Source
The reference was:
It is never too late to start treatment:
reductions in
fracture rates can occur in as little as 18 months. [Source]
Quote from Robert Heaney, endocrinologist, taken from Medical
Sciences Bulletin. See Heaney, RP, Annual Rev. Nutr. 1993; 13: 287-316.
Dr. Heaney is actually the source for a very large number of studies on
osteoporosis, many of which are listed below, in the abstract form you can find searching
with HealthGate.
Return To The Article
- Title
- Calcium absorption as a function of calcium intake.
- Author
- Heaney RP; Saville PD; Recker RR
- Source
- J Lab Clin Med, 85: 6, 1975 Jun, 881-90
- Abstract
- The relationships between the amount of calcium absorbed and the quantity ingested was
evaluated in 180 adult humans. Absorption was measured from the concentration ratio of
concurrently administered oral and intravenous calcium isotopes. Intake ranged from 0.163
to 7.48 Gm. Ca per day. In 14 subjects, intakes were artificially elevated for purposes of
this study. All others were studied at their usual intake levels. Absorption (Ca Abs) was
found to follow a curvillnear relationship with intake (Ca-D), and was characterized by
the following equation: Ca Abs equals 0.1541 - Ca-D plus 0.3127[exp(-1.0539 - Ca-D)] -
Ca-D. The exponential term of this equation provided the major component of total
absorption at intakes below 0.8 Gm. per day, but fell to negligible values when intake
reached 2 to 3 Gm. per day, above which absorption was characterized by a simple linear
function of intake. We found that there was no detectable upper limit to absorption
capacity, which, at the 7.48 Gm. intake level, averaged more than 1.0 Gm per day. The
observed mathematical description is consistent with the generally recognized inverse
relationship between absorption efficiency and intake. At the same time it indicates that
a component of absorption is independent of control mechanisms and is related solely to
intake. A more general form of the foregoing equation, suggesting provision for other
physiological variables such as growth hormone and cortisol, is proposed and discussed.
- Language of Publication
- English
- Unique Identifier
- 75171093
- MeSH Heading (Major)
- Calcium, Dietary [*ME]
Intestinal Absorption
- MeSH Heading
- Acromegaly [ME]
Adult
Calcium [BL/UR]
Calcium Radioisotopes
Diet
Female
Human
Hyperparathyroidism [ME]
Male
Mathematics
Middle Age
Models, Theoretical
Pregnancy
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0022-2143
- Country of Publication
- UNITED STATES
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Of Viewpoint #1
- Title
- Effects of nitrogen, phosphorus, and caffeine on calcium balance in women.
- Author
- Heaney RP; Recker RR
- Source
- J Lab Clin Med, 99: 1, 1982 Jan, 46-55
- Abstract
- The effects of different levels of nitrogen, phosphorus, and caffeine intake on calcium
balance and on certain of its components were assessed in 170 studies in normal
middle-aged, but still premenopausal women. Statistically significant negative
associations with calcium balance were found for nitrogen and for caffeine, but no effect
could be found for phosphorus. Higher nitrogen intakes were associated with
proportionately higher levels of urinary calcium; higher phosphorus intake was associated
with slightly lower levels of urinary calcium but also with slightly more intestinal
secretion of calcium. Since these two effects were opposite in direction, there was no net
association of different phosphorus intakes with calcium balance. Caffeine intake was
associated with higher levels of both urinary calcium and intestinal calcium secretion.
None of the three intake variables was associated with differences in calcium absorption
efficiency. Both the nitrogen and the caffeine effects were proportional to intake. The
magnitude of the effects observed was such that a 50% increase in intake of nitrogen above
the group mean intake value would be predicted to result in calcium balance shift of
-0.032 gm/day. For caffeine, the corresponding calcium balance shift would be predicted to
be -0.006 gm/day.
