Category Archives: Calcium

What’s the Ideal Calcium Intake Level?

Posted on March 2, 2020 | Comments Off on What’s the Ideal Calcium Intake Level?
paleo diet, Steve Parker MD,calcium, osteoporosis

That milk mustache is a tell-tale sign she’s not eating pure paleo

I don’t know, and I’m not sure anybody knows.

The biggest concern about inadequate calcium consumption is that your bones will be weak and brittle, leading to fractures.

Dr Harriet Hall at Science Based Medicine reviewed a New England Journal of Medicine article written by Drs Willets and Ludwig on the health effects of milk.

From Dr Hall:

I was surprised to learn that the US recommendations for milk consumption were based on small, flawed studies of calcium balance. Other countries recommend lower levels of calcium intake. The US recommends 1000–1200 mg for adults, the UK 700 mg, and the World Health Organization, 500 mg. Counterintuitively, countries with high milk and calcium intake actually have the highest rates of hip fracture. Clinical trials of calcium for fracture prevention are complicated, because of confounding factors like vitamin D, phosphorous, and adult height. High calcium intake during childhood and adolescence was thought to serve as a way to “bank” calcium, but studies have not supported that hypothesis. In fact, men’s risk of hip fracture increased by 9% for every additional glass of milk consumed during adolescence.

Source: Milk and Health: The Evidence – Science-Based Medicine

Paraphrasing Churchill’s comments on Russia, ideal calcium consumption is “a riddle, wrapped in a mystery, inside an enigma….”

Steve Parker, M.D.

PS: Use the search box at upper left for my other posts on calcium.

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Are Calcium Supplements Safe?

Posted on February 18, 2017 | Comments Off on Are Calcium Supplements Safe?

 

Death in a bottle?

Death in a bottle?

Monica is a smart and media-savvy nutritionist who brought me on board as a blogger at NutritionData many years ago. Click the link below for her surprising conclusion on calcium supplementation.

Monica writes:

“The National Osteoporosis Foundation published a new report this week, insisting that calcium supplements are safe for your heart. Two weeks ago, Johns Hopkins cardiologist Erin Michos published a paper saying the opposite.

She claims that the NOF review (which was funded by a pharmaceutical company that makes calcium supplements) omitted certain studies (such as the ones she included in her own review) that might have changed the conclusion.

These are just the latest two volleys in a five-year-long tennis match between experts on whether you should or shouldn’t take calcium supplements.  And you thought politics was divisive.”

Source: Calcium Supplements: Safe or Not?

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Worried About Inadequate Calcium on Your Paleo Diet?

Posted on January 27, 2014 | 1 comment

Bix at Fanatic Cook has a post on calcium and dairy consumption as regards to protection against broken hips from thin bones (osteoporosis). Or rather the lack of protection!

I’ve worried before that most paleo diets could be deficient in calcium because they don’t include milk products. Osteoporosis in adults or inadequate bone growth in kids are about the only significant problems you might see if that’s the case.

Bix quotes Harvard professor and pediatrician Dr. David Ludwig:

“Humans have no nutritional requirement for animal milk, an evolutionary recent addition to diet. Anatomically modern humans presumably achieved adequate nutrition for millennia before domestication of dairy animals, and many populations throughout the world today consume little or no milk for biological reasons (lactase deficiency), lack of availability, or cultural preferences.

Adequate dietary calcium for bone health, often cited as the primary rationale for high intake of milk, can be obtained from many other sources. Indeed, the recommended levels of calcium intake in the United States, based predominately on balance studies of 3 weeks or less, likely overestimate actual requirements and greatly exceed recommended intakes in the United Kingdom.

Throughout the world, bone fracture rates tend to be lower in countries that do not consume milk compared with those that do. Moreover, milk consumption does not protect against fracture in adults, according to a recent meta-analysis.”

Read the whole enchilada.

