BioAvailablity of Calcium

[Guest guest]

Here's everything you could want to know. Yes Calcium Carbonate

is " cheaper " but citrate is almost 3 times as bio available.

Read on gentle readers.

Optimal Calcium Intake

National Institutes of Health

Consensus Development Conference Statement

June 6-8, 1994

This statement was originally published as:

Optimal Calcium Intake. NIH Consens Statement 1994 June 6-8; 12(4):1-

31

For making bibliographic reference to consensus statement number 97 in

the electronic form displayed here, it is recommended that the

following format be used:

Optimal Calcium Intake. NIH Consens Statement Online 1994 June 6-8; 12

(4):1-31

________________________________

NIH Consensus Statements are prepared by a nonadvocate, non-Federal

panel of experts, based on (1) presentations by investigators working

in areas relevant to the consensus questions during a 2-day public

session; (2) questions and statements from conference attendees during

open discussion periods that are part of the public session; and (3)

closed deliberations by the panel during the

remainder of the second day and morning of the third. This statement

is an independent report of the panel and is not a policy statement of

the NIH or the Federal Government.

The statement reflects the panel's assessment of medical knowledge

available at the time the statement was written. Thus, it provides a

" snapshot in time " of the state of knowledge on the conference topic.

When reading the statement, keep in mind that new knowledge is

inevitably accumulating through medical research.

[From Section 4. " What are the best ways to obtain optimum calcium

intake " - **highlighted** text selected by me (JAZ)]

" **For some individuals, calcium supplements may be the preferred way

to attain optimal calcium intake.** Calcium supplements are available

as various salts, and most preparations are well absorbed except when

manufactured such that they do not disintegrate during oral ingestion.

**Absorption of calcium supplements is most

efficient at individual doses of 500 mg or less and when taken between

meals.** Ingesting calcium supplements between meals supports calcium

bioavailability, since food may contain certain compounds that reduce

calcium absorption (e.g., oxalates). **However, absorption of one form

of calcium supplementation,

calcium carbonate, is impaired in fasted individuals who have an

absence of gastric acid.** Absorption of calcium carbonate can be

improved in these individuals when it is taken with certain food.

**The potential for calcium supplementation to interfere with iron

absorption is an important consideration when it is ingested with

meals. Alternatively, calcium supplementation in the form of calcium

citrate does not require gastric acid for optimal absorption and thus

could be considered in older individuals with reduced gastric acid

production.** In individuals with adequate gastric acid production, it

is preferable to ingest calcium supplements between

meals. "

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

ASK AHSC

Answers to Health Questions

from The University of Arizona Health Sciences Center (AHSC) in Tucson

MAY 2001

Q I was told to take calcium supplements daily after my gastric bypass

operation. Which is better, calcium carbonate or calcium citrate? Why?

And how much should I take? ( I'm a 55-year-old male, 6'3 " , 205 lbs.)

R.H.

A Calcium carbonate has more calcium per gram than calcium citrate, so

it would take less volume (fewer pills or less liquid) of the calcium

carbonate to provide the same amount of absorbable calcium.

Because calcium carbonate requires hydrochloric acid, a stomach acid,

to be digested and absorbed, the type and extent of your gastric

bypass will determine which calcium supplement is better for you.

The recommended intake of calcium for a 55-year-old male is 1,200

milligrams daily based on the 1997 Institute of Medicine guidelines.

However, you should check with the dietitian who assisted you after

your surgery, or check with your surgeon, for a specific,

individualized recommendation.

-Deborah Pesicka, R.D., registered dietician, University Medical

Center, Tucson

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

http://www.geocities.com/medcin/calcium.html

<http://www.geocities.com/medcin/calcium.html> Another source, an MD

http://www.askapot.com/prod_info/calcium.htm

<http://www.askapot.com/prod_info/calcium.htm> A nutritional

supplement store

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

http://www.myhealthylife.com/myhealthylife/Tips/May01Tip2.asp

<http://www.myhealthylife.com/myhealthylife/Tips/May01Tip2.asp>

Do I need a special supplement if I'm over 65 years old?