- Language of Publication
- English
- Unique Identifier
- 82099794
- MeSH Heading (Major)
- Caffeine [*PD]
Calcium [*ME/SE/UR]
Nitrogen [*PD]
Phosphorus [*PD]
- MeSH Heading
- Adult
Biological Transport
Body Height
Body Weight
Dairy Products
Diet
Female
Human
Intestinal Absorption
Meat
Middle Age
Support, U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0022-2143
- Country of Publication
- UNITED STATES
- CAS Registry/EC Number
- 58-08-2 (Caffeine)
7440-70-2 (Calcium)
7723-14-0 (Phosphorus)
7727-37-9 (Nitrogen)
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Of Viewpoint #1
Document: 3
- Title
- Calcium absorbability from milk products, an imitation milk, and calcium carbonate.
- Author
- Recker RR; Bammi A; Barger-Lux MJ; Heaney RP
- Address
- Department of Internal Medicine, Creighton University School of Medicine, Omaha, NE.
- Source
- Am J Clin Nutr, 47: 1, 1988 Jan, 93-5
- Abstract
- Whole milk, chocolate milk, yogurt, imitation milk (prepared from dairy and nondairy
products), cheese, and calcium carbonate were labeled with 45Ca and administered as a
series of test meals to 10 healthy postmenopausal women. Carrier Ca content of the test
meals was held constant at 250 mg and subjects fasted before each meal. The absorbability
of Ca from the six sources was compared by measuring fractional absorption by the double
isotope method. The mean absorption values for all six sources were tightly clustered
between 21 and 26% and none was significantly different from the others using one-way
analysis of variance. We conclude that none of the sources was significantly superior or
inferior to the others.
- [Karl Note: Notice that these
tests all used damaged milk -- pasteurized milk -- heated milk -- where LESS
of the calcium is available to the body than when raw milk is used.]
- Language of Publication
- English
- Unique Identifier
- 88103403
- MeSH Heading (Major)
- Calcium [AN/*ME]
Calcium Carbonate [*PK]
Dairy Products
Food, Formulated
Milk
- MeSH Heading
- Absorption
Adult
Aged
Animal
Calcium Radioisotopes [DU]
Comparative Study
Female
Human
Menopause
Middle Age
Reference Values
Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0002-9165
- Country of Publication
- UNITED STATES
- CAS Registry/EC Number
- 0 (Calcium Radioisotopes)
471-34-1 (Calcium Carbonate)
7440-70-2 (Calcium)
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Of Viewpoint #1
Document: 4
- Title
- Variability of calcium absorption.
- Author
- Heaney RP; Recker RR; Hinders SM
- Address
- Creighton University, Omaha, NE 68178.
- Source
- Am J Clin Nutr, 47: 2, 1988 Feb, 262-4
- Abstract
- Variability in calcium absorption was estimated in three groups of normal subjects in
whom Ca absorption was measured by standard isotopic-tracer methods at interstudy
intervals ranging from 1 to 4 mo. Fifty absorption tests were performed in 22 subjects.
Each was done in the morning after an overnight fast with an identical standard breakfast
containing a Ca load of approximately 250 mg. Individual fractional absorption values were
normalized to permit pooling of the data. The coefficient of variation (CVs) for
absorption for the three groups ranged from 10.57 to 12.79% with the size of the CV
increasing with interstudy duration. One other published study presenting replicate
absorption values was analyzed in a similar fashion and was found to have a CV of
absorption of 9.78%. From these data we estimate that when the standard double-isotope
method is used to measure Ca absorption there is approximately 10% variability around any
given absorption value within an individual human subject and that roughly two-thirds of
this represents real biological variability in absorption.
- Language of Publication
- English
- Unique Identifier
- 88130779
- MeSH Heading (Major)
- Calcium [AN/*ME]
- MeSH Heading
- Absorption
Adult
Calcium Radioisotopes [AD/DU]
Comparative Study
Fasting
Female
Human
Male
Middle Age
Reference Values
Scintillation Counting
Support, Non-U.S. Gov't
Support, U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0002-9165
- Country of Publication
- UNITED STATES
- CAS Registry/EC Number
- 0 (Calcium Radioisotopes)
7440-70-2 (Calcium)
-
Return To The Text Only Version
Of Viewpoint #1
Document: 5
- Title
- Calcium absorbability from spinach.
