first ask you a few questions: In addition to
may affect height and bone density, what trouble does calcium deficiency have?
Who needs calcium supplements? What can
eat to supplement calcium?
What kind of calcium supplement should I choose? How to eat calcium supplements without waste?
There are many people who have taken calcium tablets, but it is estimated that not many people can answer all these questions.
Let's start with the first question.
Calcium is the most abundant mineral in the human body. Calcium not only constitutes an important element of bones and teeth, but also participates in maintaining a variety of important physiological functions [1], and is also helpful for the prevention of some diseases.
-Calcium is involved in regulating the excitability of nerves and muscles. When calcium is deficient, the mood is prone to anxiety, irritability, shallow and rapid breathing, difficult to relax muscles, easy cramps, and insomnia. .
-Calcium is involved in regulating blood pressure. When there is too much sodium in and insufficient calcium and magnesium, it is difficult to control due to high blood pressure.
-Calcium affects blood coagulation function. Calcium is an activator of many prothrombins, and the clotting process is hindered when severe calcium deficiency occurs.
-epidemiological studies suggest that insufficient calcium intake in may increase the risk of intestinal cancer [2].
-A summary analysis of related studies suggests that when is deficient in calcium, not only the body temperature decreases, the activity of liposynthesis enzymes increases, the blood sugar control ability decreases, and the changes in intestinal flora are also unfavorable to prevent obesity [3].
recently conducted a comprehensive analysis of 8 randomized controlled human intervention studies and found that moderate calcium and vitamin D supplementation with can significantly reduce the blood C-reactive protein level and help reduce the body's inflammatory response [4]. A daily intake of more than 700 mg of calcium and more than 500 international units of vitamin D can play a good role. Z1z
also has a meta-analysis of intervention experiments and found that for overweight and obese subjects, the combined supplementation of calcium and VD can reduce low-density lipoprotein cholesterol (LDL-c) and increase high-density lipoprotein cholesterol (HDL-c). ) Z23z[5].
However, despite the substantial improvement in living standards, the calcium intake of Chinese residents has not increased significantly in the past 30 years, and the degree of insufficient dietary calcium intake is still not optimistic. According to data from the National Nutrition Survey, the average daily calcium intake of Chinese residents was 366.1 mg per day from 2010 to 2012, and was less than half of the recommended intake of 800 mg for adults [6].
So, how can we supplement calcium correctly? We did a solicitation of questions about calcium from netizens, so let's answer them here.
1 Who needs calcium supplementation?
Is calcium deficiency only a problem for the elderly? of course not. People need to prevent calcium deficiency throughout their lives. Here I will sort out the calcium supplementation needs of the whole life cycle.
Infants and young children: Due to the daily consumption of breast milk and infant milk powder during this period, the supply of calcium is not lacking, so calcium supplementation is not required, but vitamin D supplementation needs to be considered. Blind calcium supplementation increases the burden on the kidneys of infants and young children.
Adolescents: As children grow up, the intake of dairy foods in many families has dropped significantly, and they have even stopped consuming dairy products for many years, and the intake of soy products and green leafy vegetables is also very small. These three types of foods are the main sources of high-quality calcium in the Chinese diet. If the intake is not enough, it may lead to insufficient calcium intake in children and adolescents, which affects height development. In particular, the growth and development of adolescents is extremely rapid. The recommended daily calcium for 11-13 year olds is as high as 1200 mg, and 14-17 year olds need to supply 1,000 mg of calcium a day.
