The Role Of Calcium In Osteoporosis

Osteoporosis is a decrease in bone density and is related to insufficient intake of calcium and vitamin D.
The role of calcium in osteoporosis

Osteoporosis affects millions of people around the world, causing an increased risk of bone fractures. In this article, we’re going to talk specifically about the role calcium plays in preventing and treating osteoporosis.

What is osteoporosis?

Osteoporosis  is a skeletal disease that occurs with decreased bone density. Although it is a silent pathology, its presence implies frailty, increased risk of fractures and disability.

at risk populations

From age 30 onwards, the risk of osteoporosis increases  as a result of the increase in the amount of calcium that separates from the bone. Thus, after that age, the increase in bone density will be impossible and the calcium consumed, at best, will only allow us to make up for losses.

This risk is even greater in postmenopausal women and is due to the associated drop in estrogen levels. Estrogen is a bone lifesaver, as it stimulates the activity of osteoblasts – bone building cells – and reduces that of parathormone – a hormone that increases the removal of calcium from the bone.

Finally, we find those people who have an altered gut microbiota. Intestinal dysbiosis  means an increase in the permeability of the intestine, which induces a generalized inflammatory state. This inflammation increases osteoclast activity. Its importance is so relevant that there are multiple studies, such as the one published in the journal Nan Fang Yi Ke Da Xue Bao , which point to the intestinal microbiota as a new therapeutic target in this matter.


The role of calcium in osteoporosis

Calcium is the most abundant mineral in the human body: it represents 2% of total body weight and 99% is found in our bones and teeth. Its main function is bone mineralization, although it has other important functions, such as muscle contraction and nerve transmission. In fact, it’s one of the most important minerals for heart contraction.

Plasma calcium concentrations must be within a very narrow range.  For this, there are several factors involved, including:

  • Parathormone: increases the intestinal reabsorption of bone calcium.
  • Vitamin D : promotes intestinal calcium absorption.
  • Vitamin K2 : regulates calcium concentrations inside and outside bones.

Calcium, along with phosphorus, is one of the main constituents of the bone matrix made by osteoblasts. Thus,  bone density is directly dependent  on calcium levels and, therefore, its lack is essential in the origin of osteoporosis.

What to do to prevent osteoporosis?

Nowadays, it is common to believe that to enjoy good bone health, it is enough to ingest calcium through food. However, this is not entirely true. To have strong bones, we need ingestion, absorption and movement.

The role of calcium intake in preventing osteoporosis

The recommended calcium intake is 1000-1300 mg of calcium daily. To achieve it, we can resort to:

  • Dairy products. They are the most important source of calcium in our diet because their calcium is what is best absorbed. A serving of dairy products (a glass of milk, two yoghurts or 60g of cheese) contains 280mg of calcium. However, those fortified with vitamin D have a higher rate of absorption of the mineral, according to a study published in 2017.
  • Small fish  (canned sardines, for example)  and vegetable sources  (soybeans, broccoli, Brussels sprouts, chickpeas, figs, almonds and hazelnuts). Its absorption is less and it is estimated that, at most, we could obtain 500 mg of calcium per day with a dietary pattern that includes such foods.
  • Supplementation with calcium carbonate or calcium citrate. While the first is cheaper and needs to be consumed with other foods, the second is more expensive and can be eaten on an empty stomach. It is not recommended to take more than 500 mg as absorption is reduced and side effects such as dyspepsia and/or constipation increase.
  • Fortified foods such  as calcium-fortified vegetable drinks.
Calcium against osteoporosis

calcium absorption

The next step would be to ensure the absorption of the calcium we ingest. In this regard, it  is essential to have enough vitamin D.  To do this, just expose yourself to the sun every day for 30 minutes without protection.

If you eat foods fortified with vitamin D, remember that this is a fat-soluble vitamin and that its absorption, therefore, requires the presence of fat. Vitamin D-enriched skim milk is not a good solution.

On the opposite side, we find those  substances that hinder the absorption of calcium:

  • Excess fat.
  • Fibers.
  • Phytic acid: cereals, legumes, nuts and seeds.
  • Oxalic acid: vegetables, fruits and vegetables.
  • Tannins : spinach, coffee, tea, cocoa, grapes and red wine.

mechanical stimulus

The last step would be to get enough mechanical stimuli, ie movement. In this sense, a study published in the  Journal of Bone and Mineral Research  concluded that high-impact exercise  improves the bone mineral density of the femoral neck (hip).

In the same vein, research with tennis players shows how the bone density of their dominant arm is 10% greater than that of the opposite arm.

Optimize calcium intake to prevent osteoporosis

Remember that calcium plays an essential role in preventing and treating osteoporosis. To do this you need ingestion, absorption and movement.

It is also essential that vitamin D levels are in the proper range to ensure absorption of this mineral. Therefore, frequent sun exposure is important.

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