Rumor on the Internet: Will calcium deficiency increase fat and cause obesity? Pharmacist: A comparison of three major categories of calcium supplements

Do you often suffer from insomnia and short temper? Osteoporosis showing up early? Be careful of the above signs, which indicate that you are lacking in calcium! Recently, it has been widely circulated on the Internet: "Calcium deficiency may cause fat accumulation and lead to obesity." According to the report on changes in the national nutritional health status, more than 90% of people have problems with insufficient calcium intake. Does calcium deficiency really cause weight gain? What other harms does calcium deficiency bring to your health? Which one is better absorbed, animal calcium or plant calcium?

Calcium is the most abundant mineral in the human body and the main component of bones. Calcium plays a key role in cell signaling pathways throughout the body. Calcium is also necessary for vasoconstriction and vasodilation, blood coagulation, muscle contraction and muscle relaxation, as well as neurotransmission and hormone secretion.

Complications of calcium deficiency in the human body: osteoporosis, poor sleep, emotional instability, and rapid heartbeat

Pharmacist Zhao Shunrong, chairman of the Taiwan Preventive Health Association and a master of pharmacy, said that if the human body lacks "calcium", in addition to problems with the growth and development of bones and teeth, osteoporosis and rickets, there will also be hyperactivity, excitement, poor sleep, emotional instability, neurosis (calcium can calm the nervous system), rapid heartbeat (calcium can help the heart muscle regulate signals), as well as imbalance in body fluid concentration and cramps.

Most of the calcium is stored in the bones before the age of 20. After the age of 20, it will continue to be stored in the bones at a slower rate, reaching its peak at the age of 30 to 35. After the age of 35, the bones will begin to become thinner and more fragile with the increase of age, especially after middle age, especially in post-menopausal women, the rate of bone destruction exceeds the rate of formation, resulting in bone loss, which will increase the risk of osteoporosis over time. Men usually develop a decade slower, and once bone loss is severe and bone strength weakens, the chance of fractures increases.

To combat childhood obesity, calcium and vitamin D micronutrients need to be supplemented appropriately

In addition, the outside world has recently begun to discuss that "calcium deficiency will cause fat accumulation and obesity". What is the truth? Pharmacist Zhao Shunrong pointed out that obesity is a major health problem worldwide, especially in developed countries. The World Health Organization (WHO) reports that childhood obesity is on the rise internationally. According to the results of literature search, vitamin D and calcium are negatively correlated with childhood obesity. Therefore, supplementation of these two micronutrients is necessary when combating childhood obesity.

Calcium deficiency in the human body can cause problems with bone and tooth growth and development, osteoporosis, and rickets, as well as hyperactivity, excitement, poor sleep, emotional instability, neurosis (calcium can calm the nervous system), rapid heartbeat (calcium can help the heart muscle regulate signals), imbalance in body fluid concentration, and cramps.

Pharmacist Zhao Shunrong searched the literature from 2001 to 2014 and found that 216 studies on the topic of obesity were published in countries including the United States, Portugal, Brazil, and South Korea (91 of which explored "calcium" and 125 explored "vitamin D"). Sixty-five of these articles were selected based on title relevance to studies on body adiposity or the relationship between calcium or vitamin D and obesity in children.

Summary Key Points: The concentration of 25(OH) D circulating in the human blood is considered the best indicator of systemic vitamin D stores. The association between 25(OH) D concentration and obesity is mainly due to the fact that in addition to being converted into active vitamin D in the kidneys to produce endocrine effects, circulating 25(OH) D can also be converted into active vitamin D in other organs, tissues and cells through 1α-hydroxylase, which further produces autocrine and regulated secretion effects through the vitamin D receptor (VDR). However, prospective studies on the role of vitamin D supplements are still uncertain about their impact on obesity treatment. However, vitamin D deficiency is associated with cardiac and metabolic risks in obesity.

American Endocrine Society: Increasing calcium intake can reduce weight and fat mass

Calcium plays an important role in regulating many other biological activities, including muscle building, neurotransmitter release, hormone secretion, lipid and glycogen metabolism, adipocyte proliferation and differentiation, and body weight homeostasis. In 2014, the American Endocrine Society proposed the "Effect of Calcium Supplementation on Weight and Fat Reduction in Women". Data showed that a diet lacking calcium is associated with higher body weight, and increasing calcium intake can reduce weight and fat mass. However, pharmacist Zhao Shunrong still believes that this argument still needs more clinical evidence.

