Thursday, February 7, 2019

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How to know if you are taking all the calcium you need every day

Eight out of ten Spaniards do not ingest the recommended amounts of calcium and vitamin D, despite being essential for our bone health.

It is evident that eating a good diet is essential to feel good. However, sometimes, we do not know with precision what products and especially in what quantities they contribute some nutrients and which others. It is well known that milk is an unbeatable source of calcium, as well as proteins, phosphorus and vitamins. Even so, we Spaniards do not take all the calcium we need to be healthy.



Dr. Cannell's Advanced Vitamin D Women's Formula | Purity Products | Fortified with Lutein & Biotin for Healthy Skin & Hair* | 60 Vegetarian Capsules
Dr. Cannell's Advanced Vitamin D Women's Formula | Purity Products | Fortified with Lutein & Biotin for Healthy Skin & Hair* | 60 Vegetarian Capsules




According to experts, the ideal is that on average we consume between 800 and 1,300 mg. a day, although we are not all the same. For example, adolescents, pregnant women, menopausal women and the elderly must overcome these levels. Now, the bad news is that eight out of ten Spaniards do not get to consume the adequate levels of calcium, which can lead to health problems in the medium term.

To avoid all this and never have more doubts about the amount of calcium you should consume, the Puleva Nutrition Institute has developed an online calculator , which allows you to know if daily calcium recommendations are reached based on eating habits. And it is that the requirements change according to sex and age. Thus, for example, a woman between 19 and 30 years old should consume 1,000 mg, while for pregnant women or breast-feeding mothers the recommended amount is 1,200 mg. up to date. Adolescents between 14 and 18 years old will have to take about 1,300 mg. and women older than 70 years, 1,500 mg. newspapers.

Calculate the calcium you need each day depending on your sex and age.

The worrying thing is that, according to the clinical report 'Milk as a health vehicle: calcium and its determinants in the health of the Spanish population' , prepared by the Spanish and Ibero-American Nutrition Foundations and the Spanish Federation of Nutrition, Food and Nutrition Societies Dietetics (FESNAD) and published in 2017, the intake is not only below recommended levels among adults, but also harms children and adolescents.

What is the best way to consume calcium?

Our body is not able to naturally generate calcium, so it is necessary that we acquire it through food. And among them milk and its derivatives become one of the best sources to achieve the necessary levels of calcium. Only one glass of cow's milk contains approximately 300 mg.

Experts recommend consuming one liter of milk per day.

In addition, milk not only stands out for the amount of calcium it provides, but also for its quality. Although we have heard that there are other foods that contain calcium, what is not known is that the rest of its components make the absorption of this mineral is limited. This is the case, for example, of oxalates and phytates in green leafy vegetables or fiber in legumes that interfere with the absorption of calcium.

Meanwhile, in milk, thanks to its composition in vitamins, proteins and phosphorus, the absorption is much higher than the average with other foods. Thus, an adequate consumption of this dairy that has been with us since the Neolithic period guarantees us good bone health and prevents us from related diseases.

What problems can a low calcium intake bring?

Calcium is an essential mineral in our bones and muscles, so their lack weakens them considerably, producing fractures and sprains. In addition, one of the most common bone diseases is osteoporosis that, according to the Spanish Association with Osteoporosis and Osteoarthritis , affects about 3 million people in our country.

For example, something very common among the elderly, caused by this disease, are hip breaks, which in most cases, and contrary to what is usually believed, occur before they fall to the ground. This does not mean that all these people suffer from calcium deficit; However, guaranteeing our organism optimum levels throughout our lives will influence in avoiding those incidents.

An adequate supply of calcium keeps bones strong.

In addition, calcium prevents hypertension, since this mineral is one of those responsible for having blood pressure under control, especially during pregnancy. Epidemiological studies have suggested that pregnant women who take too little calcium, that is, below 400 mg. daily, are more likely to suffer high blood pressure.

This lack of calcium can also lead to dental problems, as well as dry skin, weak nails and even hair disorders. While having optimum levels of this mineral keeps safe from cardiovascular disorders, chronic degenerative diseases and diabetes mellitus.

The plus of enriched milk

Although milk and its derivatives already provide a good part of the calcium we need, the greater the benefit if we consume milks enriched with this mineral. These make an extra contribution and make it much easier to reach daily calcium recommendations.

During pregnancy and lactation the consumption of calcium should be higher.

In addition, there are modified or adapted milk that incorporate more vitamins D and K. These nutrients are naturally present in milk; However, increasing its intake not only facilitates the absorption of calcium, but also favors an adequate development and maintenance of bone mass.

Calculate here the calcium you need each day depending on your sex and age.

Bariatric Advantage - Liquid Vitamin D-3, 30 Count

Calcium tablets: Properties, benefits and side effects

Associated mainly with the formation of diets and the good condition of bones in general, calcium is considered one of the components that is most present in your body and one of the most important for your development. This can be achieved in foods such as milk, one of the main ones, cabbages and hazelnuts; although it can equally be consumed in calcium pills in the form of supplements. In this post we will talk about the properties, benefits and side effects of calcium pills .



Bariatric Advantage - Liquid Vitamin D-3, 30 Count
Bariatric Advantage - Liquid Vitamin D-3, 30 Count




Types of calcium

Sometimes the food we eat is not enough to cover the calcium needs your body needs to function properly. That's why doctors prescribe calcium pills to help get everything back in order, especially in particular cases.

Calcium lactate

Although it can be achieved in foods such as cheese or baking powder, it is also used in medicine because it has a lot of value as an antioxidant and is also a calcium supplement that is very easily digested by the intestines.

Calcium citrate

This calcium supplement, also considered dietary, has innumerable benefits for the organism. It is one of the most recommended in terms of calcium pills , especially for pregnant women; This is because it is digested very easily by its water-soluble properties and with which the body can distribute it better where it is needed.

Calcium gluconate

It is a calcium supplement used for more extreme cases. It can come in several presentations, but the most used are injections for cases such as severe lack of calcification in the blood flow or pitting of dangerous animals such as the black widow. When it is used for this type of situation, its use is not suitable for any person, therefore it must be implemented under medical prescription.

Calcium carbonate

It is the most commonly used calcium supplement since it can be applied in different branches. Among them is in the food industry, to regulate the pH; In medicine, as a nutritional supplement; and even in the cosmetic part, in the making of soaps. Although the fields of development are many others such as painting or textile branches.

What is the best way to take calcium

Calcium is an essential mineral for the body, as it helps to perform numerous functions, for example to contribute to the formation and maintenance of bones.

Dairy foods

The best way to obtain the calcium that our body needs is through food , since the organism of the human being is not capable of producing it by itself. In this sense, it is important to know what kind of foods are those that have the most presence of calcium.

In food, calcium is associated with the presence of phosphorus. Among the products that have more presence of calcium we can find soft-spined fish, the case of sardines . On the other hand, all products derived from dairy products , such as milk, butter or cheese, also have a high calcium content.

Nuts and legumes

Other foods with a high calcium intake are nuts or legumes . Within this last group, soybeans must be cited, as it is one of the legumes with the highest calcium intake.

Vegetables

In addition, there are also several vegetables that also contribute to maintaining balanced levels of calcium in the body. Among them, we can highlight some such as broccoli or spinach .

Calcium supplements

On the other hand, there may be people who, because of some birth pathology, or because they are suffering from some type of illness (or even poor diet) suffer from low levels of calcium in the bones. In these cases, the intake of calcium supplements may be recommended, in order to supplement the nutritional intake. This should always be done under the recommendations of a doctor or nutritionist, and always adhering to the recommended doses in the treatment.

But let's dig a little deeper into what we've pointed out in the last paragraph and let's take a closer look at who should take these calcium supplements.

Who should take calcium supplements?

Throughout life through people, doctors and even advertisements on television we are constantly reminded of the importance of consuming calcium for all human beings, hence there are so many supplements or calcium pills. Therefore, we tell you beforehand that it is important to consume them, without exaggeration, in every facet of your life, besides that for each age there is a recommended dose.

There are people who need these calcium supplements more than other human beings. This is due to some disease or stage of life where the body can not so easily absorb calcium from food, lowering its levels, needing help to recover them and that's what the pills are for.

The most well-known cases of lack of calcium and taking calcium supplements are in women of advanced ages, especially those who are going through menopause or have left it behind. As for women, they are also prescribed for pregnancy (under facultative supervision) or also if they have an eating disorder.


For people who are intolerant to dairy products are really necessary calcium supplements or pills , as a way to compensate for the lack of it in the body. This also applies to vegetarians or vegans , since not eating meat (or animal products in general) could really feel the lack in their body.

Others who should be warned about taking calcium supplements are those who suffer from intestinal , liver or kidney diseases ; as well as those who ingest a drug associated with osteoporosis .

How to take calcium pills?

The first thing you have to take into account if you want to include calcium supplements in the form of pills in your body is that you should consult it previously with your trusted doctor , remember it is important that he do the respective analysis and tell you if in You really need it or not.

Everything must be with time, you can not include the calcium tablets in one shot and from one day to the next, you must do so long with well-established doses that allow your body to adapt to a greater amount of this element.

So that your body absorbs calcium even better and you can avoid side effects, we recommend that you take your doses throughout the day , two or three times, and not all in a single intake.

