Calcium

Warning: "These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease." "Calcium, the twentieth chemical element on the periodic table of elements, is a silver, crystalline alkaline earth mineral that is critically important to the human body and also the most commonly found dietary mineral in a human being. Nearly two percent of human body weight is made up of calcium, with 98 percent found in bones, one percent in teeth, and one percent in muscles, the blood, and nerve pathways" (Haas, n.d.). "The body needs calcium to maintain strong bones and to carry out many important functions. Calcium is required for vascular contraction and vasodilation, muscle function, nerve transmission, intracellular signaling and hormonal secretion, though less than 1% of total body calcium is needed to support these critical metabolic functions. Calcium is found in some foods, added to others, available as a dietary supplement, and present in some medicines (such as antacids)" (NIH, 2013). As an ergogenic aid, supplemental calcium can also be used for weight loss (Davies, 2000).
 * __ Definition __**

The simplest way to obtain calcium is through your diet. In the United States, almost all individuals get the recommended amount of calcium in their daily diet. Calcium is abundant in many food sources such as dairy products, green leafy vegetables and fish. Listed below are the top 10 products where calcium can be found.
 * __ Sources __**

1. Cheese 2. Yogurt 3. Milk 4. Sardines 5. Dark leafy greens like spinach, kale, turnips, and collard greens 6. Fortified cereals such as Total, Raisin Bran, Corn Flakes (They have a lot of calcium in one serving.) 7. Fortified orange juice 8. Soybeans 9. Fortified soymilk (Not all soymilk is a good source of calcium, so it's best to check the label.) 10. Enriched breads, grains, and waffles (Web MD, 2015).

Below is a table that lists common food types and milligrams of calcium per serving that people can reference to consider which foods are best for meeting their daily calcium needs (Dietary, 2012). The table is provided by the Office of Dietary Supplements - National Institutes of Health (Dietary, 2012).


 * ===__Food Type __=== || ===__Milligrams (mg) per serving __=== ||
 * ====Yogurt, plain, low-fat, 8 ounces ==== || ====415 ==== ||
 * ====Mozzarella, part skim, 1.5 ounces ==== || ====333 ==== ||
 * ====Sardines, canned in oil, with bones, 3 ounces ==== || ====325 ==== ||
 * ==== Yogurt, fruit, low fat, 8 ounces ==== || ====313-384 ==== ||
 * ====Cheddar cheese, 1.5 ounces ==== || ====307 ==== ||
 * ====Milk, nonfat, 8 ounces ==== || ====299 ==== ||
 * ====Soymilk, calcium-fortified, 8 ounces ==== || ====299 ==== ||
 * ====<span style="background-color: #ffff00; font-family: Arial,Helvetica,sans-serif;">Milk, reduced-fat (2% milk fat), 8 ounces ==== || ====<span style="font-family: Arial,Helvetica,sans-serif;">293 ==== ||
 * ====<span style="background-color: #ffff00; font-family: Arial,Helvetica,sans-serif;">Milk, buttermilk, lowfat, 8 ounces ==== || ====<span style="font-family: Arial,Helvetica,sans-serif;">284 ==== ||
 * ====<span style="background-color: #ffff00; font-family: Arial,Helvetica,sans-serif;">Milk, whole (3.25% milk fat), 8 ounces ==== || ====<span style="font-family: Arial,Helvetica,sans-serif;">276 ==== ||
 * ====<span style="background-color: #00ffff; font-family: Arial,Helvetica,sans-serif;">Salmon, pink, canned, solids with bone, 3 ounces ==== || ====<span style="font-family: Arial,Helvetica,sans-serif;">181 ==== ||
 * ====<span style="background-color: #ffff00; font-family: Arial,Helvetica,sans-serif;">Cottage cheese, 1% milk fat, 1 cup ==== || ====<span style="font-family: Arial,Helvetica,sans-serif;">138 ==== ||
 * ====<span style="background-color: #ffff00; font-family: Arial,Helvetica,sans-serif;">Frozen yogurt, vanilla, soft serve, 1/2 cup ==== || ====<span style="font-family: Arial,Helvetica,sans-serif;">103 ==== ||
 * ====<span style="background-color: #ff00ff; font-family: Arial,Helvetica,sans-serif;">Turnip greens, fresh, boiled, 1/2 cup ==== || ====<span style="font-family: Arial,Helvetica,sans-serif;">99 ==== ||
 * ====<span style="background-color: #ff00ff; font-family: Arial,Helvetica,sans-serif;">Kale, raw, chopped, 1 cup ==== || ====<span style="font-family: Arial,Helvetica,sans-serif;">100 ==== ||
 * ====<span style="background-color: #ff00ff; font-family: Arial,Helvetica,sans-serif;">Kale, fresh, cooked, 1 cup ==== || ====<span style="font-family: Arial,Helvetica,sans-serif;">94 ==== ||
 * ====<span style="background-color: #ffff00; font-family: Arial,Helvetica,sans-serif;">Ice cream, vanilla, 1/2 cup ==== || ====<span style="font-family: Arial,Helvetica,sans-serif;">84 ==== ||
 * ====<span style="background-color: #ff00ff; font-family: Arial,Helvetica,sans-serif;">Chinese cabbage, bok choi, raw, shredded, 1 cup ==== || ====<span style="font-family: Arial,Helvetica,sans-serif;">74 ==== ||
 * ====<span style="background-color: #00ff00; font-family: Arial,Helvetica,sans-serif;">Bread, white, 1 slice ==== || ====<span style="font-family: Arial,Helvetica,sans-serif;">73 ==== ||
 * ====<span style="background-color: #00ff00; font-family: Arial,Helvetica,sans-serif;">Tortilla, corn, ready-to-bake/fry, one 6" diameter ==== || ====<span style="font-family: Arial,Helvetica,sans-serif;">46 ==== ||
 * ====<span style="background-color: #00ff00; font-family: Arial,Helvetica,sans-serif;">Tortilla, flour, ready-to-bake/fry, one 6" diameter ==== || ====<span style="font-family: Arial,Helvetica,sans-serif;">32 ==== ||
 * ====<span style="background-color: #ffff00; font-family: Arial,Helvetica,sans-serif;">Sour cream, reduced fat, cultured, 2 tablespoons ==== || ====<span style="font-family: Arial,Helvetica,sans-serif;">31 ==== ||
 * ====<span style="background-color: #00ff00; font-family: Arial,Helvetica,sans-serif;">Bread, whole-wheat, 1 slice ==== || ====<span style="font-family: Arial,Helvetica,sans-serif;">30 ==== ||
 * ====<span style="background-color: #ff00ff; font-family: Arial,Helvetica,sans-serif;">Broccoli, raw, 1/2 cup ==== || ====<span style="font-family: Arial,Helvetica,sans-serif;">21 ==== ||
 * ====<span style="background-color: #ffff00; font-family: Arial,Helvetica,sans-serif;">Cheese, cream, regular, 1 tablespoon ==== || ====<span style="font-family: Arial,Helvetica,sans-serif;">14 ==== ||