- Author
- Heaney RP; Weaver CM; Recker RR
- Address
- Department of Medicine, Creighton University, Omaha, NE 68178.
- Source
- Am J Clin Nutr, 47: 4, 1988 Apr, 707-9
- Abstract
- The absorbability of calcium from spinach was compared with the absorbability of Ca from
milk in 13 healthy adults in a randomized cross-over design in which the test meal of
either milk or spinach had 200 mg of Ca labeled with 45Ca. Absorption was measured by the
standard double-isotope method in which both the test food and the miscible Ca pool are
labeled with different Ca tracers. Measurement of both Ca and oxalate in our test spinach
revealed a very slight stoichiometric excess of oxalate; hence it is likely that all of
the spinach Ca was effectively bound. Absorption was higher from milk in every case, with
the mean absorption from milk averaging 27.6% and from spinach, 5.1%. The mean
within-subject difference between Ca absorption from milk and from spinach was 22.5 +/-
9.5% (P less than 0.0001). These results conclusively establish that spinach Ca is much
less readily available than milk Ca.
- Language of Publication
- English
- Unique Identifier
- 88180866
- MeSH Heading (Major)
- Calcium [*ME]
Intestinal Absorption
Vegetables
- MeSH Heading
- Adult
Animal
Biological Availability
Cattle
Female
Human
Male
Milk [AN]
Random Allocation
Reference Values
Support, Non-U.S. Gov't
Support, U.S. Gov't, P.H.S.
- Publication Type
- CLINICAL TRIAL
JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0002-9165
- Country of Publication
- UNITED STATES
- CAS Registry/EC Number
- 7440-70-2 (Calcium)
-
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Of Viewpoint #1
Document: 6
- Title
- Calcium absorption from a new calcium delivery system (CCM).
- Author
- Smith KT; Heaney RP; Flora L; Hinders SM
- Address
- Procter & Gamble Company, Miami Valley Laboratories, Cincinnati, Ohio.
- Source
- Calcif Tissue Int, 41: 6, 1987 Dec, 351-2
- Abstract
- Absorption of calcium from a highly soluble form of calcium, a mixed calcium
citrate-malate salt (CCM), was tested against calcium carbonate and milk in both rats and
humans. The rat method estimated absorption from the 6-day retention of an oral tracer,
and the human method employed the standard double-isotope procedure. CCM was given both as
a dry powder and in an orange juice beverage. In two experiments in rats calcium from CCM
was absorbed at least as well as, if not better than from calcium carbonate or milk. In
two separate experiments in humans, calcium from CCM was absorbed significantly better
than from calcium carbonate or milk. We conclude that CCM exhibits excellent
bioavailability and that this formulation is a useful addition to the forms of calcium now
available either for direct supplementation or for food fortification.
- Language of Publication
- English
- Unique Identifier
- 88135442
- MeSH Heading (Major)
- Calcium [*PK]
Calcium Carbonate [*AD]
Citrates [*AD]
Malates [*AD]
- MeSH Heading
- Absorption
Administration, Oral
Adult
Animal
Biological Availability
Calcium Radioisotopes [ME]
Female
Human
Male
Rats
Rats, Inbred Strains
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0171-967X
- Country of Publication
- GERMANY, WEST
- CAS Registry/EC Number
- 0 (Calcium Radioisotopes)
0 (Citrates)
0 (Malates)
471-34-1 (Calcium Carbonate)
6915-15-7 (malic acid)
7440-70-2 (Calcium)
77-92-9 (citric acid)
-
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Of Viewpoint #1
Document: 7
- Title
- Calcium supplements: anion effects.