What is the best calcium supplement for bones

There are several products on the market that work as calcium supplements. Most of them also incorporate some other type of nutrients, such as potassium or Vitamin D. If you are looking for calcium supplements in Google you will find many products , but we tell you some of the most recommendable ones.


First, we mention Solgar Calcium Magnesium with Vitamin D3 . As we can see is a product with a clearly descriptive name, and is characterized by high doses of calcium, magnesium and Vitamin D3. In addition, it has the support of Solgar, a company that has 70 years of experience in the sector of products related to nutrition.

Another of the effective products and that we can find easily and at a good price is Citrate of Calcium, Magnesium and vitamin D3 of Blue Bonnet. It is a product similar to the previous one in terms of its characteristics. It is produced by the company Blue Bonnet Nutrition, a company that has been in the nutrition sector for more than 25 years.

In any case, we recommend, as always, that if we are going to take a supplement of this type, we do it under the supervision of a nutritionist.

Properties of calcium

You have to remember that calcium is one of the minerals that is mostly related to the part of our body's growth . For this specific property are recommended during the growth of children or during pregnancy. On the other hand, among the properties of calcium we have.
Properties for the body

Calcium is a precious mineral for the well-being of bones and teeth : it is, in fact, essential for its health and growth, since it guarantees its elasticity and density. Calcium is indicated in the prevention of contractures and cramps, as it contributes to adequate muscle development. This mineral stimulates, therefore, the cellular metabolism, the production of energy and the assimilation of nutrients: for this reason, it is indicated for pregnant and lactating women .

Avoid diseases

Also among the beneficial properties of calcium, there is undoubtedly that of reducing the risk of contracting certain types of cancer , stroke and type 2 diabetes , as well as being useful in the prevention of fluoride poisoning in children.

Also the calcium tablets have properties that guarantee the health of our bones, as well as that our cardiovascular system is not exposed to so many diseases. They are also highly recommended for the treatment of cramps or to help improve the healing of the skin .

Therapeutic properties

Calcium can be useful in the treatment of caries , osteoporosis and Lyme disease. This precious element is capable of reducing cholesterol , as well as regulating the blood pH and its coagulation, it also stabilizes the heart rate and provides significant benefits to the heart . In addition to this, calcium is used in the prevention and treatment of diseases such as rickets and osteomalacia, but not only that: calcium is useful to combat the symptoms of premenstrual syndrome : pain, mood swings and swelling - hypertension - high blood pressure - and leg cramps.

Soothing properties

Calcium is useful in the treatment of depression , anxiety, insomnia , apathy and nervousness, since it balances the nervous system. : this mineral is, in fact, important for the psyche, as it acts as a natural tranquilizer. Football instills confidence in itself, stabilizes emotions, helps overcome fear, anguish and aggression. In addition, this mineral strengthens memory and learning skills.

Along with the properties of calcium, we can also see some of the benefits it has, through the intake of calcium pills or supplements.

Benefits of supplementing with calcium

Taking calcium supplements or pills is a benefit to be able to supplement the amount of this mineral that your body needs. Its benefits are directly linked to its properties that is why we get it working in the prevention of diseases such as osteopenia and osteoporosis.

Let's see in detail, what are the benefits of taking calcium supplements.

Help to lose weight

According to some studies, it seems that calcium also has slimming properties: it seems, in fact, that it helps to lose weight and body fat, combat overweight and obesity .

It benefits the skin

Calcium is also important for the health and well-being of the skin : associated with vitamin A, it helps maintain a healthy skin and prevents the formation of eczema .

Recover calcium shortage


The calcium supplement can obviously face a deficiency of calcium as you get older or if you are following a poor diet : the presence of this mineral in the body tends, in fact, to decrease with advancing age. The necessary intake of calcium can be taken through proper nutrition or, in case of deficiencies, with the intake of the aforementioned supplements .

Speaking of daily needs, this varies according to age and sex. An adult needs approximately 900 mg of calcium per day ; as it increases in pregnant women, nursing mothers and menopause, in men over 65 and in children. In any case, the recommended daily dose should not exceed 1000 to 1300 mg per day in adults.

Control of blood pressure

As a protector of the cardiovascular system , calcium tablets are recommended for the control of high blood pressure and for diseases related to the heart. In addition to that their benefits also vary for premenstrual syndrome and even treatments against depression.

Side effects of calcium supplements

We have repeated throughout this section that you should take calcium supplements under the prior control of your doctor. Let's see what side effects we can have by taking pills or calcium supplements.

  •     In the event that you do not, you can generate indigestion effects or gases due to the lack of processing of your organism, in the mildest cases.
  •     Similarly, the indiscriminate use of calcium supplements can have consequences such as kidney stones , lack of absorption of other minerals that are equally important or abdominal pain or problems with heart rhythm.
  •     On the other hand, an excessive dose can, in fact, cause constipation, hypercalcemia, hypertension, nausea and heart attack . However, it is good to seek the advice of your own doctor if you are pregnant or breast-feeding, and if you are taking certain medications such as those taken for hypothyroidism with which calcium might conflict.

Taking calcium by means of supplements is not a practice that is prohibited or, on the contrary, must be done. To take calcium supplements you must take into account if you really need it and the way you are managing it over certain periods, the idea of ​​taking calcium in this way is to help your body and not make it worse.

Isotonix® Vitamin D3 with K2 (3.5 oz)

Calcium and Vitamin D

The foods we eat contain a variety of vitamins, minerals and other important nutrients that help keep our bodies healthy. In particular two nutrients - calcium and vitamin D - are needed to have strong bones.

Vitamin D

The body needs vitamin D to absorb calcium. Without enough vitamin D, we can not produce the hormone calcitrol (known as "active vitamin D") in sufficient amounts, which causes insufficient absorption of calcium from the diet.

In this situation, the body must take the calcium it needs from its supplies in the skeleton, which weakens the existing bone material and prevents the formation of new and strong bone material.



Isotonix® Vitamin D3 with K2 (3.5 oz)
Isotonix® Vitamin D3 with K2 (3.5 oz)




You can get vitamin D in two safe ways: by skin and diet. Vitamin D occurs naturally in the body after exposure to sunlight.

Exposing yourself to the sun for fifteen minutes is more than enough to produce and store all the vitamin D you need.

Experts recommend a daily consumption of between 400 and 800 International Units (IU) of vitamin D, which can also be obtained from supplements or foods rich in vitamin D such as egg yolks, saltwater fish and liver .

Do not take more than 800 IU a day unless prescribed by your doctor as massive doses of up to 5,000 IU or more of vitamin D may harm you.

The role of calcium

Calcium is necessary for the heart, muscles and nerves to function properly and to coagulate the blood. Insufficient calcium contributes significantly to the development of osteoporosis.

Many published studies show that a low calcium intake during life is related to low bone density and high fracture rates. National nutrition surveys have shown that many women and girls consume less than half the recommended amount of calcium to grow and maintain healthy bones.

To see how much calcium you need, see the attached table titled Recommended Calcium Consumption . See the list of select foods rich in calcium to see what can easily include more calcium in your diet without adding fat.

However, calcium alone can not prevent osteoporosis and does not replace drugs that may be necessary to stop the excessive loss of bone material.

What prevents getting enough calcium

Although a balanced diet helps with the absorption of calcium, it is thought that high levels of protein and sodium (salt) in the diet also increase the elimination of calcium by the kidneys. Excessive amounts of these substances should be avoided, especially in those that have a low calcium intake.

Lactose intolerance can also lead to inadequate calcium intake. People who can not tolerate lactose have insufficient amounts of the lactase enzyme that is needed to break down the lactose found in dairy products.

To include dairy products in the diet, these foods can be consumed in small amounts or they can be added lactase drops, or the lactase can be taken as a pill. There are also some dairy products on the market that already contain lactase treatment.

RECOMMENDED CALCIUM CONSUMPTION

AGE QUANTITY OF CALCIUM

Babies

  • birth at 6 months 210 mg
  • 6 months to 1 year 270 mg
  • Children / young adults
  • 1 to 3 years 500 mg
  • 4 to 8 years 800 mg
  • 9 to 18 years 1,300 mg
  • Adult women and men
  • 19 to 50 years 1,000 mg
  • More than 50 1,200 mg
  • Pregnant or breastfeeding
  • 18 years or younger 1,300 mg
  • 19 to 50 years 1,000 mg

Calcium supplements

If you have difficulty consuming enough calcium in your diet, you may have to take a calcium supplement. The amount of calcium you will need from a supplement depends on how much calcium you get from food sources. There are several different calcium compounds to choose from, such as, among others, calcium carbonate and calcium citrate.

It is necessary that the calcium tablet disintegrates so that the body absorbs it.

If you are not sure if a tablet will dissolve, you can test how it disintegrates by placing it in six ounces of vinegar or warm water and shaking it occasionally for 30 minutes. If the tablet has not dissolved almost completely in that period, it probably will not in your stomach.

All calcium supplements are best absorbed when taken in small doses (500mg or less) several times during the day. Many people absorb calcium supplements better if they take them with food.

A complete program to combat osteoporosis

Remember, a diet rich in calcium is only part of a program for the prevention or treatment of osteoporosis. As with the exercises, consuming enough calcium is a strategy that helps strengthen bones at any age.

But it is possible that these methods are not enough to stop the loss of bone material caused by lifestyles, medications or menopause.

