Calcium requirements: new estimations for men and women by cross-sectional statistical analyses of calcium balance data from metabolic studies

Hunt, Curtiss D.; Johnson, LuAnn K.

doi:10.1093/ajcn/86.4.1054

Cited by 107 publications

(93 citation statements)

References 31 publications

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“…In a large series of calcium balance studies, Hunt and Johnson reported that neutral calcium balance occurred at a much lower calcium intake (741 mg/d) than reported by Heaney and colleagues, and also was not altered by age or sex (89). Although longer than previous studies (each balance study had a minimum duration of 16 days), nevertheless these studies still may not be long enough for adaptation to a change in calcium intake.…”

Section: Later Researchmentioning

confidence: 83%

Calcium supplementation in osteoporosis: useful or harmful?

Chiodini

Bolland

2018

European Journal of Endocrinology

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Osteoporosis and fragility fractures are important social and economic problems worldwide and are due to both the loss of bone mineral density and sarcopenia. Indeed, fragility fractures are associated with increased disability, morbidity and mortality.It is known that a normal calcium balance together with a normal vitamin D status is important for maintaining well-balanced bone metabolism and for many years calcium and vitamin D has been considered crucial in the prevention and treatment of osteoporosis. However, recently the usefulness of calcium supplementation (alone or with concomitant vitamin D) has been questioned, since some studies reported only weak efficacy of these supplementations in reducing fragility fracture risk. On the other hand, besides the gastrointestinal side effects of calcium supplements and the risk of kidney stones related to use of coadministered calcium and vitamin D supplements, other recent data suggested potential adverse cardiovascular effects from calcium supplementation.This debate article is focused on the evidence regarding both the possible usefulness for bone health and the potential harmful effects of calcium and/or calcium with vitamin D supplementation.

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Section: Later Researchmentioning

confidence: 83%

Calcium supplementation in osteoporosis: useful or harmful?

Chiodini

Bolland

2018

European Journal of Endocrinology

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“…All of these values, from 300 mg daily during the third trimester to 120 mg daily during late lactation, may seem achievable given normal intake of calcium and normal efficiency of intestinal calcium absorption. However, fractional calcium absorption is normally ϳ25% of intake in healthy adults who consume adequate calcium (420). If normal efficiency of intestinal calcium absorption were relied upon, pregnant women would have to consume an extra 1,200 mg/day during the third trimester, whereas lactating women would have to consume an extra 800 mg daily during the first 6 mo and 480 mg daily during the second 6 mo.…”

Section: Introductionmentioning

confidence: 99%

Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

Kovacs

2016

Physiological Reviews

359

524

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During pregnancy and lactation, female physiology adapts to meet the added nutritional demands of fetuses and neonates. An average full-term fetus contains ϳ30 g calcium, 20 g phosphorus, and 0.8 g magnesium. About 80% of mineral is accreted during the third trimester; calcium transfers at 300-350 mg/day during the final 6 wk. The neonate requires 200 mg calcium daily from milk during the first 6 mo, and 120 mg calcium from milk during the second 6 mo (additional calcium comes from solid foods). Calcium transfers can be more than double and triple these values, respectively, in women who nurse twins and triplets. About 25% of dietary calcium is normally absorbed in healthy adults. Average maternal calcium intakes in American and Canadian women are insufficient to meet the fetal and neonatal calcium requirements if normal efficiency of intestinal calcium absorption is relied upon. However, several adaptations are invoked to meet the fetal and neonatal demands for mineral without requiring increased intakes by the mother. During pregnancy the efficiency of intestinal calcium absorption doubles, whereas during lactation the maternal skeleton is resorbed to provide calcium for milk. This review addresses our current knowledge regarding maternal adaptations in mineral and skeletal homeostasis that occur during pregnancy, lactation, and post-weaning recovery. Also considered are the impacts that these adaptations have on biochemical and hormonal parameters of mineral homeostasis, the consequences for long-term skeletal health, and the presentation and management of disorders of mineral and bone metabolism.

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“…In our study this can be achieved easily with calcium supplements of 1000 mg/d in 12% of the patients with lowest baseline calcium intake and with 500 mg/d in 56% of the patients with moderate baseline calcium intake, while 31% did not need calcium supplementation. It is of interest that cross-sectional studies show that a neutral calcium balance is achieved at an intake of 741 mg/day of calcium [15]; and that, if vitamin D serum levels are adequate, the need of total calcium intake would be lower than 1000 mg/d [44]. However, such hypotheses still need to be tested prospectively.…”

Section: Need Of Calcium and Vitamin D In Patients After A Recent Framentioning

confidence: 99%

“…Therefore, medical therapy is advocated in fracture patients at high risk of subsequent fractures, including drug therapy and adequate intake of calcium and vitamin D [9][10][11][12][13]. Regardless of fracture history, calcium intake is low in subjects older than 50 years, in the elderly and in patients with osteoporosis [14][15][16]. Vitamin D insufficiency (serum 25(OH)D concentration <50 nmol/l) is endemic worldwide [17] and is frequently present in patients with osteoporosis, with or without a fracture [18][19][20][21][22][23][24][25][26][27][28][29][30][31].…”

Section: Introductionmentioning

confidence: 99%

Need of Calcium and Vitamin D in Patients after a Recent Fracture

Bergh¹,

Shab-Bidar²,

Bours³

et al. 2012

FNS

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Adequate calcium and vitamin D intake is advocated in guidelines of osteoporosis. However, the dosage needed to achieve an optimal calcium intake and vitamin D status is still a point of debate. Of 902 consecutive patients older than 50 years presenting at the time of fracture, 502 were evaluable for measurement of calcium intake and serum 25(OH)D concentration. We calculated the percentage of patients who needed calcium supplements to achieve intake of 1000 mg/d and who needed cholecalciferol supplementation to achieve serum levels of 50 nmol/l. Calcium intake ranged between 250 and 2050 mg/d and serum 25(OH)D between <10 and 130 nmol/l. A combination of calcium intake of ≥1000 mg/d and serum 25(OH)D concentration of 50 nmol/l was present in 11% of patients. To achieve 1000 mg/d of calcium, 57% of patients needed supplementation of 500 mg/d and 12% needed 1000 mg/d. Systematic calcium supplements of 500 mg/d would achieve an intake of 1000 mg/d in 88%. To achieve serum 25(OH)D concentrations of 50 nmol/l, 41% of patients needed a supplement of 800 IU D3/d and 25% needed higher doses. Systematic supplementation of 800 IU/d would achieve 50 nmol/l in 75% of patients. Calcium intake and vitamin D status vary considerably between fracture patients. Conclusion: calcium supplements need to be titrated individually to achieve desirable levels. Most patients achieved 50 nmol/l of 25(OH)D with 800 IU D3/d. Prospective studies are needed to study how to achieve and maintain optimal serum vitamin D levels and adequate calcium intake.

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Calcium requirements: new estimations for men and women by cross-sectional statistical analyses of calcium balance data from metabolic studies

Abstract: The findings suggest that the calcium requirement for men and women is lower than previously estimated.

Cited by 107 publications

References 31 publications

Calcium supplementation in osteoporosis: useful or harmful?

Calcium supplementation in osteoporosis: useful or harmful?

Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

Need of Calcium and Vitamin D in Patients after a Recent Fracture

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