1. Rachel Peterson CALCIUM

2.  Osteoporosis, the deficiency disease of calcium, has been discovered in 4000 year old Egyptian mummies  Determined by presence of dowager’s hump or curved spine  Used to create plaster of Paris 1000 years ago to set broken bones HISTORY

3.  Leafy greens: collards, kale, broccoli, turnip greens  Fortified foods: breakfast cereals and fruit juices  Dairy Products: milk, yogurt, cheese  Crackers, white bread, rolls  Salmon and sardines CALCIUM IN FOODS

5.  RDA for Adults 19-50 years  1000 mg/day  RDA after women are 50 and men are 70  1200 mg/day  Adolescents  1300 mg/day  Daily Value  1000 mg/day CALCIUM NEEDS

6.  Occurs along length of intestinal tract  Absorbed most efficiently in upper region of small intestine  Absorption decreases at end of small intestine and colon  Some is absorbed via passive diffusion ABSORPTION

7.  Our bodies are able to absorb greater amounts of calcium during periods of growth  Infancy  Pregnancy  Vitamin D promotes calcium absorption  Adults absorb 25-30%  Reduced absorption  Secretion of stomach acid  Chronic diarrhea  Intake of phytic acid, oxalic acid, phosphorus, polyphenols ABSORPTION

8.  Calcium is transported in two forms  Free ionized form  Protein-bound form  99% of calcium is stored in bones and teeth  Calcium is excreted via urine and sweat TRANSPORT AND STORAGE

9.  Low calcium levels:  Parathyroid hormone (PTH) released  PTH works with vitamin D to increase kidney’s reabsorption of calcium  Kidneys inhibit calcium from being excreted in urine  PTH promotes synthesis of vitamin D and helps calcium be released from bones  High calcium levels:  Less PTH is released  Urinary calcium excretion increases  Vitamin D synthesis decreases  Calcitonin is released to block calcium loss from bones CALCIUM IN THE BLOODSTREAM

10.  Bone development and maintenance  Blood clotting  Transmission of nerve impulses  Muscle contraction  Cell metabolism  Controlling blood pressure FUNCTIONS

11.  UL: 2500 mg/day for adults aging 19-50  UL: 2000 mg/day for adults 50+  Typically caused by supplementation  Hypercalcemia  High concentration of calcium in blood  Kidney stone development  Kidney failure  Irritability and headache  Decreased absorption of other minerals UPPER LEVEL OF CALCIUM

12.  Osteopenia  Osteoporosis  Affects 8 million women and 2 million men in US  More prevalent in Caucasian/whites and postmenopausal women  Kyphosis  Prevention: early intake of calcium and vitamin D, intake of other minerals, exercise/weight training CALCIUM DEFICIENCY

13. KYPHOSIS

14. OSTEOPOROSIS

15.  45% of adults report using  Contain salts like calcium carbonate or calcium citrate  May contain vitamin D to increase absorption  Should be used with caution  Hypercalcemia  Calcium deposits  Interactions with other minerals  Lead contamination SUPPLEMENTATION

16.  Relationship between calcium supplementation and cardiovascular events  Found that supplementation had varied effects on cardiovascular events, stroke, and myocardial infarction  Concluded that the benefits of a calcium supplement outweigh the risk of cardiovascular events CURRENT RESEARCH

17.  Relationship between protein intake, calcium balance, and the health consequences  Researchers hypothesized that a high protein intake would exert a hypercalciuric effect and a low urinary pH  Effects together promote skeletal demineralization  Found that high protein diets do induce an increase in urinary calcium excretion, but are not linked to an impaired calcium balance or decrease in bone density CURRENT RESEARCH

18.  Unable to access the Evidence Analysis Library EAL

19.  What are sources of calcium?  What is the RDA for calcium?  What two hormones are used in maintaining blood calcium levels?  What is the deficiency disease associated with calcium? QUESTIONS

20.  Byrd-Bredbenner, G. Moe, D. Beshgetoor, & J. Berning, Wardlaw's Perspectives in Nutrition-Ninth Edition (pp. 512-523). New York, NY: The McGraw-Hill Companies. (2013)  Calvez, J., Poupin, N., Chesneau, C., Lassale, C., & Tome, D. (2012). Protein Intake, Calcium Balance, and Health Consequences. European Journal of Clinical Nutrition, 281-295.  Dietary Supplement Fact Sheet: Calcium. (2013, March). Retrieved October 27, 2013, from Office of Dietary Supplements: National Institutes of Health: http://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/#h10  Downing, L., & Islam, M. A. (2013). Influence of Calcium Supplements on the Occurance of Cardiovascular Events. American Journal of Health-System Pharmacy, 1132-1139.  Hacker, A. N., Fung, E. B., & King, J. C. (2012). Role of Calcium during Pregnancy: Maternal and Fetal Needs. Nutrition Reviews, 397-409.  Peters, B., Verly Jr., E., Marchioni, D., Fisberg, M., & Martini, L. (2011). The Influence of Breakfast and Dairy Products on Dietary calcium and Vitamin D Intake in Postpubertal Adolescents and Young Adults. Journal of Human Nutrition and Dietetics, 69-74.  Sizer, & Whitney, Nutrition: Concepts & Controversies (pp. 288-290). Belmont, CA: Wadsworth Cengage Learning. (2011)  Spangler, M., Bryles-Phillips, B., Ross, M. B., & Moores, K. G. (2011). Calcium Supplementation in Postmenopausal Women to Reduce Risk of Osteoporotic Fractures. American Journal of Health-System Pharmacy, 309-318. BIBLIOGRAPHY