It is important to talk with your doctor to determine if you need a medication for osteoporosis in addition to diet and exercise.

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Calcium: Something to keep in mind

Calcium is one of the metals that are fundamental for the development of our life and is one of the easiest elements to find on the planet.

In humans many cells use calcium ion for different purposes, it is important to remember its function in nerve conduction, in cardiac or skeletal musculature and, obviously, as raw material of bone mass.

As we know it is one of the basic pillars in the prevention and treatment of osteoporosis.

Much has already been said about it and much is the controversy about possible side effects that calcium salts could produce in extraosseous tissues such as the vascular endothelium and the excretory urinary tract.



Cooper Complete - Vitamin D3 1000 IU - Easy to Digest, Increased Absorption - 120 Day Supply
Cooper Complete - Vitamin D3 1000 IU - Easy to Digest, Increased Absorption - 120 Day Supply




Without pretending to enter into Byzantine polemics, we are going to provide data on why we believe it is not harmful to health, and for us, calcium is a nutrient rather than a drug, as stated by Prof. Dr. Jorge Talbot [1, 25] .

We will answer questions that arise in our daily practice:

What are the primary food sources of calcium?

The main food sources of calcium, in developed countries, are products of massive and daily use, particularly milk, yogurt and other dairy products. Convinced of the contribution of calcium beneficial to the individual; and in the intention to reach all age groups and the different physiological conditions and in light of the results of the 1999 osteoporosis risk factor survey, which clearly demonstrates the poor intake of dairy products in our population; is that the GEOSUR group decided, as a first step, to support and promote the consumption of milk and milk products [3, 4, 26].

There are other food products in the diet that provide calcium in different proportions, here we attach a table.

Calcium content in foods
(milligrams of calcium per 100 grams of food)


Cereals
  • White wheat bread 38
  • Whole wheat bread 65
  • Toasted wheat bread 13
  • Rice in paella 3
  • Wheat flour 25 - 187

Vegetables
  • Cooked chickpeas 35
  • Cooked beans 18
  • Cooked white beans 87
  • Cooked beans 103

Vegetables and tubers
  • Cooked artichokes 44
  • Raw cress 192
  • Raw lettuce 29
  • Fried potato 16
  • Raw tomato 11
  • Fried tomato 36

Eggs
  • Boiled 54
  • Fried 81
  • Tortilla 190
   

fruit
  • Cherry 267
  • Fresón 31
  • Lemon 58
  • Orange 36
  • Pear 12

Nuts
  • Almond and hazelnut 240
  • Dried chestnut 98
  • Figs 212
  • Raisins and peanuts 61

Dairy products
  • Cow's milk 120
  • Condensed milk 290-380
  • Soft cheese 350-550
  • Hard cheese 800-1200
  • Yogurt 145

meats
  • Cattle, pigs and cattle 10
  • Birds and game 20

Fish and seafood
  • Fried squid 240
  • Cooked hake 16
  • Cooked Mussel 197
  • Sardine preserves 410
  • Fried flounder 93
  • Fried hake 20
  • Fried sardine 409
  • Seafood 30 -300

Now, if we look at the calcium content of these products; and taking into account that the absorption of them is not total since the calcium coming from the dairy products is absorbed by 30% and by the fish by 20% [31]; We would have to consume large quantities, which in practice is not real. For what would be a good complement a pharmacological contribution of calcium.

Another resource is the use of foods to which calcium salts are added, which are compatible with good bioavailability for the organism. In this land are: breads, pastas, cereals, fruit juices etc.

What is the best way to get calcium?

The contribution of calcium in the diet to prevent and treat osteoporosis averages between 1000 and 1500 mg / day, hence it is necessary to interrogate dietary habits before facing a supplemental treatment of calcium [2].

In the survey conducted by GEOSUR, analyzing 256 Uruguayan women, it was shown that women with osteoporosis consumed less white meat, scarce vegetables rich in carotene (tomato and carrot) and onions. Instead they consumed more salt and products of animal origin with higher fat content. This survey shows that we must insist not only on a high intake of calcium but also other nutrients.

Surveys conducted by ANEP in children and the School of Nutrition and Dietetics of the University of the Republic showed that the majority of children and adolescents do not get to consume the daily requirements of calcium with the diet [19, 20].

After making it clear to the patient that life habits favor him in the development and maintenance of bone mass, we indicate pharmacological supplements of calcium salts [3, 4].

The majority of patients can not reach daily requirements through diet, in these cases it is recommended to supplement with pharmaceutical preparations.

What calcium salt is preferable to use?

When using a calcium supplement, it is important to know the mineral content of calcium in the salt to be used, which varies between 40% of calcium carbonate, 30% of calcium citrate and 9% of calcium biolate or gluconate .

In fact, the most commonly used salts are: carbonate and citrate, which must be administered during main meals to achieve greater absorption. It is advisable not to give doses higher than 500 mg at a time and this is because calcium is absorbed at the level of the duodenum by an active and saturable dependent vitamin D mechanism, and the rest of the absorption is carried out passively in small intestine.

The carbonate often has little adhesion by the patient to produce gastrointestinal disorders.

Citrate is the salt most used by the authors. It has, in our opinion, the advantage of being able to be administered at any time of the day, since these salts are better absorbed than carbonate, even in conditions of gastric achlorhydria.

The possibility of greater passive absorption makes it much more usable. The intestinal absorption of calcium varies from one person to another and decreases linearly after 50 years in women and 60 in men, making it the salt of choice for older adults [1, 5, 6, 9 , 13, 14].

It must be taken into account that the absorption of calcium depends on the amount that is ingested, if we take 1 g, 20% is absorbed, instead of the 500 mg intake, absorption increases to 30%.

It is not recommended to take calcium before going to sleep, because night rest increases bone resorption [31].

In a comparative study between calcium citrate and calcium carbonate, after supplying these salts to two groups of women with osteopenia or osteoporosis for 12 weeks, an improvement in markers of bone resorption was found in the group treated with citrate. it did not happen in the group treated with carbonate [32, 33, 34].

Vitamin D in the absorption of calcium?

Vitamin D plays an important role in the intestinal absorption of calcium and the dose / day required varies, either in prevention or treatment, age and time of year.

Although 400 ui / day is commonly recommended at 800 ui / day, there is a lot of literature that shows that in higher doses of osteoporosis, higher doses could be used weekly, monthly or quarterly (macrodoses of vitamin D) [5, 6]. , 7, 15].

The best calcium absorption depends on the gene of vitamin D receptors (VDR) [31].

In addition to experimental confirmation; in numerous clinical investigations of the beneficial effect of calcium and vitamin D on the skeleton (which we will not discuss here); the remarkable consequences of vitamin K on the carboxylation of osteocalcin are already known: this bone protein, in its carboxylated form, favors the deposit of the mineral phase in the osteoid; Vitamin K prevents hypercalciuria and post-castration osteopenia in rodents and humans. In Japan, this vitamin has been marketed since 1995 for the prevention and treatment of osteoporosis. Other vitamins with osteoprotective potential, attributed to their antioxidant properties, are E and C [24].

What can act on the absorption of calcium supplements?


Some foods such as spinach, cocoa, tea, potatoes, cereals etc. they diminish the intestinal absorption of calcium. The anti-nutrient effects are overcome with a balanced diet and sometimes calcium should be removed from these nutrients.

In turn, caffeine interferes with the absorption of calcium, an effect probably mediated by Calcitriol, (this does not contraindicate the addition of a part of coffee to the milk, since the coffee portion neutralizes only a small part of the milk) [ 28, 27].

There are works that mention that the tea would act as an antinutrient of calcium, however other studies show that the high consumption of tea is associated with higher bone mineral density and lower risk of fractures in elderly women. Tea is rich in fluoride and antioxidants [24].

Moderate alcohol consumption tends to conserve and even increase bone mass in both sexes [24], while abusive consumption produces significant bone loss, alcohol induces poor food intake, alters liver metabolism and increases excretion renal calcium and phosphorus [26, 27].

Another of the public health issues that concern us is the increase in alcohol consumption in adolescents, the time of their lives in which their greater bone mass is forming with the deleterious effect on it that this noxa causes.

Cocoa also acts by inhibiting the absorption of calcium. Its use is important because chocolate milk is much more accepted by children and adolescents than milk alone (which in general they do not like), and although less is absorbed, "it is better little than nothing".

It is recommended not to ingest fibers along with dairy products, since the phytates and oxalates they contain interfere with absorption.

The phosphoric acid contained in cola soft drinks has a demineralizing effect since phosphorus precipitates with calcium and prevents its absorption. It is for this reason that the abusive use of these beverages is not recommended [21, 22]. In a paper presented by Dr. Katherine L. Tucker. (25th Annual Meeting of the American Society for Bone and Mineral Research) reports that high consumption of cola beverages is correlated with low mineral density in the hip of female patients [22].

In our talks to the community, regarding the prevention of osteoporosis, we made it clear that the dairy snack should not be substituted for soft drinks and that the intake of these beverages should be less than 3 glasses per day [22].

The consumption of broccoli (1-3 servings per week) seems to protect against fragility fractures. Supplementation with plum, fruit rich in polyphenols and antioxidant compounds, prevents and reverses osteoporosis in the castrated rat model. In another murine model, 1 g / day of onion (but also of fennel, parsley, garlic, lettuce and other common vegetables in the human diet) increased bone mass significantly [25].

