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How much calcium do we need?

MagazineFebruary 2010 (Vol. 20 Issue 11)How much calcium do we need?

It was at a June 1994 conference that the US National Institutes of Health (NIH) recommended as much as 1500 mg of calcium daily for women over 50 who aren't taking oestrogen

It was at a June 1994 conference that the US National Institutes of Health (NIH) recommended as much as 1500 mg of calcium daily for women over 50 who aren't taking oestrogen. Yet, as Dr Robert P. Heaney of Creighton University in Omaha, NE, pointed out, the amounts of sodium and protein in the diet affect the amount of calcium needed.
When the diet is low in sodium and protein, the daily calcium require-ment for an adult female may be no higher than 450 mg, which is closer to the amount recommended by the World Health Organization (WHO), and an amount easy to obtain from a diet of beans, grains and vegetables, with small amounts of animal foods-what most traditional peoples around the world have historically eaten.
Hip fracture rates in many developing countries are much lower than in the West, even though calcium intakes in those countries are typically lower. In South Africa, rural Bantu women have one-tenth the hip fractures of Caucasian women, yet they consume only half the calcium (250-400 mg daily, even into their ninth decade). In Gambia, the average daily calcium intake is 360 mg, yet bone fractures are again rare.
As the proportions of calcium, sodium, protein and other nutrients in the diet vary greatly from culture to culture, and from person to person, it must be concluded that there is no single, universal calcium requirement applicable to all individuals (Am J Clin Nutr, 2000; 71: 1381-3).
The popular belief that insufficient calcium is unhealthy for the bones often encourages excess supplementa-tion. According to Nan Kathryn Fuchs, a PhD in nutrition who edits the Women's Health Letter, too much calcium encourages calcium deposits in soft tissues such as the joints, arteries, kidneys, muscles and brain, and contributes to kidney stones and gallstones (Women's Health Letter, December 2003). Too much calcium can also increase the risk of cardiovascular mortality (Exp Opin Emerg Drugs, 2007; 12: 355-65), and supplementation has been associated with a higher incidence of heart attack and stroke in postmeno-pausal women (Nainggolan L. Calcium supplements increase vascular events? 2008; www.medscape.com/ viewarticle/569160).
Sue Hitzmann, an exercise physiol-ogist teaching in New York who also performs cadaver dissections, men-tioned in a class that an older woman she had dissected the week before had calcium deposits throughout her body. "We find calcium deposits in many layers of the body . . . not just near the bones like you would see in a bunion, but in the connective tissue layers and in between joints," she wrote to me in an e-mail in 2007.
Interestingly, a 2005 study in Japan found that calcium and mag-nesium deposits in the ligaments of the neck increased progressively with age (Biol Trace Elements Res, 2005; 103: 217-28).
What these deposits show, I believe, is that the excess calcium that people consume, whether from dairy or supplements, often ends up in areas other than where it's wanted-in the bones.
Excess calcium also makes the bones more brittle, which makes sense, as calcium provides hardness and density, but not flexibility. It is flexibility, provided by collagen or protein, that keeps bones from breaking. Bones that are high in calcium, and so proportionately lower in collagen, can shatter with a blow. In a recent study, calcium supplements were associated with doubling of the risk of hip fractures, and use of a popular brand of calcium antacids led to a 70 per cent higher risk of fore-arm fractures (Am J Epidemiol, 1997; 145: 926-34).
Excess calcium out of its natural context-supplements-causes other problems, too. Muscle contraction, important for, among other things, the regular beating of the heart, depends on mineral balance. When excess calcium disrupts this balance, it can cause the abnormal heart rhythms and chest pain of heart disease, which is often treated with calcium-channel blockers. According to Ruth Winter, a medical writer and author of many books, calcium supplements and calcium-based medications can cause stomach bleeding, nausea, vomiting, excessive thirst or abdominal pain, and should be used with extreme caution by people with heart or kidney disease.
Looking at only a small part of the picture (a single nutrient like calcium) and losing sight of the whole (mineral and nutrient balance, and the effects of supplements and dairy foods) can have unexpected out-comes. Nature protects us from imbalances by building checks and balances into foods. An excess of calcium creates a relative deficiency of magnesium, and may cause symptoms associated with those deficiencies. We also need magnesium and vitamin D to absorb calcium properly.
The key is to consume calcium within its natural context, together with magnesium and all the other nutrients it naturally co-occurs with. That is how our bodies are meant to absorb and utilize all nutrients. Whenever we take one nutrient out of context and consume large amounts of it, we become relatively deficient in all the other nutrients that assist in its assimilation.
As naturopathic physician Alex Vazquez, former adjunct professor of orthopaedics and rheumatology at Bastyr University, has written, nutritional effectiveness "depends on synergism of diet, lifestyle, exercise, emotional health, and other factors".
This is wise counsel. Give it careful consideration before you rush into buying a bagful of one-size-fits-all supplements.
Annemarie Colbin
This has been adapted from Dr Colbin's book Whole-Food Guide to Strong Bones: A Holistic Approach (Oakland, CA: New Harbinger Publications, 2009).


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