- Author
- Heaney RP; Recker RR
- Address
- John A. Creighton University, Omaha, NE 68178.
- Source
- Bone Miner, 2: 6, 1987 Sep, 433-9
- Abstract
- The effects on bone remodeling of two anions commonly associated with calcium in the
food and supplement chain (carbonate and phosphate) were evaluated in a pilot study in
eight normal premenopausal women. Each woman was studied twice under full metabolic
balance controls, once before starting treatment and then a second time after 4 months of
treatment with either sodium bicarbonate in a dose providing 3240 mg carbonate daily or a
mixture of sodium and potassium phosphates, providing 1144 mg additional phosphorus daily.
Intakes of calcium and protein remained approximately constant between studies. Remodeling
was measured by paired studies of both whole body calcium kinetics and trans-ilial bone
biopsies. The extra phosphate was almost completely absorbed and produced the expected
decline in urine calcium. Both anions were associated with slight decreases in intestinal
calcium absorption efficiency; however neither anion altered bone remodeling as measured
either by radiocalcium kinetics or by histomorphometry. Since the anion doses we used were
larger than the average woman is likely to receive from either food or supplement sources,
we conclude that neither anion alters bone remodeling in humans to a clinically
significant degree. Additionally these findings underscore the essential safety of
increased phosphorus intakes and have relevance to the use of phosphate as a remodeling
activator in the ADFR (coherence therapy) approach to treatment of osteoporosis.
- Language of Publication
- English
- Unique Identifier
- 89118559
- MeSH Heading (Major)
- Bone and Bones [AH/*DE]
Calcium [*PK/UR]
Carbonates [*PD]
Phosphates [*PD]
- MeSH Heading
- Adult
Anions
Bicarbonates [PD]
Calcium Radioisotopes [DU]
Female
Human
Intestinal Absorption [DE]
Middle Age
Phosphorus [BL]
Potassium [PD]
Sodium [PD]
Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0169-6009
- Country of Publication
- NETHERLANDS
- CAS Registry/EC Number
- 0 (Anions)
0 (Bicarbonates)
0 (Calcium Radioisotopes)
0 (Carbonates)
0 (Phosphates)
144-55-8 (Sodium Bicarbonate)
16068-46-5 (potassium phosphate)
7440-09-7 (Potassium)
7440-23-5 (Sodium)
7440-70-2 (Calcium)
7632-05-5 (sodium phosphate)
7723-14-0 (Phosphorus)
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Document: 8
- Title
- Nutritional factors in causation of osteoporosis.
- Author
- Heaney RP
- Address
- Creighton University, Omaha, Nebraska.
- Source
- Ann Chir Gynaecol, 77: 5-6, 1988, 176-9
- Abstract
- Peak bone mass is gained by the age of 35 years. Bone mass is a fragility-related factor
for which there are currently recognized nutritional interactions. Calcium seems to be the
most important nutrient for bone health. In addition manganese, zinc and copper are needed
but their role in the pathogenesis of osteoporosis is largely unknown. For prophylactic
purposes daily calcium intake should be high enough (1,000-1,500 mg).
- Language of Publication
- English
- Unique Identifier
- 89334262
- MeSH Heading (Major)
- Calcium [*PH]
Calcium, Dietary [*AD]
Osteoporosis [*ET/PC]
- MeSH Heading
- Adult
Aged
Copper [PH]
Female
Human
Male
Manganese [PH]
Middle Age
Nutritional Requirements
Risk Factors
Zinc [PH]
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0355-9521
- Country of Publication
- FINLAND
- CAS Registry/EC Number
- 0 (Calcium, Dietary)
7439-96-5 (Manganese)
7440-50-8 (Copper)
7440-66-6 (Zinc)
7440-70-2 (Calcium)
-
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Document: 9
- Title
- The calcium controversy: finding a middle ground between the extremes.
- Author
- Heaney RP
- Address
- Creighton University, Omaha, NE.
