Calcium supplements

It is unlikely for anyone to not want a ‘healthy body’. Bones form the framework of the body and are very much vital for healthy living.  

Calcium renders strength to the bones. It is crucial to meet the daily requirements of calcium to maintain bone health and prevent adverse effects.  

Calcium supplement comes to aid when the diet cannot provide the required calcium. People who are vegan and have weak bones also benefit from supplement intake.

Calcium

Calcium is one of the minerals in the human body known for the vital functions it performs. It is most commonly linked with strong bones and teeth in addition to helping in the regulation of normal heart rhythms, blood clotting, nerve functions and muscular contraction.  

Types of Calcium supplements

Calcium is available in the form of calcium supplements, multivitamin-mineral supplements and supplements containing calcium and other minerals like vitamin D.  

The two most common calcium supplements include calcium carbonate and calcium citrate.  

Calcium sulphate, calcium lactate, calcium ascorbate, calcium phosphate, calcium microcrystalline hydroxyapatite and calcium gluconate are some of the other calcium forms found in supplements and fortified foods.

Calcium carbonate

Calcium carbonate is calcium in a concentrated form. It is found in certain over-the-counter antacids. These are inexpensive and low-cost sources of calcium.  

Each calcium pill contains at least 200 milligrams of calcium. Since stomach acid is required for calcium carbonate absorption, it’s ideal for taking this supplement with food.  

They provide the same amount of calcium in a smaller tablet than calcium citrate supplements. Caltrate, Os-Cal, Viactiv Calcium Chews and Tums are some well-known calcium carbonate products.

Calcium citrate

Calcium citrate is a bulkier form of calcium. This is a more expensive calcium supplement.

Calcium citrate is better absorbed on a full stomach or an empty stomach. Calcium citrate is more easily absorbed by people with less stomach acid than calcium carbonate. This is most common among the elderly.   

However, calcium citrate contains only 21% calcium. To meet the daily requirements, additional tablets have to be taken. Citracal and GNC Calcimate Plus 800 are two calcium citrate supplements.

Why does the body need calcium?

Calcium is beneficial to the overall health of a person. Most cells in the body utilise calcium. Muscles, the heart, bones and the nervous system are a few places where the body utilises calcium.  

Apart from providing support for the body, the bones also store calcium. Calcium is required for bone and teeth strengthening.  

They also play a vital role in:

• enzyme function
• muscle contraction and relaxation
• blood clotting
• heart functioning
• message transmission in the nervous system

Daily intakes of calcium

The following data is the Recommended Daily Allowance (RDA) of calcium provided by ICMR – National Institute of Nutrition (NIN), 2020.

AGE GROUP	CALCIUM (mg/d)
Infants (0 – 12 months)	300
Children (1 – 3 years)	500
Children (4 – 6 years)	550
Children (7 – 9 years)	650
Boys and Girls (10 – 12 years)	850
Boys and Girls (13 – 15 years)	1000
Boys and Girls (16 – 18 years)	1050
Men	1000
Women	1000
Pregnant woman	1000
Lactating woman	1200

What are the best ways to get adequate calcium?

Calcium is best obtained through food sources. Eating a wide variety of meals from all food groups can serve the purpose of providing adequate calcium. Also, adding calcium-rich foods to the diet can help meet the requirements.  

When a diet doesn’t render the needed calcium, calcium supplements can be taken with the advice of a doctor. Calcium can be consumed in the form of a pill or a multivitamin tablet.  

Good sources of calcium

There exist various natural foods with the high calcium content. Consuming these foods along with vitamin D rich foods is beneficial as vitamin D enhances the absorption of calcium.  

Milk

Milk is a popular food source of calcium. Current markets have many modified types of milk, such as lactose-free milk and skimmed milk. A range of health benefits has been linked to milk and other dairy products.

Cheese

The majority of cheeses are calcium-rich, with hard cheese containing a high amount of the mineral. Also, calcium from dairy products is more easily absorbed by the body than calcium from vegan sources, making it preferable.  

Yoghurt

Yoghurt cultures ferment lactose, a natural sugar found in milk. These are used to manufacture yoghurt.  

It is best known for having a high calcium content, which is essential for strong teeth and bones. It is said that 49% of daily calcium requirements can be met with one cup of yoghurt intake.  

Green leafy vegetables

Leafy vegetables like broccoli, spinach, collards and cabbage are found to be calcium-rich. Calcium in broccoli is better absorbed in comparison to spinach due to the presence of oxalate in them, which inhibits calcium absorption.  

Kale

An article from foodunfolded.com suggests that kale has 250 milligrams of calcium per 100 grams which is substantially higher than that of milk. Other green vegetables, such as collard greens, are also high in calcium.

Chinese cabbage

Chinese cabbage is regarded as the king of calcium. They are loaded with easily absorbable calcium.  According to the Indian Food Composition Table (IFCT), NIN 2017, Chinese cabbage provides 58 milligrams of calcium per 100 grams, with a 54 percent absorption rate. This makes it the vegetable with the highest calcium content.

This is particularly one of the best options for lactose intolerant people or those who do not consume a lot of dairies.

Fortified cereals

Many foods are fortified with vitamins and minerals in order to ensure that people get enough calcium.

