~ 052207 Majority of Americans Fail to Meet Calcium Requirements

The May, 2007 issue of the American Journal of Clinical Nutrition published the finding of researchers from the Program on Prevention Outcomes and Practices at Stanford University that despite well publicized recommendations concerning the need for calcium to aid in osteoporosis prevention, 60 percent of a sampling of Americans fail to receive an adequate intake.

Jun Ma, Rachel A. Johns, and Randall S. Stafford analyzed data from the 1999 to 2002 National Health and Nutrition Survey (NHANES), which involved 5,094 men and 5,760 women aged 19 and older. The current study included 4,477 men and 5000 women for whom there was reliable dietary data. Daily calcium intake was calculated from the results of dietary interviews provided by the participants. Supplemental calcium intake was estimated from the subjects’ intake of prescription and nonprescription supplements, and calcium-containing antacids.

Just forty percent of the study population was found to meet age-specific national calcium adequate intake levels, and less than half of the participants reported using calcium supplements. Participants who were at low as well as high risk of osteoporosis were more likely to have adequate intake levels than those at moderate risk, although those at moderate risk were more likely to use calcium supplements than subjects at low risk. Men, ethnic minorities, and individuals who did not graduate from high school were more likely to have inadequate calcium intake and were less likely to use calcium supplements. Using supplements increased the odds of meeting the adequate intake recommendation by a factor of four compared with nonusers.

The authors acknowledged that men and minorities have been underrepresented in osteoporosis clinical trials and interventions. “Targeting men and ethnic minorities of moderate and high osteoporosis risk to increase their calcium consumption through diet, or through diet and supplements when necessary, is an important consideration," they observe.

“Our results show that, overall, most US adults do not meet daily calcium adequate intake levels through diet alone, and that, among those taking supplements, supplemental calcium is often inadequate to overcome the deficits between dietary intake and the recommendations," the authors conclude. “Our finding of lower calcium consumption among men, ethnic minorities, and the socioeconomically disadvantaged than in their respective counterparts supports the Surgeon General’s call for including these subpopulations, along with the traditionally targeted older white women, among the priority populations in bone health improvement interventions."

Related Health Concern: Osteoporosis

Many studies have shown that calcium can reduce bone loss and suppress bone turnover. Calcium intake is a foundation of osteoporosis prevention (Kasper DL et al 2005). Calcium requires the presence of vitamin D for maximum absorption.

Although calcium is readily available in dairy products and other dietary sources, many Americans are calcium deficient. There are a few possible explanations for calcium deficiencies:
  • Decreased vitamin D availability, possibly due to kidney or liver problems or insufficient exposure to sunshine (ultraviolet radiation)
  • Decreased gastrointestinal tract absorption due to stomach or intestinal problems
  • Increased loss of calcium from the kidneys
  • Increased loss of calcium from the colon and bowels
  • Low dietary calcium intake
  • Medications that inhibit calcium absorption
There are many forms of calcium on the market, including the common calcium carbonate, calcium gluconate, and calcium citrate. Of these, calcium citrate is the most easily absorbed and a good way to receive supplemental calcium.

It may also turn out that not only is supplementation vital to preventing and treating osteoporosis but that the timing of the supplementation is important. For example, in a study of healthy volunteers, two doses of 500 mg calcium and 400 IU vitamin D taken six hours apart produced a more prolonged decrease in serum parathyroid hormone levels (low levels of which indicate adequate calcium levels) than a single dose with the same total amounts of calcium and vitamin D.

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