What medications alter absorption?

Calcium interferes with the absorption of iron, so it is advisable to separate iron from calcium supplements.

In turn, calcium interferes with the absorption of certain antibiotics such as tetracycline, isoniazid, aluminum-containing antacids and corticosteroids.

Another of the interferences is with the thyroid hormones that decrease calcium absorption in the order of 20%.

What happens with calcium after being absorbed?

It is important to remember that 48% of the total serum calcium is composed of free calcium (Ca ++) ion which is biologically active, 12% bound to citrate, phosphate and sulfate that is diffusible and ultrafiltrable as well as ionic calcium (Ca ++) and the remaining 40% is bound to proteins, especially to albumin.

Recall that about 1% of skeletal calcium (500-700 mg) is interchangeable, the rest is more stable and is removed slowly.

In turn, the three hormones that fundamentally handle calcium homeostasis are: calcitriol, which is the active metabolite of vitamin D that promotes the absorption of calcium from the intestine, has an important effect on the mineralization of bone and inhibits the PTH. Paradoxically, in very high doses, it can divert small amounts of calcium from the bone to the extracellular space.

PTH, in turn, stimulates the renal activation of vitamin D and increases bone resorption in hypocalcemic states.

Calcitonin is a hormone synthesized by thyroid C cells and decreases calcemia because it inhibits the mobilization of calcium from the bone.

At the same time, the diffusible calcium calculates that about 9,000 mg per day are filtered through the glomeruli and that the tubules reabsorb 98% of the ultrafiltered calcium.

It is known that after an intake of 1000 mg of calcium, the kidney excretes 250 mg in women and 300 mg in men. Major urinary excretions pose a hypercalciuria that is often corrected with small doses of thiazides or indapamide. Remember that diets rich in protein and salt and the use of diuretics, except those mentioned, are associated with elevated calciurias [1, 7].

What is the role of calcium in patients with renal lithiasis?


Currently there are works that clearly show that patients with kidney stones that have a decreased calcium intake increase the chances of having an increase in their kidney stones. So the best way to prevent lithiasis would be with high calcium doses. There is evidence that calcium citrate salts, as well as carbonate salts, inhibit the precipitation of calcium in the urine (protective factor) [8].

Urinary stones are, in general, carbonate or oxalate and not citrate (where Coke is).

Why calcium is deposited in soft tissues?

Calcium is deposited in damaged or dead tissues, by changes in Ph at the tissue level.

It is the example of a calcification of the shoulder ligaments in calcified periarthritis or enthesopathies.

At breast level in calcified tissues in mammograms that can often correspond to neoplasms, only because there is tissue damage caused by the neoplasm.

In turn, many times the role of calcium in vascular atheromatosis arises, what calcium does in fact is seal the atheroma plaque, something like healing what is a primary endothelial lesion. We must reaffirm that, under normal conditions, calcium is not deposited [2].

Calcium and obesity

There are several published studies where there is no direct relationship between calcium and obesity, however it has been shown in experimental models of obese mice that low calcium diets lead to an increase in intracellular calcium concentrations, which acts to promote deposit of body fat, reducing lipolysis and thermogenesis.

Diets high in calcium reverse this trend . Calcium in the form of dairy products would be more effective than elemental [16,17].

The calciotrophic hormones, the parathyroid hormone (PTH) and the 1,25 dihydroxyvitamin D promote the influx of calcium to the adipose cell, mediating lipogenesis.

A low intake of calcium increases these hormones and, therefore, the deposit of lipids. There are repeated observations of a high BMI in subjects with elevated parathyroid hormone [16, 17, 18, 23].

The impact of calcium intake on weight loss, or the prevention of weight gain, is controversial. Riggs et al. have shown; in a wide range of ages, from Caucasians to African-Americans of both sexes; the relationship between calcium and obesity .

Calcium, taking these results into account, could play a role in reducing the incidence of obesity and the predominance of insulin resistance syndrome [16, 17, 18, 23].

What are the adverse effects of calcium?

Digestive intolerance, especially constipation and meteorism.

Hypercalciuria can be observed in patients with a previous history of renal lithiasis, or in the concomitant use of Calcitriol.

Paradoxically, hypercalciuria caused by increased bone resorption gives way with calcium replacement therapy [25].

With this work we have tried, as a summary, to highlight our experience with the use of calcium salts, both in the prevention and treatment of osteoporosis. We have tried to show that treatment with calcium, except digestive intolerances such as flatulence or constipation, does not cause major problems even in the case of nephrolithiasis.

We also remember that calcium, despite the contribution of calcium, is a very stable value, that if it is altered we must look for a secondary cause (hyperparathyroidism, renal failure, myeloma, etc.).

Finally, the positive effect in a calcium treatment depends on the proper salt, the appropriate time and the appropriate dose for each particular circumstance.

Remember that prevention measures should be applied in all stages of life, and that according to the data provided by GEOSUR studies it is convenient to reduce dietary proteins, especially meats with higher fat content, decrease coffee consumption , salt, tobacco and increase the consumption of certain vegetables, especially onions, tomatoes and carrots; with this we will have changed the dietary pattern of calcium utilization, increasing its absorption and decreasing its elimination. This translates into greater health in general and bone in particular. If in addition we do muscle strengthening exercises appropriate for the age and situation, it can even improve and in some cases even revert bone fragility [2, 3, 4].

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Take calcium, exercise and be in the sun protect against osteoporosis

"The remarkable drop in estrogen during menopause makes women more prone to this disease"

"Osteoporosis: diagnosis and prevention of morbidity and mortality" is the title of the talk that yesterday offered the doctor Salamanca Arias Patience in the auditorium of the University College, within the forum of the newspaper. A conference where the keys were given to prevent this disease that affects women in most cases.



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-What people are more likely to suffer from osteoporosis?

-The most prone patients are established universally that are women over 40 years, those who have already reached menopause.

- Does this disease affect men less?

-It is also a disease of men, but just as in women it appears in that period of life, in men it happens later. The deterioration is slower because one of the important factors is the loss of estrogen. Women are markedly diminished during menopause, but loss in men, who also have estrogen, does not occur so quickly. That is why osteoporosis appears after 65 years of age.

-What are the alarm symptoms?

-There are no symptoms, but risk factors that must be taken into account. One of the most important is the genetic, for example if the parents of the person we are evaluating have had a hip fracture. You also have to know if this person has had some toxic habits, especially tobacco. Another factor is that you have had a fracture before, a disease that favors the loss of bone mass or a treatment that is favoring the fragility of the bone.

- Is there any form of prevention?

There is an English research group that has determined a program called FRAX, where twelve risk factors are introduced. Through a mathematical calculation two data are obtained to know if you will have hip fracture or osteoporotic fracture of another bone. What is usually done to avoid these risks is to make an assessment according to this calculation and the risk factors, along with bone densitometry, to obtain a high, medium and low risk. And this is the way to know who to treat: always when it is maximum risk or has had a fracture, if it is medium risk too and when it is low risk only will have to take preventive measures.

- What are those measures?

-That they exercise, that they take an adequate amount of calcium and the sun a little a day. They are very easy measures to comply with and, if done well, during the adolescence stage and the first part of adulthood they get a high peak of bone mass that will later have less chance of having loss and osteoporosis. To keep it, you have to keep doing the same so that the loss is less. We must also know that certain minerals and vitamins such as D not only get this type of action on the bone, but also has other effects on biological processes that until now were not very clear and that get some protection against cancer and autoimmune diseases or infectious. This type of actions are very important for health, not only bone, but general.

- What do you think of the products that provide extra calcium, like some milks?

- They provide more calcium, although perhaps not as much as explained in the packaging. But neither is it necessary to resort to these products because there are many foods that have calcium other than dairy, such as almonds and hazelnuts, chickpeas, sardines in oil, some cheeses? The amount of calcium is easy to get, what is not so much is the adequate level of vitamin D. Although in Spain we think we have a wonderful sun, more than 50% of the population have it low, even in the south of the country . This vitamin is very important, because it helps calcium to be absorbed and deposited in the bone so that it can then be distributed to all other organs when necessary.

- Is it true that playing certain sports, such as football or handball, during puberty, prevents the disease, as a recent study has confirmed?

-It is a protective factor, along with taking a calcium intake of about a gram a day and sunbathing for twenty or thirty minutes. These are the three actions that help the bone stay healthy.

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Calcium is a weapon to fight diseases

Calcium , besides being the most valuable weapon to alleviate the effects of osteoporosis , is a very effective mineral to prevent the possible development of periodontal disease, colon cancer, kidney stones or to control blood pressure.

Osteoporosis

Osteoporosis is a disease that causes a progressive decrease in bone mass , reducing the strength of the bone that can be broken by small traumas and even spontaneously.

To prevent this disease is necessary an adequate intake of calcium , especially in adolescence, which is where most of our bone capital is acquired. Along with the consumption of calcium, a healthy lifestyle in which there is room for regular exercise, a prudent exposure to the sun (necessary for the synthesis of vitamin D) and an abandonment of the use of tobacco, alcohol and caffeine (which they have a negative effect on bone remodeling), they will be the best allies in the fight against osteoporosis.