If you do not consume enough dairy products, soy products and green leafy vegetables, and do not take calcium supplements, it is difficult to supply sufficient calcium with only three meals. Calcium deficiency may not only cause the height development not to reach the genetic potential, but may even have mild calcium deficiency such as growth pain, weak legs, cramps, and lack of concentration.
during pregnancy: fetal bone formation requires all calcium from the mother. Generally speaking, the calcium requirement increases during pregnancyAdd about 20%, especially for pregnant women in the middle and late stages of pregnancy, the best intake of calcium per day is 1000~1200 mg. Some pregnant women are accompanied by morning sickness, decreased appetite, etc., and their food intake is often insufficient; some pregnant women need to control their food intake due to gestational diabetes or excessive weight gain, which can easily lead to insufficient calcium intake. If it is difficult to meet the body's calcium needs by simply relying on food supplements, it is best to take calcium supplements reasonably under the guidance of doctors and registered dietitians.
Lactation period: breastfed babies all take in calcium from their mother's milk, which shows that mothers need to take in more calcium. And if the mother's diet is insufficient for calcium, she will use the calcium in her bones to supply the baby through milk, laying down hidden dangers for the future health of breastfeeding mothers. How great breastfeeding mothers are, they need more calcium for support.
2 What foods should I eat to supplement calcium?
Dairy products, soy products and green leafy vegetables are the main sources of calcium supplementation in the diet of Chinese residents.
Dairy products: milk, yogurt, cheese and other dairy foods are good foods for calcium supplementation. They have high calcium utilization rate and are convenient to eat. They also contain vitamin D, lactose, essential amino acids, casein phosphopeptides and many other factors that promote calcium utilization.
The chronic lack of calcium intake among Chinese people has a great relationship with the low intake of dairy products. In the long-term farming society, cows and dairy farms are relatively scarce. Except for the nomads, only aristocrats and wealthy businessmen have the opportunity to drink milk. Milk has long been used as a material for making luxury desserts and as a nutrient for the weak. Only in recent decades, milk, yogurt, cheese and other dairy foods have gradually become foods that the general public can enjoy at any time. The
survey on the consumption status of residents' dairy products (including liquid milk, milk powder, yogurt, milk beverages, cheese, condensed milk, etc.) found that in 2015, the rate of drinking milk among residents aged 18-59 in 15 provinces in China was only 16.8% [6, 7]. Based on the 10th round of the "China Health and Nutrition Survey (CHNS)", a study analyzed the dietary data of 9766 middle-aged and elderly residents over 45 years old in 2015. The results found that among middle-aged and elderly residents, dairy consumption The amount is closely related to the intake of dietary calcium. The daily dietary calcium intake of the group that drank the least milk was only 283.8 mg, while the highest group could reach 785.8 mg. Among the elderly who do not consume dairy products, only 1.3% of them meet the recommended daily dietary calcium intake[8]!
Soy products: brine tofu, gypsum tofu, dried tofu, dried tofu, shredded tofu, etc. Both are good sources of calcium and magnesium. But in terms of calcium supplementation, soy milk is completely inferior to milk, and the calcium content of soy milk is only about one-tenth of that of milk. In addition, lactone tofu and yogurt tofu have high water content, and no gypsum or brine is added, and the calcium and magnesium content is relatively low.
Green leafy vegetables: Although a few green leafy vegetables contain more oxalic acid, there are still many vegetables that are high in calcium and low in oxalic acid, such as rape (including small rape, chicken wool), Chinese cabbage, Chinese kale, mustard greens, green leafy cabbage, and turnip And so on, the calcium content is quite considerable. Although amaranth and spinach contain more oxalic acid, as long as they are blanched in boiling water, most of the oxalic acid can be removed. Fortunately, calcium is not soluble in water, so blanched vegetables can still help us with calcium. Besides, green leafy vegetables are rich in magnesium and vitamin K, both of which are very helpful for bone health.
in addition to fish and shrimp with bones and shells, tahini sauce , etc. can also provide calcium. However, their consumption in the diet is relatively small, so the above three types of foods do not contribute much to calcium.
Milky white soups such as "stick bone soup" and "pig's foot soup" cannot supplement calcium. Experiments have shown that after two hours of steaming in a pressure cooker, the fat in the bone marrow has surfaced, but the calcium in the soup is still minimal. If you want to cook the calcium in the bones, you need to use a lot of vinegar instead of water to stew the soup, but at this time the taste of bone soup is difficult for many people to accept.
