Supplement Sunday - Calcium
Calcium is the most abundant mineral in the human body. It is not only important for bone health but is crucial in the ability of cells to transmit nerve impulses, muscles to contract and hormones to be released. It is so important to eat enough calcium-rich foods in our diet every day. I have to really watch it, because I have such a strong family history of osteoporosis.
People that are at higher risk for inadequate calcium intake are those that are lactose intolerant (so dairy free) and vegans.
There are also medications that can interfere with absorption like steroids, certain breast cancer drugs called aromatase inhibitors, tetracycline and good old acid reducing medications (eg. Nexium, Prilosec, Protonix etc).
How much do I need a day?
If you are under 50 it is recommended that you have about a 1000 mg a day.
If you are over 50 the recommendation is 1000 mg a day for men, but 1200 mg a day for women.
There is some concern that high calcium intake may be associated with increased risk of prostate cancer and heart disease.The NIH (National Institute of Health) has set the upper tolerable limit (UL) for calcium at 2000-2500 mg per day. This is the absolute total you should get from all sources, including supplements and food.
Most experts recommend trying to meet daily requirements through diet rather than through use of supplements
Calcium rich foods include :
Dairy products - (eg. milk 300 mg /cup, ice cream 100mg/half cup, yogurt 400 mg/cup and cheese about 200 mg/oz )
Vegetables - (eg. Acorn squash, cooked 90 mg/cup, Arugula 125mg/cup, Broccoli 180mg/cup, Kale 55 mg/cup and Spinach 240 mg/cup)
Soy products - (eg. soy milk 200-400 mg/cup, tofu 120-390/4 oz.)
Some fruits - (eg. figs 300/cup, fortified orange juice 300/cup and kiwis 50)
Nuts and Nut products - (eg.almonds 80/oz, Sesame seeds 280/oz, tahini 130/oz. (2 Tbsp), Sunflower seeds 50/oz) There’s actually quite a lot of calcium in almonds, but almond milk contains next to no calcium, as it is lost during the manufacturing process. So many brands offer calcium-fortified almond milk– that means they add extra calcium to the milk.
Legumes - generally 75-80/cup
Fortified cereals and breads
Some fish like Mackerel 250mg/ 3 oz., Salmon, canned, with bones.170 to 210mg/3 oz and Sardines 370mg/3 oz
If you are getting a lot of calcium in your diet you may not need to take a supplement.
Most adults do not need to supplement with more than 300-500 mg a day, if they regularly consume calcium rich foods.
It is also in most multivitamins so count that in your number.
The body can only absorb so much calcium at once, so it is best to divide your dose throughout the day and take it apart from medicines that can interfere with absorption like those mentioned above.
Your health care provider might recommend you take supplements if you have any of the following:
Osteoporosis or a family history of osteoporosis
Obesity
Pre-diabetes
High blood Pressure
Cancer
PMS - Premenstrual syndrome (WHO KNEW?)
Always check with your health care provider to ask how, when and for how long you need to take calcium.
If your health care provider recommends you take a supplemental calcium, there are several preparations. Calcium carbonate is the most widely available, as it is cheap and has the highest proportion of elemental calcium. However, it has been associated with symptoms like gas and bloating.
There are also formulations with calcium gluconate, calcium lactate and calcium phosphate. Do you feel like you are in chemistry class?
Be sure to check the ingredient label carefully, as many products contain high amounts of fillers, additives, artificial sweeteners, and preservatives.
Many products also contain added ingredients like vitamin D, which can help optimize the absorption of calcium. Calcium supplements can be constipating (JOY!), so some brands combine them with magnesium to help with this.
Some calcium supplements have been found to contain measurable amounts of lead. So as in all the other supplements, if you choose to take one, make sure and use a reputable company with independent laboratory analysis. Here is a great short video put out by Consumer lab regarding calcium supplements that they tested:
Some good brands are as follows:
If you hate swallowing big pills, there are chewables:
I like calcium citrate as it is absorbed equally well when taken with or without food and is a form recommended for individuals with low stomach acid (more common in people over 50 or taking acid blockers), inflammatory bowel disease or absorption disorders. It is a little more expensive.
All material gathered and researched through my amazing fellowship program, The Arizona Center for Integrative Medicine.
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