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What is calcium?

Calcium, the most abundant mineral in the body, is an essential nutrient that is vital to growth and development. About 99 percent of the body's calcium is stored in the bones and the teeth; the rest circulates in the blood and is essential to a number of bodily processes, including the proper contraction of the heart and other muscles. When the level of circulating calcium is low, the bones release stored calcium into the blood. When there is adequate calcium circulating in the blood, calcium taken in from the diet is stored in the bones or excreted in the urine.

Why is calcium important to nutrition?

Calcium plays several essential roles in maintaining health. These include:

• Building bones and teeth.
• Promoting blood clotting.
• Aiding proper nerve and muscle function.
• Activating certain enzymes that convert food into energy.

How much calcium do I need?

The Recommended Dietary Allowances (RDAs) for calcium (in milligrams per day) are as follows:

• 360 to 540 for infants.
• 800 for children age 1 to 10 years.
• 1,200 for ages 11 to 18.
• 800 for adults.
• 1,200 for pregnant or nursing mothers.

In recent years, some experts have contended that adult women may need more than 800 milligrams of calcium a day, and many advise women to consume 1,000 milligrams a day. Calcium is especially important for pregnant women to ensure that the unborn baby's teeth and bones develop properly. If the woman is in her teens or early 20s, her own bones are still developing, and the need for calcium is even greater. In order for the body to

Good sources of calcium

• Milk and milk products.
• Green, leafy vegetables such as broccoli.
• Sardines, shellfish, and canned salmon (with the bones).
• Citrus fruits, such as oranges, tangerines, and grapefruit.
• Dried peas and beans.
• Tofu.
• Dried figs and dates.
• Antacids made of calcium carbonate

Rich sources of calcium include milk, cheese, and other dairy products as well as broccoli and other dark green, leafy vegetables.

absorb calcium, it also needs vitamin D, which can be obtained by exposing the skin to sunlight for brief periods every few weeks, or by eating foods such as fortified milk, egg yolks, or cold-water fish.

What happens if I don't get enough calcium?
Children who do not get adequate calcium (and/or vitamin D, which is needed to metabolize calcium) suffer growth abnormalities and rickets, a disease characterized by soft bones. Even if they do not develop rickets, children who do not consume adequate calcium often have thin or weak bones.

Inadequate calcium over the years can contribute to the process of osteoporosis, or thinning of the bones. As people age, their bones lose calcium, becoming porous and brittle. Osteoporosis occurs most commonly in women, especially small-boned, white women over age 50. Osteoporosis can lead to compression fractures of the vertebrae, muscle spasms, and broken bones due to minor falls. While it appears that dietary calcium alone cannot prevent osteoporosis, it may retard its progress and keep the condition from becoming a serious problem.

What happens if I get too much calcium?
Excessive calcium can increase the risk of kidney stones. High levels of calcium in the blood can lead to hypercalcemia, a potentially serious condition characterized by constipation, loss of appetite, nausea, abdominal pain, and kidney damage.

Overdoses of vitamin D or calcium supplements taken in combination with certain drugs, such as diuretics, can result in excessive calcium, a condition called hypercalcemia. However, excessive calcium in the body is usually due to other diseases, rather than to dietary factors. These include certain cancers, kidney disease, overdoses of vitamin D, or hormonal disorders. Exceptions are milk-alkali syndrome, in which a person (usually an ulcer patient) consumes large amounts of milk and antacids containing alkali.

Should I take calcium supplements?
In general, no. A balanced diet normally provides an adequate amount of calcium for most children and adults. Supplements should not be taken unless recommended by a doctor, because they may interact adversely with medications being taken for some other medical problem. Calcium supplements are sometimes recommended for pregnant women and for middle-aged and postmenopausal women. For example, a pregnant woman following a vegetarian diet that does not include dairy products almost certainly needs a calcium supplement, but she should rely on her doctor's advice.

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