Mmmm = seafood Mmmm = grains Mmmm = vegetables ||
 * Mmmm = dairy

__** Recommendations **__

It has been found that almost all individuals in the United States get enough calcium in their diet. If you don't get an adequate amount of calcium in your diet, you could have health problems that are related to weak bones. This may result in children not reaching their full potential height and a low bone mass in adults which can lead to osteoporosis.

How much calcium you need depends on your age and sex. Note that the upper limit in the chart represents the safe boundary — it's not how much you should aim to get. If you exceed the upper limit, you may increase your risk of health problems related to excessive calcium. (Mayo Clinic, 2015)

The following table shows the RDA for specific age groups.
 * <span style="font-family: Arial,Helvetica,sans-serif;">1-3 years: 700 milligrams daily
 * <span style="font-family: Arial,Helvetica,sans-serif;">4-8 years: 1,000 milligrams daily
 * <span style="font-family: Arial,Helvetica,sans-serif;">9-18 years: 1,300 milligrams daily


 * **Calcium: Recommended Dietary Allowance (RDA) for adults** ||
 * **Men** || **Daily RDA** || **Daily upper limit** ||
 * 19-50 years || 1,000 mg || 2,500 mg ||
 * 51-70 years || 1,000 mg || 2,000 mg ||
 * 71 and older || 1,200 mg || 2,000 mg ||
 * **Women** ||  ||   ||
 * 19-50 years || 1,000 mg || 2,500 mg ||
 * 51 and older || 1,200 mg || 2,000 mg ||

<span style="font-family: Arial,Helvetica,sans-serif;">The follow groups of people should take special concern as they are more likely to have trouble getting enough calcium: (NIH, 2013)
 * <span style="font-family: Arial,Helvetica,sans-serif;">**Girls aged 9-18** because they are going through puberty and their bodies are changing rapidly during this time.
 * <span style="font-family: Arial,Helvetica,sans-serif;">**Postmenopausal women** because they experience greater bone loss and do not absorb calcium as well. Sufficient calcium intake from food, and supplements if needed, can slow the rate of bone loss.
 * <span style="font-family: Arial,Helvetica,sans-serif;">**Women of childbearing age whose menstrual periods stop** (amenorrhea) because they exercise heavily, eat too little, or both. They need sufficient calcium to cope with the resulting decreased calcium absorption, increased calcium losses in the urine, and slowdown in the formation of new bone.
 * <span style="font-family: Arial,Helvetica,sans-serif;">People with **lactose intolerance** cannot digest this natural sugar found in milk and experience symptoms like bloating, gas, and diarrhea when they drink more than small amounts at a time. They usually can eat other calcium-rich dairy products that are low in lactose, such as yogurt and many cheeses, and drink lactose-reduced or lactose-free milk.
 * <span style="font-family: Arial,Helvetica,sans-serif;">**Vegans** (vegetarians who eat no animal products) and ovo-vegetarians (vegetarians who eat eggs but no dairy products), because they avoid the dairy products that are a major source of calcium in other people's diets.