- Source
- Public Health Rep, 104 Suppl:1989 Sep-Oct, 36-46
- Abstract
- Involutional bone loss, and the fracture syndromes that are designated
"osteoporosis," are multifactorial phenomena. Gonadal hormone deficiency,
inadequate exercise, and a multitude of lifestyle factors are involved in their
pathogenesis. Calcium is important during growth, and probably up to about age 35, when
peak bone mass is finally achieved. Recent controversy concerning the role of calcium in
the middle-aged and elderly, arising out of population studies showing sometimes only weak
calcium effects, can be resolved by recognizing the multifactorial character of
involutional bone loss, and by careful attention to such details as national differences
in habitual calcium intakes. Thus interpreted, metabolic, epidemiologic, and intervention
studies are internally consistent, and indicate that inadequate calcium intake also makes
an important contribution to involutional bone loss.
- Language of Publication
- English
- Unique Identifier
- 90272932
- MeSH Heading (Major)
- Calcium, Dietary [*ME]
Osteoporosis [*ET]
- MeSH Heading
- Adult
Aged
Animal
Calcium [DF]
Cats
Female
Human
Male
Middle Age
- Publication Type
- JOURNAL ARTICLE
REVIEW
REVIEW LITERATURE
- ISSN
- 0033-3549
- Country of Publication
- UNITED STATES
- Number Of References
- 60
- CAS Registry/EC Number
- 0 (Calcium, Dietary)
7440-70-2 (Calcium)
-
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Of Viewpoint #1
Document: 10
- Title
- For better and worse: the technological imperative in health care.
- Author
- Barger-Lux MJ; Heaney RP
- Source
- Soc Sci Med, 22: 12, 1986, 1313-20
- Abstract
- Few elements of our lives have changed as profoundly these past 30-40 years as health
care. Despite almost miraculous advances and the acquisition of powers previously
undreamed-of, there is a sense that all is not right. Paradoxically, dissatisfaction seems
to have grown in parallel with the ability to intervene in the course of illness and
injury. Many astute observers believe that the problem lies in the smothering dominance of
technology, in the fact that technology tends to displace persons as the focus of interest
and to create confusion about the purpose and limits of restorative health care. We shall
review briefly the terms of the problem as seen by health professionals, social
scientists, and ethicists. Out of this analysis we shall suggest the rough outline of an
approach to establish some measure of balance in the application of technology to human
health problems.
- Language of Publication
- English
- Unique Identifier
- 86289585
- MeSH Heading (Major)
- Delivery of Health Care
Ethics, Medical
Social Values
Technology, Medical
- MeSH Heading
- Attitude to Death
Human
Patient Advocacy
Philosophy, Medical
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0277-9536
- Country of Publication
- ENGLAND
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Document: 11
- Title
- Calcium intake and bone health throughout life.
- Author
- Heaney RP
- Address
- Creighton University, Omaha, NE 68178-0650.
- Source
- J Am Med Wom Assoc, 45: 3, 1990 May-Jun, 80-6
- Abstract
- Calcium requirement varies with stage of growth, with physiological drains (eg,
pregnancy and lactation), and with factors that influence absorption and excretory loss
(eg, gonadal hormone status and sodium and protein intakes). While for certain life-stages
the cited requirement values are higher than currently recommended, they are below the
intakes of both contemporary hunter-gatherers and our closest primate relatives, after
adjusting for body size. Hence, they can be considered high only in comparison with
current US practices. However, it also needs to be emphasized that bone health is a
multifactorial affair and that meeting calcium requirements alone will neither guarantee
optimal bone growth nor protect against bone loss if other critical factors are missing.
For example, calcium affords only minimal protection against either immobilization or
estrogen-withdrawal bone loss. Thus, while assuring an adequate calcium intake remains a
sound strategy, it cannot be considered a panacea.