Calcium intake increases serum calcitriol levels, which can increase intracellular calcium levels and regulate lipogenesis and lipolysis, resulting in reduced body fat accumulation. A close link between calcium and vitamin D in lipogenic metabolism was demonstrated. The mechanism between calcium and weight regulation is still under study. It is generally believed that it is related to the accelerated circulation of vitamin D and parathyroid hormone (PTH) in the body. When calcium intake is insufficient and blood calcium concentration decreases, the circulation of vitamin D and parathyroid hormone (PTH) in the body will accelerate, causing the concentration of vitamin D and PTH in the blood to increase, which will promote the expression of genes that produce fat and inhibit fat decomposition, thus causing the accumulation of fat cells, weight gain and other obesity symptoms.

Additionally, vitamin D supplementation may help people with obesity and severe vitamin D deficiency lose weight, according to research presented at the 2015 European Congress on Obesity in Prague. Dr. Luisella Vigna and her team at the University of Milan in Italy analyzed data from 400 obese or overweight patients from 2011 to 2013. The researchers concluded: Current data show that in obese and overweight groups with vitamin D deficiency, vitamin D supplements can help reduce weight and enhance a low-calorie diet.

In addition to their auxiliary effects in combating childhood obesity, calcium and vitamin D are also essential nutrients for strong bones.

Eat the right calcium foods to avoid stepping on landmines

Reminder: It is also important to eat the right calcium foods in order to truly supplement calcium. Pharmacist Zhao Shunrong said that the possible causes of calcium absorption and stone problems include:

1. Milk: May combine with other ingredients in calcium tablets.

2. Some astringent vegetables contain oxalic acid, such as spinach, amaranth, bamboo shoots and other vegetables. Oxalic acid in the intestine

It can combine with calcium to form insoluble precipitates, affecting calcium absorption.

3. The National Academy of Sciences of the United States pointed out that excessive calcium intake can cause constipation and may interfere with the absorption of iron and zinc.

High calcium intake from calcium supplements, rather than food, can increase the risk of kidney stones.

4 The New England Journal studied 36,282 healthy menopausal women aged 50-79 and found that taking vitamin D3 ≤ 400 IU + calcium 1000 mg would increase the risk of kidney stones. In 2013, the New US Preventive Services Task Force (USPSTF) proposed that "supplementation with 400 IU of vitamin D3 and 1000 mg of calcium appears to increase the risk of kidney stones."

In addition to their auxiliary effects in combating childhood obesity, calcium and vitamin D are also essential nutrients for strong bones. Pharmacist Zhao Shunrong explained that when a low dose of 400 IU or a high dose of 800 IU of vitamin D is used together with calcium, the mechanism of action and benefits of the two are different. The Osteoporosis Society of the Republic of China recommends that adults between the ages of 19 and 50, including pregnant or breastfeeding women, need to supplement 1,000 mg of calcium, 800 IU of vitamin D, 200 mg of magnesium, zinc, and B complex every day. These five "bone calcium nutrients" are key supplements for those who need to maintain bone health and can effectively prevent osteoporosis and falls.

The key to preventing osteoporosis: balanced nutrition and moderate exercise

Prevention is better than cure. Paying attention to calcium intake and exercising to strengthen bones is the most effective way to prevent osteoporosis. The key to preventing osteoporosis still depends on the following two key points:

1. Balanced nutrition:

According to the 2015 Taiwan Osteoporosis Prevention and Treatment Consensus and Guidelines: In daily diet, you can adopt a Mediterranean diet, rich in colorful plants, large amounts of beans, fish, plus low-sugar, low-fat dairy products and moderate consumption of some high-calcium foods, such as cheese, beans, dark green vegetables, sesame, golden needles, seaweed, kelp, black fungus, shiitake mushrooms, dried fish, hair algae, etc., and take calcium and vitamin D supplements when necessary.

(ii) Appropriate exercise:

Exercise can promote blood flow and endurance to bones, thereby increasing bone density, and can improve the body's coordination and reduce the chance of falls or injuries. Appropriate "weight-bearing exercise", such as walking, brisk walking, cycling, ball games, Tai Chi, etc.; especially outdoor sports, through sunlight exposure, can activate vitamin D and help calcium absorption.

Prospective studies of the role of vitamin D supplementation in obesity remain inconclusive, although vitamin D deficiency is associated with cardiovascular and metabolic risks in obesity.