There has only really been one study out there that has been proven that calcium can be beneficial for performance. This article states that a supplement of 1,000 mg of calcium is associated with an 8 kg difference in weight (Davies, 2000). However, some of the data in this study is not very clear and farther research needs to be done to establish how significant this finding is.

Since we know that calcium allows for the muscles to contract and be active, some people think that it can be used it as a performance supplement. However, there are no real clear cut studies done that prove that this is true.

The more popular way that this product is used is in preventing osteoporosis or increasing bone density. Studies have found that this supplement is beneficial in those with osteoporosis or older post-menopausal females who may be more susceptible to bone degeneration (Body et al., 2012). We understand that y our body needs calcium to build and maintain strong bones. Your heart, muscles and nerves also need calcium to function properly.Some studies suggest that calcium, along with vitamin D, may have benefits beyond bone health, perhaps protecting against cancer, diabetes and high blood pressure. But evidence about such health benefits is not definitive. (NIH, 2013; Tang et al., 2007).

Besides foods, calcium can also be taken in a supplemental form. The most common form of supplemental calcium is calcium carbonate. This can be found in supplements such as Citrical, Caltrate, other vitamin supplements and even antacids like Tums and Rolaids. Those who supplement with calcium should make sure that they are following the RDA (listed above) and the labeling on the back of the calcium supplement. Calcium supplementation, outside of a healthy diet, is usually not recommended in children under age 18.
 * __ Usage __**

Below are some of the common supplemental brands of Calcium and about how much they would cost if you decided to use them as a supplement.


 * Citracal Calcium Citrate**
 * $11.99 per bottle**
 * 180 capsules**
 * 1 serving = 2 capsules**
 * 1 serving = $0.13**


 * Caltrate 600 + Vitamin D3**
 * $14.99**
 * 200 tablets**
 * 1 serving = 1 tablet**
 * 1 serving = $0.08**


 * Caltrate 600 + Vitamin D3 chocolate soft chews**
 * $6.99**
 * 60 chews**
 * 1 serving = 1 chew (recommended to take 2 daily)**
 * per day (2 servings) = $0.23**


 * Tums Antacid**
 * $6.49**
 * 150 tablets**
 * 1 serving = 2 tablets**
 * 1 serving = $0.09**


 * Rolaids Ultra Strength**
 * $4.18**
 * 150 tablets**
 * 1 serving= 2 tablets**
 * 1 serving = $0.06**

Although it it is not very likely to happen, an excessive amount of calcium in the diet can be potentially dangerous.
 * __ Warnings and side effects __**

Listed below is the tolerable upper intake level (UL) for calcium. Amounts consumed over this level can lead to potential side effects such as gastrointestinal problems.


 * **__Age__** || **__Upper Intake Level__** ||
 * 0-6 months || 1000 mg ||
 * 6-12 months || 1500 mg ||
 * 1-3 years || 2500 mg ||
 * 9-18 years || 3000 mg ||
 * 19-50 years || 3000 mg ||
 * 51 + years || 2000 mg ||


 * Special Precautions & Warnings: **


 * __****<span style="font-family: Arial,Helvetica,sans-serif;">DO NOT TAKE IF on the medication Ceftriaxone (Rocephin) as it dangerously interacts with CALCIUM**** __**
 * <span style="font-family: Arial,Helvetica,sans-serif;">The use of both these supplements simultaneously can result in life-threatening damage to the lungs and kidneys. Calcium should not be administered intravenously within 48 hours of intravenous ceftriaxone. **

The following individuals should take special precautions with calcium intake and extra supplemental forms of calcium:
 * Pregnancy and breast-feeding**: Calcium is LIKELY SAFE when taken by mouth in recommended amounts during pregnancy and breast-feeding. There is not enough information available on the safety of using calcium intravenously (by IV) during pregnancy and breastfeeding.


 * Low acid levels in the stomach (achlorhydria**). People with low levels of gastric acid absorb less calcium if calcium is taken on an empty stomach. However, low acid levels in the stomach do not appear to reduce calcium absorption if calcium is taken with food. Advise people with achlorhydria to take calcium supplements with meals.


