Calcium Pre-reading

PHA 4010
Fall 2014

Calcium
Most abundant mineral in the
body
99% is present is skeleton while
the remaining 1% is present in
extracellular fluid
Functions
Enzyme activation
Vitamin B12 absorption
Muscle contraction and relaxation
Activation of plasma-clotting
factors

Calcium
Providers should evaluate dietary
intake of calcium, including calciumfortified foods, before recommending
daily calcium supplementation
Take a look at the chart in the next
slide which describes recommended
and dietary intakes of calcium in
various age groups

Calcium Intakes NHANES

2003 - 2006 Database
Women
Age
(yrs)

Adequat
e
Intakes

Men

Dietary Supplemen
Intake
t
Use (%)

Adequat
e
Intakes

Dietar
y
Intake

Supplement
Use (%)

19 30

1000

686

34

1000

942

42

31 40

1000

730

43

1000

968

50

41 50

1000

671

47

1000

852

56

51 60

1200

646

50

1000

777

66

61 70

1200

641

53

1000

758

70

71 80

1200

633

56

1200

735

64

> 81

1200

589

54

1200

728

64

J Am Diet Assoc 11;111:687-695

Calcium
Recommendations of calcium intake
is based on elemental calcium, not
the calcium salt. Beware there are
salt forms and different percentages
of elemental calcium in each (see
chart on next slide)

Calcium
Salt

Percent of elemental Ca++

Carbonate

40%

Phosphate

23-39%

Gluconate

9%

Lactate

18%

Citrate

21%

Calcium
Deficiency
Causes

Malabsorption syndromes
Vitamin D deficiency
Renal failure
Long-term anticonvulsant therapy

Results

Rickets
Osteomalacia
Convulsions
Tetany
Personality disorders
Mental retardation

Calcium
Uses
Osteoporosis
Osteomalacia
Rickets
Latent tetany
Dyspepsia
Hyperkalemia
Renal failure
PMS

Calcium
Toxicity
Hypercalcemia

Constipation
Nausea
Vomiting
Anorexia
Polyuria
Kidney stones
Cardiovascular Disease

Bone Healthy Lifestyle

Adequate intakes of calcium from diet
1000 mg per day for men 50 70 years old
1200 mg per day for women > 50 years and men > 71 years old

Adequate intakes and or supplements of vitamin D

800 1000 units (NOF); others higher doses

Exercise
Aerobic, strengthening, and balance
Less bone loss

Cochrane Database Syst Rev. 2011 Jul 6;(7):CD000333

No smoking
Minimal alcohol (< 3 drinks/day)
1 drink/day for women; 2 drinks/day for men

Minimal caffeine
Or additional calcium intake

Assess falls risk and offer modification

Home safety assessment, bifocals, balance exercises,
correct vitamin D deficiency, avoid certain medications
2013 NOF, 2010 AACE, 201 NAMS, 2012 Endocrine Society, 2013