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Kidney stones

90% of kidney stones are made of calcium oxalate and in most patients with stones a high level of calcium is detected in the urine. This suggested that if calcium consumption were reduced, this pathology would be mitigated. However, it has been proven that calcium is not the cause of kidney stones and that a limitation of its consumption can increase the risk of it occurring. This protective function is carried out thanks to its ability to bind oxalate in the intestine, preventing it from being absorbed and causing kidney stones.

Periodontal disease

The bone that is the cause of the loss is the jaw . Increasing calcium intake has found improvements in inflammatory processes and dental mobility. Therefore it is especially convenient to increase the calcium intake in people suffering from periodontal disease.

Blood pressure

The increase in calcium intake can be positive to avoid the increase in blood pressure , which is especially important during pregnancy, since hypertension can pose a danger to the health of the mother and child. During pregnancy the calcium needs increase . Epidemiological studies suggest an inverse relationship between dietary calcium and the incidence of hypertension induced by pregnancy, so the risk of blood pressure problems during this period can be reduced by an adequate intake of calcium.

Colon cancer

The consumption of calcium and dairy products exerts a protective effect against colon cancer . Several studies show the correlation between calcium intake (1,200-1,400 mg per day) and the significant decrease in the risk of this type of cancer. It has also been found that higher levels of circulating vitamin D in the blood reduce the risk of colon cancer by up to 40% compared to people with the lowest levels.

Although the results confirm the relationship between vitamin D and the etiology of colon cancer, experts do not recommend taking vitamin D supplements to prevent the tumor. There are also no studies that recommend the use of calcium supplements to prevent colon cancer.

Know more

Scientific evidence shows that the best way to reduce the risk of colon cancer is to stop smoking, increase physical activity, reduce obesity and abdominal fat and limit the consumption of alcohol and red meat.

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Calcium (citrate) and Vitamin D3 prevents osteoporosis

Calcium, the most abundant mineral in the human body, plays an essential role in the construction and strength of bone mass , as well as in the prevention of osteoporosis.

Present in almost all the cells of the organism, it intervenes in the numerous biochemical reactions indispensable for its functioning.

Calcium citrate is associated with vitamin D3 (cholecalciferol) which allows assimilating the ingested calcium . However, the ingestion of this vitamin - usually carried by food or produced by the body after sun exposure - is especially necessary in adults with deficiencies and, in particular, in the elderly.



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In addition, it participates in the prevention of colon cancer: during digestion, excess calcium neutralizes fatty acids, a source of irritation of the intestinal mucosa.

Of organic origin, calcium citrate is the source of calcium that the body better absorbs, better assimilates and better tolerates. Powered by vitamin D3, it is also the most effective in the prevention and treatment of osteoporosis.

Calcium (citrate) + vit. D3: Detailed information


Calcium is the most abundant mineral in the human body. It plays an essential role in the acquisition and consolidation of bone mass by preventing osteoporosis.

Present in very low concentrations in almost all the cells of the organism, it intervenes in many biochemical reactions indispensable for its functioning: the contraction of the muscles, the heartbeat, the regulation of the blood pressure in the blood vessels, the communication between the cells nervous and blood clotting.

In addition, it performs a preventive action of colon cancer: after digestion, excess calcium neutralizes fatty acids that cause irritation of the intestinal mucosa.

According to the experts, the calcium intake is often insufficient, especially in the elderly, who assimilate the calcium of intestinal origin worse and meet their needs for this mineral from an aged bone.

Bone is a dynamic tissue that is destroyed and re-forms continuously. With age, bone destruction (reabsorption) predominates and osteoporosis appears, a risk factor for fractures and vertebral crushing. This mechanism is further aggravated when the organism, not receiving an insufficient external input, is forced to obtain from its bone reserves the calcium essential for many of its functions, further weakening the skeleton.

The supply of calcium can be guaranteed with natural supplements that contain a source of calcium. Most often, add calcium carbonate or calcium citrate.

Calcium carbonate is obtained from sea shells, bone powder, coral or dolomite. The "raw materials" are of natural origin but may be contaminated with toxic materials (heavy metals) or other contaminants. They can also be poorly tolerated by some people suffering from gastric acid causing constipation and distension.

We use calcium citrate of organic origin. Perfectly tolerated, calcium citrate is the source of calcium that best absorbs and assimilates the body. It does not interfere with the absorption of other minerals (iron, magnesium, zinc) or vitamins (A, D, C).

Calcium citrate is associated with vitamin D3 (cholecalciferol) which allows assimilating the ingested calcium . However, the ingestion of this vitamin - usually carried by food or produced by the body after sun exposure - is especially necessary in adults with deficiencies and, in particular, in the elderly.

Calcium is produced according to the Standards of Proper Manufacturing of the European Pharmaceutical Industry. It also complies with the ISO-9001 standard of international quality.

INGREDIENTS:

For 2 tablets: 800 mg of calcium (calcium salts of citric acid) (100% VRN *), 2.5 μg of vitamin D3 (Colecalciferol 110000 IU / g max) (50% NRV).

* VRN: Nutrient Reference Values.

OTHER INGREDIENTS:

Dextrose, sweetener (E420): sorbitol, bulking agent (E460ii): microcrystalline cellulose, orange flavor, anti-caking agent (E470b): magnesium salts of fatty acids.

ALLERGENS:

This product does not contain allergens (according to Regulation (EU) No. 1169/2011) or genetically modified organisms.

MANUFACTURE AND QUALITY GUARANTEE:

This food supplement is manufactured by a laboratory following the BPF standards. The GMP are the Good Manufacturing Practices in force in the European pharmaceutical sector (in English GMP, Good Manufacturing Practice).
The content of the active principle is guaranteed by regular analyzes that can be consulted online.

USE TIPS:

2 tablets a day to chew or suck, during meals.

PRECAUTIONS:

Contraindicated in case of renal failure. It is recommended for pregnant or lactating women. Do not exceed the recommended daily dose.

WARNINGS:

Food supplements should not be used as substitutes for a varied and balanced diet and a healthy lifestyle. In case of medical treatment, consult with your therapist. Only for adults. Keep out of the reach of little kids.

STORAGE INSTRUCTIONS:

Store in a cool, dry place and out of reach of light.

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How to assimilate well the calcium that we need?

Our readers already know that the best source of calcium is not milk, not only because advertising has exaggerated the content of this mineral, and especially absorption, but because of its low quality, as Paul Pichford points out in the "Bible" Healing with Whole foods , which publishes official data on the number of cases of Americans with osteoporosis, arthritis and calcium deficit with delicious diets of milk and derivatives.



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WHAT IS CALCIUM?

Calcium is crucial for the organism and is involved in almost all biological and metabolic functions.

  •     Combined with phosphorus forms the mineral salts of bones and teeth
  •     It is essential for the blood to coagulate correctly
  •     Prevents cramps
  •     Reduces blood pressure
  •     Prevents osteoporosis
  •     Maintains the permeability of cell membranes
  •     Helps neuromuscular activity
  •     Involved in the maintenance of heart rhythm
  •     Maintains healthy skin
  •     Maintains PH balance, protecting the body from other diseases such as cancer
  •     During pregnancy reduces the incidence of preeclampsia (gestational hypertension or increased blood pressure)

MAGNESIUM, VITAMIN D AND MORE

The absorption of calcium, says Pichford, "requires an adequate amount of magnesium, phosphorus, and vitamin A, C and D. The body must have a good absorption of these minerals and vitamins so that their calcium is well assimilated."

Magnesium stimulates the production of calcitonin and, therefore, increases the calcium in the bones at the same time that it extracts it from the tissues. Many forms of arthritis are characterized by excess calcium in the tissues, while calcium is lacking in the bones, says Pichford.

Chlorophyll is in magnesium, so most green vegetables (full of chlorophyll) are valuable sources of phosphorus and vitamin A, so that calcium is metabolized well. And another essential source is the sun, vitamin D, the well-known vitamin of light. People who spend the day locked up in an office or who, in winter, do not leave metropolitan cities where the sun touches them in a flash has more calcium deficit.

But there is still more. Isabel Fernández , gynecologist and expert in orthomolecular nutrition and homeopathy, discovered in a study three years ago that the calcium that we usually eat in the diet is often neither well absorbed nor well used but there is a very rich source of calcium, the marine coral, which is absorbed practically in its entirety and also the body accepts very well. Besides being very rich in calcium, marine coral contains magnesium and more than seventy trace elements in a proportion very similar to that of the human body and which are fundamental for the body's enzymatic processes. It was seen that the intake of marine coral by the women analyzed, all selected in the menopausal stage, strengthened and recovered their bone structure, and after three months taking marine coral morning and night, there was evidence of a decreased risk of osteoporosis, as well as arterial problems, an improvement of its adrenal function and thyroid function. With the improvement of calcium metabolism, it also improved the metabolism of magnesium and other essential minerals.

Marine coral

WHAT IS EXACTLY THE MARINE CORAL?

The Natural Coral is fossil marine coral, purified and crushed. It is mined from fossil coral mines, on islands created by reefs that have been out of the sea for many thousands of years. "In this way we achieve two important objectives, firstly that no harm is done to the living reefs, so our marine coral is produced in a sustainable manner and has been awarded with the EcoSafe and Friends of the Sea stamps", says Per Bjork, responsible for Cien por Cien Natural, who commercializes the Coral Natural product, which respects the fragility of the reefs and the environment of the oceans. Fossil corals are used for its elaboration. Another very important aspect is that it has not suffered the current pollution of the oceans, having been out of the sea since long before human activity began to pollute the seas. It should also be noted that the Natural Coral is packaged without additives (additives that only serve to reduce the wear of the filling machinery), which allows dissolving the ground powder in water or, why not, as an alternative to milk to cut the coffee.

