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Developed in conjunction with The American Academy of Family
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Association, and The National Medical Association.
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Dairy Council Digest Archives
Making the Most of Calcium: Factors Affecting Calcium Metabolism
Summary
New government guidelines recommend increased dietary calcium intakes for most Americans. Unfortunately, few Americans consume sufficient calcium, thereby increasing their risk for major chronic diseases such as osteoporosis.
Calcium nutrition is affected by the total amount of calcium consumed and its bioavailability. Dietary factors that influence intestinal calcium absorption and renal calcium excretion play important roles in determining the amount of dietary calcium needed by the body. In addition, a variety of nondietary factors (e.g., age, genetics, gender, hormonal status, smoking, disease, and medications) influence an individual's need for calcium.
Among dietary factors, calcium, vitamin D, and fiber have been most extensively examined for their effect on calcium absorption. Vitamin D promotes calcium absorption and helps the body adapt to a low calcium intake.
Vitamin D is obtained from exposure to sunlight. Major dietary sources of this vitamin include cod liver oil, fatty fish, and fortified foods such as milk and cereal.
Dietary fiber is very heterogenous in nature and generally has small effects on calcium absorption, with a few exceptions. High oxalate vegetables such as spinach decrease intestinal calcium absorption, whereas low oxalate vegetables such as kale have no effect on calcium absorption.
Protein, phosphorus, sodium, and potassium influence calcium metabolism by affecting urinary calcium excretion. High dietary protein intake clearly induces renal calcium loss. However, the impact of this phenomenon on bone health appears to be small at best. There is no evidence that protein-rich foods such as dairy foods adversely impact calcium balance or bone health. The presence of calcium, phosphorus, and potassium in dairy foods or in the diet may counterbalance the calciuretic effect of protein. Both dietary phosphorus and potassium reduce urinary calcium excretion and an adequate intake of calcium offsets calcium loss due to urinary excretion.
Like protein, sodium intake raises urinary calcium excretion. The typically high intake of protein and sodium in the U.S. contributes to the higher average calcium requirements in this country compared to other nations where intake of these nutrients is much lower. When consumed in moderate amounts, lactose, caffeine, and alcohol intake have little effect on calcium metabolism.
Calcium recommendations can be met by consuming foods naturally rich in calcium such as dairy foods. Dairy foods also provide other essential nutrients which can improve the overall nutritional quality of the diet. Further, it has been demonstrated that increasing calcium intake through dairy foods can be easily done without increasing calorie or fat intake, body weight, or percent body fat.
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