3 What should be paid attention to when choosing calcium supplements?
If for various reasons, the calcium supply in the diet does not meet the body's needs, you can choose calcium supplements. However, many people are confused: what kind of calcium supplement is better? HereMake a few suggestions.
——The dosage of calcium tablets should not be too large, one tablet of 200~400 mg is better.
The calcium that the human body can absorb and use at one time is not unlimited. When it exceeds 500 mg, the utilization rate will decrease. At the same time, too much calcium can easily cause adverse gastrointestinal reactions and may also cause unstable blood calcium levels. Too much unabsorbed calcium will also combine with fatty acids in the intestines, which can easily cause constipation. Long-term high-dose calcium supplementation may increase the risk of kidney stones. If the daily dietary calcium has reached more than 800 mg, supplementing more than 1,000 mg of calcium tablets every day will even increase the risk of cardiovascular disease [9]. Therefore, a reasonable amount is important!
The dietary calcium intake of Chinese residents is about 400 mg. Choose a calcium supplement containing about 300 mg in one capsule and take it twice a day to achieve a total amount of 800 to 1000 mg per day, and it is not easy to cause adverse reactions .
-People with indigestion, hypoacidity, gastrointestinal sensitivity, suitable for taking organic acid calcium .
The calcium tablets currently on the market mainly include calcium carbonate and calcium citrate. To absorb the calcium in these tablets, people must first release the calcium ions in the compound. Calcium carbonate is most widely used because of its high calcium content and low price. However, calcium carbonate needs to react with gastric acid (hydrochloric acid) to release calcium ions and produce carbon dioxide gas.
Disperse calcium carbonate in 500 ml of water at 37 degrees Celsius, only 1% of calcium can be ionized; at pH 5.5, 86% of calcium carbonate can be dissolved; and at pH 2.5, calcium carbonate can be 100%地 ionization. The solubility of calcium citrate is 17 times that of calcium carbonate [10].
For people with healthy gastrointestinal tract, the acidity of gastric juice during digestion can easily reach a level of 2.5. But for people with weak digestion ability, patients after gastrointestinal surgery, or people who take antacids for a long time, gastric acid is partly consumed by calcium carbonate and produces a lot of gas, which can easily cause bloating and indigestion The side effects of this product hinder the digestion and absorption of nutrients in food and affect human health. This side effect is more obvious when the total amount of calcium carbonate is large.
On the other hand, for people with insufficient gastric acid, some calcium carbonate cannot fully release calcium ions and enters the intestinal tract directly in an insoluble state, while the pH of the small intestine cannot allow calcium carbonate to release calcium ions. As a result, insoluble calcium carbonate may be Irritation of the intestinal mucosa.
In comparison, calcium citrate and other organic acids generally do not cause this trouble. Because they will not react with gastric acid to produce gas, nor will it affect the activation of pepsin and the absorption of other nutrients due to excessive consumption of gastric acid.
——Choose calcium tablets with vitamin D.
Vitamin D is closely related to calcium metabolism. On the one hand, it promotes the absorption of calcium in the small intestine, and on the other hand, it promotes the absorption of minerals by bone, which directly affects the process of bone calcification. In addition, as mentioned earlier in the article, may play a beneficial role in the prevention of a variety of chronic diseases when vitamin D and calcium are combined. Vitamin D in
foods is mainly found in high-cholesterol foods such as liver, egg yolks, fatty fish and cream, and daily intake is less. Without clothing or sunscreen, 7-dehydrocholesterol in the subcutaneous tissue will synthesize vitamin D when human skin is exposed to the sun. So adequate sun exposure is an important condition for the body to obtain vitamin D.