Another article mentions Dr. Ludwig:

People with a high-quality diet — those who get adequate protein, vitamin D and calcium from things like leafy greens, legumes, nuts and seeds — may get little or no added nutritional benefit from consuming three servings of dairy a day, Ludwig argues.

Hmmm. Wonder how he feels about grains. Sounds paleoish so far.

I’m just about ready to stop worrying about calcium.

Steve Parker, M.D.

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Low Calcium Intake May Not Matter for Bone Health

Posted on December 12, 2013 | Comments Off on Low Calcium Intake May Not Matter for Bone Health
paleobetic diet, diabetic diet, calcium

Modern “films” are digital

I’ve worried about the relatively low calcium content of most paleo diets. I see lots of little old ladies eating non-paleo with hip, spine, and wrist fractures related to the bone-thinning disease called osteoporosis. The bones break because they’re not adequately dense. Some experts think low calcium intake causes osteoporosis.

A Vietnamese study published in 2009 compared bone density of Buddhist nuns, who are vegans, with omnivorous controls. Dietary calcium content was 330 mg/day in the vegans, 682 mg/day in the omnivores. Nevertheless, bone density and osteoporosis prevalence were not significantly different between the groups. (Unfortunately, fracture rates were not reported.)

So perhaps the relatively low calcium content of paleo diets isn’t anything to worry about.

Steve Parker, M.D.

h/t Jamie Scott

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CavemanDoctor On Calcium Consumption and Osteoporosis

Posted on August 7, 2013 | Comments Off on CavemanDoctor On Calcium Consumption and Osteoporosis
paleo diet, Steve Parker MD,calcium, osteoporosis

I worry about her bones 50 years hence

I’ve fretted here before about possible inadequate calcium intake on typical paleo diets. Colin Champ, M.D., otherwise known as CavemanDoctor, has a way around it. A quote summarizes his ideas:

“In Review:

  1. Calcium levels and bone health are multifactorial and calcium intake is just the tip of the iceberg.
  2. Don’t count on dairy for calcium and instead get it naturally in highly absorbable forms in the foods nature laid out for you.
  3. Instead, avoid foods that result in decreased absorption and increased excretion of calcium like milk.
  4. Get some sun (not sun burns) or if that is not possible, take some vitamin D3.
  5. Lift heavy weights and sprint as the heavy loads stimulates bone mineralization and decrease bone breakdown.
  6. Avoid chronic stress and the increase in glucocorticoids that results.
  7. Increase your highly absorbable sources like green leafy vegetables, and decrease poorly absorbable sources like milk, and avoid its downside with its large amounts of lactose (sugar).
  8. Avoid large amounts of carbohydrates that cause significant insulin release and calcium loss in the urine.”

Read the rest.

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Maybe We Don’t Need as Much Calcium As We Think

Posted on June 20, 2013 | Comments Off on Maybe We Don’t Need as Much Calcium As We Think

I’ve worried about the relatively low calcium amounts provided by most paleo diets.  Maybe I shouldn’t. Fanatic Cook Bix has a new post about various calcium absorption mechanisms in our bodies. If intake is low, certain mechanisms kick in, allowing us to absorb more than is usual. I quote:

So, someone who is eating less than 400 mg – which is half the recommended amount (the DRIs are 800-1000 mg/day, some groups recommend up to 1300 mg) – may, all else being equal, end up with a similar calcium status as someone eating 1000 mg or more because an active transport mechanism kicks in at lower intakes. As well, more calcium may be absorbed from the colon.

Calcium is not unusual in this regard. Absorption of nutrients is often higher when intake is low, and vice versa. Zooming in on one nutrient, in this case calcium, and fretting over whether we’re “getting enough” has a downside if it leads to taking supplements. Many nutrients compete for intestinal absorption, e.g. zinc supplements have been shown to substantially reduce calcium absorption. And, it should be said, what the body doesn’t absorb goes out with the feces.

