: You can also do it without milk

Even those who delete dairy products from the menu for health, ideological or other reasons do not automatically have to take the calcium tablet. However, alternative calcium suppliers such as kale, broccoli, almonds, sesame and calcium-rich mineral water should be incorporated into the diet to a greater extent.

Calcium deficiency in vegans - critical in young children

A consumption survey showed that vegans who do not eat any animal foods consume the least calcium in comparison to mixed dieters and lacto-ovo-vegetarians. Deficiencies were observed in individual cases, but most vegans were adequately cared for. Presumably, an increased absorption rate and a low protein intake (see below) contribute to a positive balance. The vegan diet of small children, who often only achieve 50 percent of the recommended calcium intake, is to be assessed very critically. Just like children who cannot tolerate dairy products because of a milk protein allergy, they should also receive calcium. For infants and toddlers, low-allergen special foods based on soy or cow's milk, which are enriched with calcium and other nutrients, can be given. Soy drinks and milk without added calcium are not an equivalent substitute for cow's milk because their calcium content is too low. Calcium-rich mineral water and fortified fruit juices can also increase the intake. But be careful with allergies: some of these juices contain milk protein. Therefore, allergy sufferers should definitely pay attention to the list of ingredients. If children reject the somewhat bitter milk substitute food and vegetables containing calcium, it is advisable to meet their needs with a low-dose calcium supplement under medical supervision.

Lacto-ovo vegetarians are best supplied with calcium

The supply of lacto-ovo vegetarians, who also consume milk, dairy products and eggs, is completely different. Here the calcium intake is usually above the recommended value. They are also better supplied than the average population, who mostly does not get enough calcium. Fears that the high fiber content of the vegetarian diet could worsen the calcium supply were not confirmed. Both vegetarian diets also have the advantage that they contain less protein than a mixed diet. The lower protein intake reduces the excretion of calcium via the kidneys, so it has a saving effect. Conversely, a high protein intake causes more calcium to be excreted and thus worsens the balance.

Calcium: protection against osteoporosis?

The fear of osteoporosis is believed to be the main reason many people become too Calcium supplements Especially women after the menopause, but also men of older age are affected by this disease. In osteoporosis patients, the bone breaks down faster than normal and becomes more prone to fractures. However, whether a high calcium intake really helps against osteoporosis is a matter of debate in science. Many studies speak for the benefit of increased intake, others doubt its effectiveness. However, one thing seems certain: the estrogen deficiency that occurs after menopause triggers rapid breakdown of bone substance. In the first five to seven years after the last menstruation, this process cannot be slowed down by a high calcium intake alone. Calcium administration only has a positive effect at a later point in time, which means that bone loss can be slowed down. However, this effect can also be achieved with calcium from food. A daily intake of 1000 to 1500 milligrams is crucial.

The real importance of calcium lies in prevention

Those who take in sufficient calcium from childhood on, mineralize their bones optimally. After the age of 30, no additional calcium is incorporated. Rather, the body then feeds on the cushion that has formed up to that point. Osteoporosis is also promoted by inadequate physical activity. A lot of exercise outdoors, so that vitamin D can be formed at the same time, is just as important as a sufficient supply of calcium.

Calcium preparations for calcium deficiency: Beware of self-medication

Calcium supplements are medicinal products and should not be swallowed lightly - especially not as a tasty soft drink, which some suppliers advise on the packaging. They are only required in certain situations and for some clinical pictures. Lies a Calcium deficiency before, the eating habits should be examined first. If an additional supply proves necessary, the dosage and duration must be discussed with the doctor.

An uncontrolled, excessive calcium intake can do more harm than good. It worsens the absorption of iron, zinc and magnesium and can lead to an undersupply of these important nutrients. If more than 1500 milligrams of calcium are consumed per day, the body excretes the excess with the urine. This can promote the formation of kidney stones and calcifications, especially in people with a corresponding predisposition or impaired kidney function. According to research, the risk of kidney stones only increased when Calcium as a preparation was taken. In contrast, high levels in the diet reduced the risk. This astonishing result leads the authors to the positive influence of certain substances such as z. B. back phosphate, which are contained in dairy products. In the event of a prolonged overdose of vitamin D and a simultaneous high calcium intake of more than 2000 milligrams per day, the natural absorption barrier is overcome, and an oversupply, known as hypercalcemia, can occur. The consequences range from loss of appetite to impaired consciousness and even coma.

Anyone who thinks they are insufficiently supplied with calcium and may have muscle cramps from time to time should consult a doctor. Self-medication based on the motto "a lot helps a lot" is not advisable in any case. Often, mineral pills are just a convenient way to avoid having to change any of your beloved but wrong habits. A healthy lifestyle and diet is the best guarantee for taking in sufficient calcium and protecting yourself against osteoporosis - side effects or deficiency symptoms are excluded.

LITERATURE:
CURHAN, G. et al. Comparison of dietary calcium with supplemental calcium and other nutrients as factors affecting the risk for kidney stones. In: Annals of Internal Medicine 7, Vol. 126, pp. 497-503, 1997
DAWSON-HUGHES, B. et al .: A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women. In: The New England Journal of Medicine, pp. 878-883, 1990
FEIEREIS, H .; SALLER, R. (Ed.): 275 new, as yet unpublished questions and answers from practice. Volume 3, Munich 1992
KASPER, H .: Nutritional medicine and dietetics. 7th edition, Urban and Schwarzenberg, Munich 1991 LEITZMANN, C .; HAHN, A .: Vegetarian Diet. UTB, Stuttgart 1996

Source: Maier, K .: UGB-Forum 5/97, pp. 285-288

This article is taken from the UGB archive.

We would like to point out that the content may have to be re-evaluated due to new scientific findings.