Fernandez confirmed that " the coral recovers the biological rhythms, produces more energy, deacidifies the body, vital for health in general. In fact it is a very alkaline mineral, the most alkaline mineral in the body.

The coral recovers the biological rhythms, produces more energy, deacidifies the body

The increase in vitality also means that the body does not have to extract calcium from the bones to balance its PH, which is why, over time, osteoporosis and other pathologies such as alopecia appear.

In fact, there is a very novel test known as HMS or Hair Metabolic System, a laboratory analysis that determines the mineral content of hair and that allows, among other parameters, to know the proportions of calcium with respect to other minerals that we have in the body (What shows us how we are in its absorption and metabolism, according to Jesus Dominguez, physiotherapist and naturopath specialist in functional naturopathy and often carries out this test. "It is a very valuable information because the content of minerals in the hair is the same as the mineral content of the cells of our body, "adds Dominguez.



Dominguez adds that, as far as calcium is concerned, it is very important to know that one of the most common findings in a mineralogram is the presence of excessive levels of intracellular calcium. This is mainly due to a decreased efficacy of the action of thyroid hormone at the cellular level.

"The mineralogram allows to see that there are also cases of excess calcium."

It is surprising how this elevation of intracellular calcium levels conditions, in addition to a diminished efficacy of thyroid hormone, tendency to hypotension, tendency to insulin resistance situations compatible with a slow metabolism.

Lilián Dous is a regular consumer of Coral Natural. "I started to consume it because it was recommended to me as a very simple option to maintain my health. At first I did not notice anything, I thought I had an iron health, but after a while I saw that it was not like that, although I did not perceive it, I had a lot of health problems, that although they did not make me impossible, they were there. Every two years I had a few weeks of terrible pain because kidney stones were forming, I was very prone to colds, I had backaches more often than I realized, etc. Little by little Lilian was realizing that all this had disappeared. The colds were reduced, the back no longer hurt, and over the years was seeing that he has not returned to have nephritic colic. And if that was not enough, a year later "I was forced to undergo surgery to remove the uterus and ovaries. I started to worry about my bones, since I do not drink milk, but the following year I did a densitometry and my bones were perfect . Two years later I had another densitometry and my bone mass had increased. Today I still have some bones in a state that surprises my gynecologist because according to him they do not correspond to my age. It shows me that when they recommended me to take Coral Natural they did me a favor.

Select your pathology and get fully informed

  • Osteoporosis
  • Arthritis

HOW MUCH CALCIUM DO WE NEED EVERY DAY?

Once we know all that, we should worry about absorbing it well and knowing the recommended amount of calcium we need to ingest, which is about 1000 mg a day in adults and a little more in periods of growth (childhood and adolescence), pregnancy and lactation, advanced age (because less is assimilated), when there are heart and vascular diseases including hypertension, bone diseases and most disorders of the nervous system. And then there are calcium-inhibiting foods : refined sugars, alcohol, coffee, drugs and drugs, very little exercise, too much salt and too much protein.

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Calcium : a summary of the evidence

Summary : The consumption of calcium helps to reduce the risk of suffering from osteoporosis, hypertension, cancer, kidney stones and obesity. Studies have shown that calcium supplementation increases or prevents the loss of bone mass, which is vital for the prevention of osteoporosis. Studies have also shown the positive impact of calcium in the regulation of blood pressure and in the prevention of colon, breast and ovarian cancer, possibly through its participation in cell division. A diet high in calcium helps prevent kidney stones by decreasing oxalate absorption and recently, it has been suggested that it can also help in weight control, decreasing lipogenesis and increasing lipolysis. The protective effect of calcium is evident in the recommended levels of calcium intake for most of the population, that is, between 1000 and 1300 mg of calcium per day.



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Summary : Intake of dietary calcium decreases the risk of osteoporosis, hypertension, cancer, kidney stones, and obesity. Studies have shown that calcium supplementation increases bone mass and prevents its loss, which is crucial in the prevention of osteoporosis. Likewise, studies have confirmed the impact of calcium in the regulation of blood pressure and in the prevention of colon, mammary and ovary cancer, possibly through its action in cellular division. A diet rich in calcium can also help against kidney stones by reducing oxalate absorption, and recently, it has been suggested that a diet rich in calcium can help in weight management, reducing lipogenesis and increasing lipolysis. The protective effects of calcium are seen within the levels actually recommended for the population, which are between 1000 and 1300 mg per day of calcium.

Introduction

Calcium is a nutrient that is involved in the prevention of chronic diseases, such as osteoporosis, high blood pressure, colon, breast and ovarian cancer, kidney stones and obesity. The association between calcium and these diseases has its explanation in the variety of functions that this nutrient fulfills in the organism. Calcium is the most abundant mineral in the human body where it forms part of the teeth and bones, where it represents up to 40% of the mineral content. Calcium is also considered a second messenger, because it acts both as a signal transmitter from outside the cell inward, as an activator of proteins involved in this process. In this way, calcium is found involved in the secretion of hormones, in the mediation of dilation and muscular and vascular contraction, as well as in neural conduction.

The following is a review of the evidence of the role of calcium in chronic diseases such as osteoporosis, arterial hypertension, cancer, renal lithiasis, and obesity.

Calcium and osteoporosis

99% of calcium is found in bones and only 1% in blood, muscle, and other tissues. However, this small fraction has priority and the calcium contained in the bones constitutes a great reservoir from which it can be extracted at any time to keep the serum level of calcium constant if the dietary intake is low. If calcium intake is persistently low, the bones become increasingly fragile, which can lead to osteoporosis.

Osteoporosis is a chronic, multifactorial disease that can progress silently for decades until a fracture occurs. It is characterized by a low bone density and by a deterioration of the bone microarchitecture (1), which produces a greater vulnerability to suffer fractures, mainly in the wrist, hip and spine (2,3).

In the world more than 200 million people have osteoporosis, and according to projections, the number of hip fractures a year will increase from 1.66 million in 1990 to 6.26 million in 2050 (4). In Venezuela, the magnitude of the problem is not well known. According to a report in 1980, the incidence of hip fractures in> 45 years was 348 and 834 (5), and in 1988 the incidence in> 80 years was 193 and 381 (6), per 100,000 inhabitants, in men and women, respectively (5).

Osteoporosis is a juvenile disease, since it is in adolescence when most of the bone mass is acquired, which will determine if the person will be at risk of fractures in the coming years. Thus, at 17 years of age the female adolescent has acquired 90% of her bone mass, at 19.8 years 95% and at 22.1 years 99% of her bone mass (7). That is to say, after the age of 22, the woman basically has already formed her bone mass. Although the process of bone mass acquisition is 60-80% determined by the genetics of the individual, there are modifiable factors that affect this process, such as calcium intake, physical activity and lifestyle, among which, the Calcium intake is the one that has the greatest effect (8). If in adolescence the individual does not consume an adequate intake of calcium, it will not reach the maximum peak of bone mass and the individual will enter the adult stage with a bone density lower than its genetic potential (dotted line, Figure 1 ). When the period of rapid loss of bone mass begins, which corresponds to menopause, this individual could have fractures. The development of bone mass up to the maximum peak potential protects against osteoporosis, since there is an inverse relationship between bone mineral density and the incidence of fractures (9,10).

Studies in adolescents and children (11-14) and adults (15-18) have shown that calcium supplementation increases bone mass. Supplementation in identical twins (6-14 years) with 1612 mg / d of calcium significantly increased bone density compared to the group with a 908 mg / d calcium intake (12). Studies in American girls and Chinese children showed that calcium supplementation for 18 months resulted in a significant additional increase in density and total bone content over the control group (11,13). In adolescent girls, an increase of 35 g more in bone mineral content was observed with the supplementation of dairy products during one year compared with the control group (14). These effects are maintained only if the high calcium intake is constant, and not as a short intervention, since after one year of the intervention, the differences in bone density disappeared (19). It has been observed that if daily calcium intake remains high throughout childhood and adolescence, this results in high bone density of the radius in post-menopausal women.

Transversal and intervention studies in adults report a positive relationship between calcium intake and bone mass. A meta-analysis of 33 studies evidenced a significant correlation between calcium intake and bone density (21). It was concluded that the intake of 1 g / d of calcium can prevent the loss of 1% of bone / year in most regions of the body. In the first years of post-menopause, bone mass does not respond as much to calcium supplementation, since it is a stage of rapid bone resorption, however, if it favors those women with more than 5 years postmenopausal (22). In the elderly it has also been observed that the intervention with calcium favors the reduction of the fracture index (18).

Calcium and high blood pressure

High blood pressure is a public health problem that affects 20% -23% of adults in Venezuela (23). Blood pressure levels predict the mortality and morbidity of cardiovascular diseases (CVD), so any factor that lowers blood pressure is important at the population level.