Currently, vitamin D deficiency among Chinese residents is also very common, and many studies suggest that vitamin D deficiency is associated with osteoporosis, lower disease resistance, higher risk of diabetes, higher risk of obesity, and even certain cancers. Risks are associated.
-children, the elderly and other people with weak swallowing ability should choose calcium tablets that are easy to swallow.
Some calcium tablets are too large, or stick to the mouth or throat, inconvenient to swallow, or not easy to slide down in the esophagus, which may cause discomfort during taking. For the elderly and young children with weak swallowing ability, there may also be a risk of choking. If the texture is loose, if the calcium tablet particles are larger, it is advisable to choose a product with a looser texture. You can break it into two halves and take it without sticking to the throat and causing discomfort.
——inTake calcium tablets with or after a meal.
Studies have shown that for people with weak digestion and absorption ability, taking calcium tablets with meals has a higher absorption efficiency than when taking an empty stomach [10]. At the same time, taking it at this time is relatively unlikely to cause gastrointestinal discomfort.
——Do not take large doses of calcium tablets while taking supplements such as iron and zinc.
Also note that too much calcium will hinder the absorption and utilization of trace elements such as iron and zinc. Therefore, when taking iron and zinc supplements, do not take calcium tablets or drink milk at the same time. Consider taking calcium tablets after one meal and taking supplements containing iron or zinc after another meal.
If you are worried about the quality of calcium tablets, you can choose calcium tablets certified by authoritative organizations, such as my country's health food logo, and other countries' nutritional supplement related certifications.
Finally, supplement the right foods and supplement the right calcium tablets, so that the body can really get the benefits of calcium. In addition, don't forget to increase physical exercise and outdoor activities in the sun!
Reference:
1 Chinese Nutrition Society, Chinese Residents' Dietary Nutrient Reference Intake (2013), Science Press, 2014
2 Chinese Nutrition Society, Food and Health-Consensus of Scientific Evidence. People's Medical Publishing House, 2016
3 Gomes JMG, Costa JA, Alfenas RC. Could the beneficial effects of dietary calcium on obesity and diabetes control be mediated by changes in intestinal microbiota and integrity? British Journal of Nutrition, 2015, 114(11):1756-1765
4 Asbaghi O, Sadeghian M, Mozaffari -Khosravi H, et al. The effect of vitamin d-calcium co-supplementation on inflammatory biomarkers: A systematic review and meta-analysis of randomized controlled trials. Cytokine, 2020, 129: 155050
5 Asbaghi O, Kashkoolia S, Choghakhori R, et al. Effect of calcium and vitamin D co-supplementation on lipid profile of overweight/obese subjects: A systematic review and meta-analysis of the randomized clinical trials. Obesity Medicine, 2019, 15: 100124
6 Yu Dongmei, He Yuna, Guo Qiya ,Wait. Energy and nutrient intake status and changing trends of Chinese residents from 2002 to 2012. Health Research, 2016, 45(4): 527-533
7 Huang Feifei, Wang Huijun, Wang Zhihong, Su Chang, Zhang Jiguo, & Zhang Ji et al. (0). Dairy products of residents aged 18-59 in 15 provinces in China in 2015 Survey on the consumption status of its products. The 13th National Nutrition Science Conference of the Chinese Nutrition Society and the Global Chinese Nutrition Scientists Conference.
8 Su Chang, Zhang Bing, Wang Huijun, 2015 China 15 provinces (autonomous regions, municipalities) 45 years and older residents drinking milk Status and its effect on dietary calcium intake, Health Research, 2018, 47(2): 194-198
9 Yang C, Shi X, Xia H, et al. The Evidence and Controversy Between Dietary Calcium Intake and Calcium Supplementation and the Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Cohort Studies and Randomized Controlled Trials. Journal of American College of Nutrition, 2020, 39(4): 352-370
10 Kopic S and Geibel JP. Gastric acid, calcium absorption, and their impact on bone health. Physiology Review, 2013, 93: 189-268