Calcium can be added to breakfast cereals, orange juice, bread and plant-based milk replacements (such as soy).  

Few countries have made it mandatory to fortify all flours with calcium.

Tofu

Tofu is manufactured by coagulating soy milk, which is usually done using calcium sulphate. The finished product has a remarkable 680 milligrams of calcium per 100 grams, as provided by foodunfolded.com.

Nuts and seeds

Almonds are the richest source of calcium among nuts. Other nuts like walnuts, Brazil nuts and hazelnuts are also good sources that can be a part of the diet.  

According to IFCT NIN, 2017, white sesame seeds provide roughly 1664 mg of calcium per 100g, making them one of the most calcium-rich seeds.

It goes without saying that nuts and seeds are excellent sources of vegan calcium.

Calcium dosage

It is always safe to follow the recommendations of a doctor for consuming the required calcium dosage.

A health care practitioner may suggest starting with 500 milligrams per day for a week. It is best to gradually increase the calcium supplement dosage.

Calcium consumption can be spread throughout the day. Taking more than 500 milligrams at a time is not recommended since calcium is best absorbed when taken in little doses of 500 milligrams or less.  

A calcium supplement of 1000 milligrams can be split and taken twice a day as it’s best to take it in lesser quantities.

Who should consider calcium supplements?

People who cannot achieve the recommended allowance for calcium through food sources may require supplementation. Calcium supplementation becomes necessary when a person is/has

Vegan

Vegans must consume a sufficient amount of calcium since plant-based foods are lower in calcium than animal foods.  

There are also issues with calcium absorption from plant-based foods, so there are concerns about vegans getting enough calcium.

When foods don’t provide sufficient calcium, a doctor should be consulted for taking a low-dose calcium supplement to make up the difference.

Lactose intolerant

Getting enough calcium throughout one’s life is critical for bone development and maintenance. The number of lactose-free, calcium-rich dietary choices is limited. This may predispose lactose sensitive individuals to poor calcium consumption. Calcium supplements may be provided to compensate for the low calcium intake.

On a high protein diet

The potential acid loads and the acidogenic impact of different dietary proteins vary substantially. Due to its acidogenic composition, a meal rich in proteins produces excessive calcium loss. Calcium supplement aid in overcoming calcium loss.  

Weak bones 

Bones are made dense and strong with regular calcium intake. Low bone density can result in brittle and fragile bones. It is a known fact that fragile bones are more prone to break more easily even if there is no injury. Calcium supplements, along with vitamin D can boost calcium absorption in the body.

On corticosteroid treatments  

Corticosteroids impair the body’s ability to absorb calcium while also speeding up bone breakdown. The chances of developing osteoporosis are greater when a person is on these medications for a longer time. Patients who are starting steroid treatment may benefit from additional calcium supplementation.

Bowel or digestive diseases  

Calcium deficiency is a problem for people with inflammatory bowel disease (IBD), which can lead to bone loss in extreme cases. Calcium shortage can occur in persons with IBD due to an inability to absorb adequate calcium.  

Malabsorption is usually seen in individuals with Crohn’s disease. People with diseases like Ulcerative colitis and Crohn’s disease may be unable to consume milk, a prominent calcium source.  

Corticosteroids like Prednisone taken to treat IBD interferes with calcium absorption leading to calcium loss.  

Calcium supplements may be recommended by a healthcare professional to avoid deficiency.

Side effects of taking extra calcium 

Too much calcium in the blood can weaken the bones, cause kidney stones and disrupt the functioning of the heart and brain.  

The risk of heart problems is high with excess calcium. This happens when the calcium from supplements deposits as fatty plaques in the arteries. Arteries are blocked by plaques, limiting the blood flow to the heart muscles.

Bloating and gas 

Calcium carbonate may cause acid rebound, in which the stomach produces additional acid to compensate for the high dose of alkaline calcium carbonate. Acid rebound can lead to bloating and gas in the stomach.

People who have had stomach ulcers in the past may need to switch to calcium citrate to prevent this.

Constipation

Calcium supplements are said to possess a modest binding effect. They seldom cause constipation on their own. Problems arise when another supplement that binds the stool is taken along with it, causing constipation.

How to prevent side effects

It is not recommended to take extra calcium supplementation without a doctor’s prescription.  

Drink more fluids

Plenty of water and fluid intake can help soften stools and encourage bowel movements. This can increase the amount of water in the colon. Constipation caused due to supplement intake may be relieved by increasing water consumption.

Eat high fibre foods 

Dietary fibre softens and increases the size of the stool. Constipation is less likely if the stool is thick and easy to pass. Eating foods high in fibre can help prevent constipation.  

Switch to another form of calcium

Calcium citrate doesn’t require stomach acid for absorption, making it more easily available to the body. Calcium carbonate can cause troubles and side effects. It can be switched to calcium citrate to manage the problem.  

Conclusion

Calcium is a significant mineral that performs various functions in the body. Calcium is widely known for its role in bone strengthening.  

With the availability of calcium supplements, it is easier to meet the daily requirement of the mineral. These are of great advantage to vegans, people with bowel diseases and other individuals who experience calcium loss.  

However, a doctor consultation is necessary before starting with the supplementation to get the right dosage prescription and to prevent side effects.

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