People over 65 produce less gastric acid (stomach acid). Gastric acid

is necessary for the absorption of most forms of calcium. If you do

not have adequate gastric acid in your stomach, it is recommended that

you consider taking a calcium citrate supplement. Take this supplement

between meals.

What if I'm taking medication that decreases the production of

gastric acid?

Again, calcium citrate is a good supplement for you. Take between

meals.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Some relevant studies from the NIH position paper on osteoporosis and

optimum calcium supplementation

http://www.nlm.nih.gov/pubs/cbm/calcium.html

<http://www.nlm.nih.gov/pubs/cbm/calcium.html> :

JJB. Nutritional biochemistry of calcium and phosphorus. J

Nutr Biochem 1991 Jun;2(6):300-7.

Brennan MJ, Duncan WE, Wartofsky L, VM, Wray HL. In vitro

dissolution of calcium carbonate preparations. Calcif Tissue Int 1991

Nov;49(5):308-12. Comment in: Calcif Tissue Int 1992 Feb; 50 (2):197.

Bronner F. Nutrient bioavailability, with special reference to

calcium. J Nutr 1993 May;123(5):797-802.

P. Calcium absorption and calcium bioavailability. J Intern

Med 1992 Feb;231(2):161-8.

Heaney RP, Recker RR, Weaver CM. Absorbability of calcium sources: the

limited role of solubility. Calcif Tissue Int 1990 May;46(5):300-4.

Pak CY, Avioli LV. Factors affecting absorbability of calcium from

calcium salts and food. Calcif Tissue Int 1988 Aug;43(2):55-60.

Schnepf M, Madrick T. The solubility of calcium from antacid tablets,

calcium supplements and fortified food products. Nutr Res 1991

Sep;11(9):961-70.

Shangraw RF. Factors to consider in the selection of a calcium

supplement. Public Health Rep 1992 Sep-Oct;Suppl:46-50.

Wabner CL, Pak CY. Modification by food of the calcium absorbability

and physicochemical effects of calcium citrate. J Am Coll Nutr 1992

Oct;11(5):548-52.

Weaver CM. Calcium bioavailability and its relation to osteoporosis.

Proc Soc Exp Biol Med 1992 Jun;200(2):157-60.

Whiting SJ, Pluhator MM. Comparison of in vitro and in vivo tests for

determination of availability of calcium from calcium carbonate

tablets. J Am Coll Nutr 1992 Oct;11(5):553-60.

Wood RJ, Serfaty Lacrosniere C. Gastric acidity, atrophic gastritis,

and calcium absorption. Nutr Rev 1992 Feb;50(2):33-40.

[Guest guest]

Let me say this info came from Z who's a RNYer. But the info is

wholesome.

Also.. the big thing to note relating to this discussion is that

CARBONATE should be taken with meals, and CITRATE absorbs best

without as much gastric acid...so it should be taken on an empty

stomach.

So take your Citrate in the morning before breakfast and at bedtime

and chew your carbonate (viative and tums) during the day

--Kym

[Guest guest]

Let me say this info came from Z who's a RNYer. But the info is

wholesome.

Also.. the big thing to note relating to this discussion is that

CARBONATE should be taken with meals, and CITRATE absorbs best

without as much gastric acid...so it should be taken on an empty

stomach.

So take your Citrate in the morning before breakfast and at bedtime

and chew your carbonate (viative and tums) during the day

--Kym

[Guest guest]

> Here's everything you could want to know. Yes Calcium Carbonate

> is " cheaper " but citrate is almost 3 times as bio available.

Kym,

This information you have posted is old. Some of the science is

weak and only someone who is trained to evaluate the validity of

research would be able to determine what parts of the information

are valid and which are not. That is why even I, a physician, will

tell everyone to listen to Dr.K and Dr.Z and do what they say.

They have been saying CsCO3 is fine and to take it with meals.

Personally, I have begun flooding my digestive tract with calcium

via both foods and supplements in the hope that some of it is

absorbed. lol

Marta