After 20 years of controversy, the evidence confirms the positive impact of calcium and calcium-rich foods in the regulation of blood pressure, through 2 lines of research:


1. Epidemiological studies: The first study that systematically investigated the relationship between calcium and blood pressure was an epidemiological analysis of the relationship of 17 nutrients with blood pressure in Americans (24). Low calcium intake was the most consistent factor in individuals with hypertension and it was determined that high calcium intake was associated with low blood pressure and a low absolute risk of hypertension. Several meta-analyzes have shown a significant decrease in blood pressure with a high calcium intake (25-28). One of these analyzes showed that calcium from food was more effective in reducing blood pressure compared to supplements (29). In children this protective effect has also been seen, and it was determined that for each 100 mg increase in calcium intake, the systolic pressure was decreased by 2.27 mm Hg (30).

2. Clinical studies: There have been numerous studies, some have used calcium supplements as the source of the nutrient and other foods. Supplementation of 1 g / d of calcium for several weeks (31) or days (32) resulted in a significant decrease in blood pressure. It was recently observed that those with low habitual calcium intake benefited more from calcium supplementation (33), although not all studies show this (34,35). The results with the use of supplementation are not consistent, possibly to the use of a single isolated nutrient. This is why several studies have investigated the impact of calcium-rich foods, which are also good sources of magnesium and potassium, in blood pressure. In hypertensive patients, a 9-8% decrease in blood pressure was observed with the consumption of dairy products and calcium fortified juice for 6 weeks, compared with the control group. The "DASH" study (37) investigated the effect of 3 diets on blood pressure: 1) diet high in saturated fat and low in calcium (450 mg / d calcium); 2) diet rich in fruits and vegetables but low in calcium (450 mg / d calcium); and 3) diet rich in fruits and vegetables and dairy products low in saturated fat "combined diet" (1240 mg / d calcium). The combined diet significantly reduced blood pressure compared to the other two diets.

The interaction of calcium with other nutrients seems to be important in the control of blood pressure, such as the salt-calcium interaction. In black hypertensive patients consuming a diet low / high in calcium / sodium, an increase in blood pressure and in the levels of parathyroid hormone (PTH) was observed, especially in black individuals, which was abolished with the high diet in calcium (38). This racial difference was also found in girls when consuming a diet low (800 mg / d) or high (> 1300 mg / d) in calcium and low (1 g / d) or high (3.86 g / d) in sodium for 3 weeks (39). The urinary excretion of sodium ( Figure 2 ) and calcium excretion ( Figure 3 ) was significantly lower in black girls in the high sodium / low calcium combination, but when calcium was added to the diet, the racial differences disappeared. These racial differences may be the result of some mutation in the channels of calcium and sodium regulation at the renal level, which may be present in other groups with a high incidence of hypertension (40-42).

The mechanism by which calcium and sodium affect blood pressure is altering their regulatory systems (43). In the case of sodium, the renin-aldosterone system and in the case of calcium, vitamin D and PTH. These hormones in turn regulate free calcium in the cytosol, which participates as a second messenger in various reactions. A high level of free calcium in the cytoplasm increases smooth muscle contraction, catecholamine secretion and central nervous system activity and therefore increases blood pressure. A high intake of calcium keeps low free calcium in the cytoplasm because vitamin D and PTH do not increase, so blood pressure does not increase either.

Calcium is also involved in the prevention of pregnancy-induced hypertension (HIE). In Guatemala, a low incidence of eclampsia has been found and is explained by the high calcium intake (44). However, in Colombia and India a high incidence of eclampsia has been observed and in these populations it has been determined that the calcium intake is 250-350 mg / d. In Ecuador it was observed that supplementation with 2 g / d of calcium reduced blood pressure in pregnant adolescents (45). In a meta-analysis of 14 randomized studies with calcium supplementation in 2459 pregnant women, a significant decrease in blood pressure was observed (26).

Calcium and cancer

Cancer is the third cause of death worldwide. In the year 2000, around 7 million people died of cancer, which represents 12% of all deaths (46). Among the different types of cancer, colon cancer is the third cause of death and breast cancer is the fifth cause. In Venezuela in 2000 there were 922 cases and 499 people died of colon cancer, 442 cases and 282 people died of ovarian cancer, and 3400 cases and 1068 people died of breast cancer (47).

Epidemiological studies have shown that a high calcium intake decreases the risk of colon cancer and its recurrence. In studies with more than 100 thousand subjects it was determined that the intake of 1200 mg / d of calcium was associated with a lower risk and incidence of colon cancer (48), both in men (49) and in women (50). Longitudinal studies with numerous subjects with or without a history of colon cancer show that the consumption of more than 2 daily servings of calcium protects against recurrent colon cancer (51), especially if low-fat dairy products are consumed (52). which results in a low relative risk of colon cancer (53). However, not all studies have found this relationship (54,55).

Clinical studies have found a decrease in the proliferative activity of colonic cells with calcium intake (56,57). In subjects with a history of colorectal adenoma, supplementation with 1200 mg / d of calcium decreased the risk of recurrence by 19% (58).

The mechanism by which calcium seems to protect against colon cancer lies in the participation of calcium in cell division and in the regulation of cell proliferation and differentiation. A low level of intracellular ionized calcium contributes to cell proliferation while high concentrations decrease the proliferation of colonic cells (59). Alternatively, calcium precipitates bile and fatty acids in faeces (60), which are potentially toxic, whereas insoluble calcium salts are less toxic to the colonic mucosa. Calcium supplementation reduces the concentration of faecal bile acids (61). However, not all studies have shown these benefits (62-64).

Regarding breast cancer, it was found that a high consumption of dairy products was related to a low relative risk in young women (65), but not in post-menopausal women (66). In Uruguay it was found that low-fat dairy products, especially fermented products (yogurt), were linked to a lower risk of cancer, while high-fat dairy products (chocolate and yellow cheese) were at higher risk (67) .

Calcium intake has also been associated with the prevention of ovarian cancer. In women, a low relative risk was observed with a high consumption of low-fat dairy products versus those with low consumption (68), although others did not achieve this effect (69).

To observe the protective effect of calcium in cancer, it is not necessary to consume levels higher than those recommended for the general population, since studies have shown that higher levels of calcium (> 1200 mg / d) do not produce additional benefits (48 ).

Calcium and kidney stones

The incidence of renal lithiasis varies by region, being low in Asia (1% -5%), average in Europe (5% -9%) and North America (12% -13%) and high in the Middle East (20%) ) (70). In Venezuela, there are no national data on the incidence of kidney stones.

Kidney stones are formed when the urine is concentrated and the substances that normally are in it crystallize, such is the case of oxalate and calcium; so the first therapeutic measure against kidney stones would involve a reduction in calcium intake, however, there is evidence to the contrary. A study with more than 45 thousand men showed that high calcium intake decreased the risk of presenting kidney stones in 34% (2), with a low relative risk in those with a high calcium intake compared with those who consumed <850 mg / d of calcium. In women it was also observed that a high calcium intake decreased the risk of kidney stones, but only if calcium came from food, since the use of calcium supplements was positively associated with the risk of kidney stones, especially those who consumed calcium. supplement without food (71). Foods rich in calcium (dairy products) may contain other substances that help reduce the risk.

It has been suggested that the mechanism by which calcium prevents kidney stones is in the interference of intestinal absorption of oxalate (72). Clinical studies show that calcium binds to oxalate at the intestinal level, making it less available for absorption, which leads to a lower oxalate content in the body and therefore to a lower excretion of oxalate in the urine (73,74 ). The high concentration of oxalate in the urine is what causes the calculation.

Calcium and obesity

Obesity is an epidemic worldwide. It is estimated that more than 1 billion people are overweight and at least 300 million people are obese (75). Recently, high calcium intake has been related to a decrease in body weight due to its relationship with the control of fat metabolism. The first study to demonstrate this association was an epidemiological study in women, where those with a high calcium intake (> 1300 mg / d calcium), presented a low relative risk (0.16) of having high body fat compared to those with an intake less than 300 mg / d of calcium (76). In young women it was observed that a high calcium intake with respect to total calories significantly decreased body fat (> 3 kg) compared to women with a low calcium / kcal intake (77). In children aged 5 to 6 years, there was also a significant decrease in body fat (2 kg) consuming 1200 mg / d versus those who consumed 500 mg / d (78) and in children aged 7 to 10 years it was determined that the low Ingestion in calcium was found to be one of the predictors of obesity (79).

Clinical studies have also shown this effect. The consumption of 2 cups of yogurt per day for 12 months resulted in a total decrease of 4.9 kg of body fat at the end of this period in obese (76). Obese subjects assigned to a diet exclusively based on dairy products lost 7.4 kg, while those with a mixed diet lost only 1.4 kg in 4 weeks (80). In a re-analysis of several studies in women it was determined that for every 1000 mg of difference in calcium intake there was 8 kg of difference in body weight (81).

The effect of calcium on weight control seems to be more effective with the consumption of dairy products compared to the use of calcium supplements, possibly due to the presence of other bioactive compounds, although there are no studies in humans (82). In obese mice, a greater decrease in body weight and fat mass was observed with a mixed diet based on dairy products versus the diet with calcium supplement (83).

The mechanism by which calcium influences weight control and body fat lies in the regulation of intracellular fat metabolism. Apparently, a diet low in calcium leads to a decrease in serum calcium, which increases intracellular calcium in the adipocytes, resulting in an increase in lipogenesis and decreased lipolysis, and therefore, fat accumulation. Conversely, a diet high in calcium suppresses intracellular calcium, increasing thermogenesis and reducing fat accumulation.