It may be better to focus on eating a variety of minimally processed foods than to focus on discrete nutrients, and let the body take care of itself.

Read the rest.

At any given time, I usually have at least one little old lady on my hospital service who has fallen and fractured her hip, wrist, pelvis, or humerus (arm bone that’s part of the shoulder). Nearly always she has the bone-thinning disease called osteoporosis, which may be related to calcium consumption. If we can prevent osteoporosis with diet and exercise, that’s much preferable to dealing with the fractures.

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Too Much Calcium May Be Worse Than Too Little

Posted on April 6, 2013 | 1 comment

I’ve been fretting that the paleo diet may not provide enough calcium to keep aging bones strong. On the other hand, the writer(s) at the Joslin Diabetes Blog point out that too much calcium may promote cardiovascular disease.

The February, 2013, issue of British Medical Journal has a pertinent research report. The Joslin blogger writes:

Participants were women from a mammography cohort who were asked about their calcium consumption, using a food frequency questionnaire, at baseline and seven-to-ten years later. The 61, 433 women were followed for a period of 19 years. During that time, 6894 participants died of cardiovascular disease or stroke. The researchers found that the women taking over 1400mg of calcium per day had a higher incidence of cardiovascular disease. Participants whose calcium consumption remained within suggested bounds, between 600mg and 1000mg per day, did not appear to have a greater vulnerability to cardiac disease.

Read the rest.

I confess I haven’t read the BMJ article.

I always wonder about overall death rates when I see results like this. A group may have higher or lower rates of cardiovascular disease, and yet live longer than the comparison group. An intervention could prevent cardiovascular disease and cardiovascular death, yet increase the incidence of death from infection, cancer, accidents, or suicide, etc.

I bet a lot of adults eating a paleo-style diet approach or exceed 600 mg a day of calcium. I’m feeling better about the calcium in paleo diets. But I don’t want to have to depend on feelings.

The Joslin blogger notes that, “Perhaps it is time to have a conversation with your health care provider to determine what the best dose of calcium is for you.” Problem is, I’m not sure any healthcare provider really knows the best “dose” of calcium for the average person, whether supplemental or dietary calcium.

Sorry, men. These findings may or may not apply to you. At least you don’t have to worry about osteoporosis nearly as much as women.

Steve Parker, M.D.

PS: In case you hadn’t run across it elsewhere, note that taking a calcium supplement without a concomitant vitamin D supplement may be more harmful than taking calcium with vitamin D.

 

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A Paleo Problem: Calcium

Posted on April 3, 2013 | 17 comments
paleo diet, Steve Parker MD,calcium, osteoporosis

I worry about her bones 50 years hence

It appears difficult to meet the Recommended Dietary Allowance (RDA) for calcium while eating most versions of the paleo diet.  That’s because they don’t include milk products.  The Linus Pauling Institute at Oregon State University has a review of calcium as related to nutrition and health, last updated in late  2010. They say that few Americans hit their recommended daily calcium goal.

I see lots of little old ladies with hip and other fractures related to osteoporosis. Trust me, you don’t want to go there. It’s difficult to reverse osteoporosis, an insidious process that’s been going on for decades before the fracture.

Osteoporosis may be related to years of inadequate calcium consumption. Adequate vitamin D is  an important part of the equation, too. Blood calcium levels are strictly regulated, and if they’re too low, calcium is pulled from the bones to fill the blood’s tank.

Broccoli and bok choy are fair sources of calcium, but pale in comparison to milk. Bok choy isn’t a part of my diet; I’m not even sure I’ve ever had it. Below is a video on bok choy cooking. Looks simple enough.  I need to look into kale, too.

Many paleophiles promote bone broth, but I haven’t figured out why yet. Is it high in calcium? (Hat tip to Wendy Schwartz for the word “paleophile”.)

A can of sardines looks like a good source of calcium: 350 mg or 35% Daily Value.

Can you help me worry less about calcium deficiency?

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