 * High levels of phosphate in the blood (hyperphosphatemia) or low levels of phosphate in the blood (hypophosphatemia):** Calcium and phosphate have to be in balance in the body. Taking too much calcium can throw this balance off and cause harm. Don’t take extra calcium without your health provider’s supervision.


 * Under-active thyroid (hypothyroidism**): Calcium can interfere with thyroid hormone replacement treatment. Separate calcium and thyroid medications by at least 4 hours.


 * Too much calcium in the blood** (parathyroid gland disorders and sarcoidosis): Calcium should be avoided if you have one of these conditions.


 * Poor kidney function:** Calcium supplementation can increase the risk of having too much calcium in the blood in people with poor kidney function.


 * Smoking**: Smokers will absorb less calcium from the stomach.

__Possible side effects__: Calcium is generally a safe substance when taken within the recommended amounts. These symptoms may be reversed by eating a meal with the supplement or changing the supplement band that you use. (Web MD, 2015)
 * gas
 * bloating
 * constipation


 * __ Rankings __**


 * Effectiveness:** 3**/5** This product is not dangerous if taken in the correct dosage. However, there are not that many clear cut benefits to performance. Studies on this mineral are more aimed towards bone health/density and strength in older individuals. Most people in the United States get the RDA of calcium just by their daily diet.


 * Cost**: **5/5** As seen above, the price per day of a calcium supplement ranges between $0.06- $0.23. This is a very reasonable price for a supplement, especially for people who may be more prone to a disease leading to a deficiency in calcium or have a diet issue, such as lactose intolerance, that may limit their daily calcium intake.


 * Ease of Use:** **5/5** This mineral can be easily supplemented in a capsule/tablet/pill form, as well as adding more calcium rich foods to your daily diet. There is also a clear cut RDA for each age group for this mineral to ensure proper dosage.


 * Safety**: **5/5** When taken correctly by following the recommendations,there are very minimal gastrointestinal side effects. The danger comes in when someone falls above or below the daily recommendations.


 * Total: 18/20 This supplement is overall a beneficial and relatively safe supplement. It is easy to obtain whether it be in foods or in tablet/capsule form. This mineral is proved to help strengthen our bones as well as help with muscular contractions. The studies done on calcium have found many benefits for postmenopausal women and those susceptible to osteoporosis. However, it has __not__ been clearly proven to be a beneficial ergogenic aid for performance in the athletic population.**

__References__

Body, J.J.,Bergman, P., Boonen, S., Devogelear, J.P., Gielen, E., Goemaere, S., Kaufman, J.M., Rozenberg, S.,Reginster, J.Y. (2012). Extraskeletal benefits and risks of calcium, vitamin D, and anti-osteoporosis medications. //Osteoporosis International,// 23(1), 1-23.

<span style="font-family: Arial,Helvetica,sans-serif;"> Davies, K.M., Heaney, R.P., Recker, R.R., Lappe, J.M., Barger-Lux, M.J., Rafferty, K., & Hinders, S. (2000). Calcium intake and body weight. //The Journal of Clinical Endocrinology & Metabolism//, 85(12), 4635-4638.

<span style="font-family: Arial,Helvetica,sans-serif;"> Dietary supplement fact sheet: calcium - Health professional fact sheet. (2012). Office of Dietary Supplements - National Institutes of Health. Retrieved January 9, 2013, from [].

<span style="font-family: Arial,Helvetica,sans-serif;"> Haas, E.M. (n.d.). Minerals: Calcium. Staying Healthy with Nutrition. Retrieved from []

National Institutes of Health. (2013). Calcium. Retrieved from **[].**

<span style="font-family: Arial,Helvetica,sans-serif;"> Mayo Clinic Staff. (2015). Calcium and Calcium Supplements. Retrieved from <span style="font-family: Arial,Helvetica,sans-serif;">[].

<span style="font-family: Arial,Helvetica,sans-serif;"> Mayo Clinic Staff. (2015). Nutrition and Healthy Eating. Retrieved from <span style="font-family: Arial,Helvetica,sans-serif;">[]**.

<span style="font-family: Arial,Helvetica,sans-serif;">Tang, B., Esgick, G., Nowson, C., Smith, C., Bensoursan, A. (2007). Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. The Lancet, 370(9588), 657-666.

<span style="font-family: Arial,Helvetica,sans-serif;">Web MD. (2015). Find a Vitamin or Supplement. Retrieved from <span style="font-family: Arial,Helvetica,sans-serif;">[].

<span style="font-family: Arial,Helvetica,sans-serif;">Web MD. (2015). Top 10 Calcium Rich Foods. Retrieved from [].

<span style="font-family: Arial,Helvetica,sans-serif;">Web MD. (2015). Vitamins and Supplements Lifestyle Guide. Retrieved from [].