In conclusion, dietary calcium helps protect against chronic diseases such as osteoporosis, high blood pressure, cancer, kidney stones and obesity. Calcium from food, especially dairy products, seems to be more effective in preventing these diseases, possibly due to the interaction with other nutrients present in these foods. To observe the protective effect of calcium against these diseases, it is not necessary to recommend high calcium intakes, since its protective effect is evident at the levels recommended for most of the population, that is, between 1000 and 1300 mg of calcium per day. However, adequate calcium intake for preventive purposes should be maintained over time and not as a punctual intervention.

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One thousand milligrams of calcium per day to prevent osteoporosis

In order to prevent osteoporosis, foods that provide one thousand milligrams of calcium per day should be consumed in general. The specialist José Zanchetta affirms that the epidemiological studies allow the understanding of this disease that weakens the bones and the awareness of the importance of the campaigns of prevention and diagnosis.

(CyTA Agency - Leloir Institute) -. The early care of our bones from childhood prevents the development of osteoporosis in adult life, a disease characterized by a decrease in the density and quality of bones.



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"Although the population's awareness of the measures that can prevent this disease is greater today, there are still many details that the population does not know," Dr. José Zanchetta, president of the Argentine Society of Health Sciences, told the CyTA Agency. Osteoporosis and member of the steering committee of the International Osteoporosis Foundation. He adds: "There is a lot that we can do daily to take care of our bones and those of our children. Care must start from early childhood. The proper diet in calcium, regular exercise, adequate sun exposure, healthy life without excessive tobacco and alcohol (both elements are toxic to the skeleton) favor the development, strengthening and maintenance of healthy and strong bones. On the other hand, the early detection of the disease plays a fundamental role in its future management ".

Calcium and vitamin D


When sufficient calcium is not supplied to the organism, the skeleton is decalcified and in the long term it becomes fragile in the face of minor traumas that can cause fractures, stresses Dr. Zanchetta who also works as a medical director of the Metabolic Research Institute.

Parallel vitamin D consumption is key to bone fortification. "This type of vitamin favors the absorption and utilization of calcium, and although it can be provided by some fortified foods, such as dairy products, the main source of vitamin D is our own body, since our skin exposed to the sun starts its production", explains Zanchetta. And he continues: "The main function of vitamin D is to help calcium to be absorbed in the intestine. In extreme situations of absolute lack of sun exposure in children, it can cause rickets, and malformation of the bones. It is recommended the solar exposure of 15 minutes in arms and legs per day (walks, shopping) avoiding the hours not recommended (11 to 16 hours). If there are contraindications for sun exposure (as in people with a history of skin cancer) it can also be easily replaced with medication droplets. "

According to the specialist, it is advisable to incorporate the calcium in the food and the most suitable are the dairy products. "The needs can vary in different moments of life but in general lines are 1000 milligrams (mg) of calcium per day," he says.

In this sense, Dr. Zanchetta states that it is useful to know how much calcium the different dairy products contain to make the daily menu. As an example, point out that a portion of semi-soft cheese provides 700 mg of calcium, a yogurt of 250 between 350-400 mg, a fortified yoghurt 450-500 mg, a glass of milk of 200 ml contains 200 mg and a glass of milk Fortified about 250-300 mg.

"If you can not meet the daily requirements for some reason such as intolerance can be supplemented with supplements in tablets," says the specialist.

Higher prevalence in women

Although osteoporosis is suffered by both sexes, this disease affects women more, especially after menopause. In order to know its prevalence in this population, Dr. Zanchetta and a team of colleagues conducted an epidemiological study in which 4 thousand Argentine postmenopausal women were evaluated.

The results of the work, presented at the 7th Congress of the Ibero-American Society of Osteology and Mineral Metabolism in 2007, showed that 35 percent of postmenopausal women over 50 have osteoporosis according to the classification set by the World Health Organization. According to Zanchetta, these results would be valid to date and can be extrapolated to the group of women of that age group in the country. And she says that at this stage in women's lives it is crucial to maintain optimal levels of calcium.

On the other hand, the specialist warns that in the case of the elderly where calcium levels tend to decrease it is critical to avoid falls to prevent fractures. "You have to take care of your eyesight, train your balance and muscular strength, wear comfortable footwear and free the house from obstacles that make it easier to get stuck, among many other measures," he says.

"Thanks to epidemiological studies we can have a more concrete idea of ​​this problem, which can help society in general to become aware of the importance of prevention and diagnosis campaigns and thus be able to identify patients at risk", Dr. Zanchetta emphasizes. And he concludes: "Prevention plays an important role, food, nutrition and exercise favor the development, strengthening and maintenance of healthy and strong bones and early detection of the disease plays a key role in its future management. Consultation with the doctor about bone health is fundamental. "

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Calcium overdose to have strong bones?

Increasing calcium intake does not prevent fractures, nor are supplements useful for bone remineralization .



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Tell me three truths about bone health:

  • - It is necessary to take a lot of calcium to have strong bones.
  • - Dairy products are essential and protect us from osteoporosis.
  • - If, despite having a high consumption of dairy products (ergo, calcium), our bone density suffers, it will be fixed by taking calcium in supplements or calcium-fortified foods.

Many will think that these three statements are obvious, everyone knows them and you do not have to be a nutritionist ... These messages come to us continuously through advertising, food marketing and the advice of some experts. Nothing new. Dairy = calcium = strong bones.

Although the truth is that it may not be so true.

    It is encouraged not to leave the dairy products even if they are not tolerated, without much pausible evidence and with economic interests behind

Maybe the dairy industry has an interest in these messages and strives to reach us, especially when the trend indicates that sales fall. Maybe calcium intake is not directly proportional to bone mineralization . Perhaps there are preventive strategies for osteoporosis that are not prioritized because they do not report any economic benefit to any industry. Perhaps professional advice is often outdated or biased by interests, or poorly updated.

Yes, we started strong. Let's reduce the tension by talking a little about the recommended calcium intakes:

How much calcium?

Calcium intake recommendations are very variable among countries with similar conditions; we went from 900mg per day for adults in Spain to 1,000mg in the US or 700mg in the United Kingdom for the same age range. 30% less for the British than for the Americans, yes. The EFSA (European Food Safety Authority) for its part indicates a reference intake of 1,000 mg / day from 18 to 24 years and 950 mg / day for people over 25 ( PDF ). No changes in pregnancy or breastfeeding (Spain rises to 1,200mg in breastfeeding and the United Kingdom to 1,250mg) Do I need less calcium in London than in Madrid? If I breastfeed, do I increase my calcium intake by more than 60% as advised by the UK or do I keep it the same as the EFSA states? Or are the recommendations very dependent on other variables such as the type of diet, the bioavailability of the mineral and the interests of the person who formulates them? It is difficult to answer. But it is worth sowing the doubt and highlight that things are far from clear.

Do we take enough calcium?

Yes, we have enough, according to the Spanish Nutrition Foundation ( PDF ) and according to a study by Eduard Baladia, Julio Basulto and María Manera ( PDF ). Is media bombing with the issue needed then? Even if the intake is low ( as suggested by other sources ), is consuming more calcium the best strategy for good bone health? No: neither increase the intake prevents fractures , nor supplements are useful for bone remineralization . To these conclusions came two reviews published in the British Medical Journal in 2015.

It seems that the affirmations that opened the article begin to not be so clear.

The population is pressured to achieve a high calcium intake, especially in childhood and in postmenopausal women. All kinds of products focused on these objectives are designed: yogurts with twice as much calcium, milk enriched with even more calcium, children's products that outline in the package its content in such a heavy mineral ... It is encouraged not to leave dairy products even though they are not tolerated , because the industry gives solutions, launching government campaigns ... All without much pausible evidence and economic interests behind.

Meanwhile, one in four postmenopausal women have osteoporosis (according to the Spanish Society of Rheumatology in 2015 ), and the trend is increasing. It does not seem that the strategy is working at the level of population health.

Leaving aside economic interests, it can be said that insisting on increasing calcium intake lacks justification, from a health point of view. On the other hand, they are remarkably more effective indications to prevent osteoporosis and take care of bone health: recommend physical activity (especially strength exercises), an adequate protein intake (especially in the elderly), maintain a good level of vitamin D, moderate consumption of salt, get enough magnesium and vitamin K consuming vegetables, do not drink and do not smoke. And in the prevention of non-communicable diseases in general, incidentally.

But the message that the population receives is only to increase the calcium intake. And based on dairy, even if you do not like them or do not tolerate them. Dairy products that are frequently accompanied by huge amounts of sugar, especially those intended for children. You could even say that these sugary dairy products are a product to avoid and not to recommend.

Can economic interests have more weight in public health guidelines than the evidence itself? Maybe it's not just happening with dairy and calcium?

Lucía Martínez Argüelles , is a dietitian-nutritionist, master in nutrigenomics and personalized nutrition, TSD.

NUTRIR CON SCIENCIA is a section on nutrition based on scientific evidence and knowledge contrasted by specialists. Eating is much more than a pleasure and a necessity: diet and eating habits are now the public health factor that can most help us prevent many diseases, from many types of cancer to diabetes. A team of dieticians-nutritionists will help us to better understand the importance of food and to tear down, thanks to science, the myths that lead us to eat badly.