Animal calcium is not as nutritious as plant calcium

What is the difference between animal calcium and plant calcium? What are the risks of taking the wrong calcium? Pharmacist Zhao Shunrong said that in terms of nutrients, animal calcium is not only inferior to plant calcium, but may also be dangerous. Because multiple studies have shown that a diet high in protein leads to more calcium loss through urine. And some dairy products contain high levels of estrogen and antibiotics to maintain low bacterial levels, which may increase the risk of prostate cancer, ovarian cancer, and breast cancer.

Large intake of plants containing calcium can reduce osteoporosis and increase bone density in postmenopausal women. However, there are still exceptions. Some vegetables, such as spinach, contain a large amount of oxalate, which will affect the effective absorption of calcium.

Plant sources of calcium:

Green leafy vegetables: such as kale, broccoli, parsley, and radishes.

Fortified foods: Such as soy milk, white flour, whole-wheat flour, oats, tofu, figs, and blackstrap molasses.

Pharmacist Zhao Shunrong said that in order to correctly prevent osteoporosis and achieve the so-called "bone protection", vitamin D + calcium must be effective! The main function of vitamin D in "bone protection" is to assist in the conversion of "calcium". Because vitamin D can promote calcium absorption in the small intestine, maintain appropriate blood calcium and phosphorus concentrations, allow normal bone mineralization, and prevent muscle cramps caused by hypocalcemia. Therefore, it is an essential nutrient for bone development. It can maintain bone health and muscle function and prevent osteoporosis.

In 1993, the FDA approved a health claim for calcium and osteoporosis for foods and supplements. In January 2010, this health claim was expanded to include vitamin D to include the following: Adequate calcium throughout life, as part of a balanced diet, may reduce the risk of osteoporosis, and Adequate calcium and vitamin D as part of a healthy diet, together with physical activity, may reduce the risk of osteoporosis later in life.

Plant sources of calcium: Green leafy vegetables such as kale, broccoli, parsley, and radish.

[Comparison of 3 major calcium supplements]

Pharmacist Zhao Shunrong explained that if you do not get enough calcium in your diet, you may need calcium supplements. The main ingredients are: calcium carbonate (Calcium carbonate), calcium citrate (Calcium citrate) and calcium phosphate (Calcium phosphate), which are the most common calcium compounds.

Calcium carbonate

Calcium carbonate is the most commonly used. It can achieve the best effect when taken with meals or after meals when gastric acid secretion is high to increase the dissolution and absorption of calcium. According to the United States Pharmacopoeia, calcium carbonate has the highest calcium content at 40%. However, when using higher doses, constipation is more likely to occur. It is best to take magnesium (Mg) in combination to help bone cells absorb and utilize calcium. Clinical research evidence shows that a calcium to magnesium ratio of 2:1 can improve calcium absorption and utilization. This not only effectively helps bone cells absorb and utilize calcium, but also reduces the risk of kidney and urinary tract stones.

Calcium citrate

Calcium citrate is better absorbed and is more suitable for patients with low gastric acid secretion or those taking stomach medicine. However, its calcium content is 21%, which is lower than that of calcium carbonate. Therefore, you may need to take 2-3 times more than calcium carbonate to reach the daily intake recommended by medicine.

Calcium phosphate

Calcium phosphate may cause side effects such as gastrointestinal problems, nausea, indigestion, diarrhea, or constipation. It is not recommended for use by the elderly or those with poor kidney function.

When purchasing calcium supplements, you should pay attention to the calcium content and the source of the calcium. It is best to take a dose of < 500 mg each time to maximize absorption, because intestinal calcium absorption decreases as the dose load increases. In addition, when purchasing calcium tablets, in addition to looking at the main ingredients and total dosage, you should also pay attention to whether the actual effective calcium content (the elemental calcium content) is indicated.

Pharmacist Zhao said that in terms of absorption rate, calcium phosphate is about 25%, calcium carbonate is about 27%, and calcium citrate is 35%. When people buy calcium supplements, they should pay more attention to the calcium ion content and source. The elemental calcium content and total calcium tablet dosage refer to different calcium qualities. According to the calcium element ratio data of the United States Pharmacopoeia, calcium carbonate is 40%, calcium citrate is 21%, calcium lactate is about 13%, and the calcium content of calcium gluconate is only 9%. For example, if calcium carbonate is labeled as 500 mg, the actual calcium content is only 200 mg. If calcium citrate is labeled as 500 mg, the actual calcium content is only 105 mg. Therefore, a larger dose is needed to obtain the recommended amount of calcium.