- Language of Publication
- English
- Unique Identifier
- 90244015
- MeSH Heading (Major)
- Calcium, Dietary [*AD/TU]
Osteoporosis [*/CO/PC]
- MeSH Heading
- Female
Fractures [ET]
Human
Nutritional Requirements
Support, U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
REVIEW
REVIEW, TUTORIAL
- ISSN
- 0098-8421
- Country of Publication
- UNITED STATES
- Number Of References
- 47
- CAS Registry/EC Number
- 0 (Calcium, Dietary)
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Of Viewpoint #1
Document: 12
- Title
- Calcium absorptive consistency.
- Author
- Heaney RP; Weaver CM; Fitzsimmons ML; Recker RR
- Address
- Center for Hard Tissue Research, Creighton University, Omaha, NE.
- Source
- J Bone Miner Res, 5: 11, 1990 Nov, 1139-42
- Abstract
- Calcium absorption efficiency was measured two or three times each in 74 premenopausal
and 142 postmenopausal women under conditions predicted to alter absorptive performance. A
woman's absorptive consistency was evaluated across differing loads, differing intervals,
and substances of differing intrinsic absorbability. In all these circumstances there was
a statistically significant correlation between a woman's absorption under differing test
situations accounting for up to 60% of the variance typically found in cross-sectional
studies. For example, when the same substance but at differing load levels was tested
three times over an 8 week period, various coefficients of correlation ranged from +0.773
to +0.849 (P less than 0.001). Even over intervals as long as 5 years correlation of
absorption fraction within individuals remained significant (r = +0.487, P less than
0.001).
- Language of Publication
- English
- Unique Identifier
- 91103092
- MeSH Heading (Major)
- Calcium, Dietary [AD/BL/*PK]
Intestinal Absorption
- MeSH Heading
- Adult
Female
Human
Middle Age
Reference Values
Support, U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0884-0431
- Country of Publication
- UNITED STATES
- CAS Registry/EC Number
- 0 (Calcium, Dietary)
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Document: 13
- Title
- Absorbability of calcium sources: the limited role of solubility.
- Author
- Heaney RP; Recker RR; Weaver CM
- Address
- Center for Hard Tissue Research, Creighton University, Omaha, Nebraska 68178.
- Source
- Calcif Tissue Int, 46: 5, 1990 May, 300-4
- Abstract
- Fractional absorption of seven chemically defined calcium sources was measured in normal
adult women under standardized load conditions. Solubility of the sources in water at
neutral pH ranged from a low of 0.04 mM to a high of 1500 mM. The relationship of
solubility to absorbability was weak. In the range from 0.1 to 10 mM, within which most
calcium supplement sources fall, there was no detectable effect of solubility on
absorption. Data from four food sources are presented for comparison. Absorbability of
food calcium was not clearly related to absorbability of the dominant chemical form in the
food concerned. These findings suggests that (1) even under controlled, chemically defined
conditions, solubility of a source has very little influence on its absorbability; and (2)
absorbability of calcium from food sources is determined mainly by other food components.
- Language of Publication
- English
- Unique Identifier
- 90248839
- MeSH Heading (Major)
- Calcium, Dietary [AD/*PK]
- MeSH Heading
- Adult
Female
Human
Hydrogen-Ion Concentration
Intestinal Absorption
Solubility
Support, Non-U.S. Gov't
Support, U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0171-967X
- Country of Publication
- UNITED STATES
- CAS Registry/EC Number
- 0 (Calcium, Dietary)
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Of Viewpoint #1
Document: 14
- Title
- Lifelong calcium intake and prevention of bone fragility in the aged.
- Author
- Heaney RP
- Address
- Department of Health Sciences, Creighton University, Omaha, NE 68178.
- Source
- Calcif Tissue Int, 49 Suppl:1991, S42-5
- Abstract
- Primary prevention of osteoporosis involves achieving the full genetic potential for
bone mass. Secondary prevention is concerned with protecting what bone mass a woman may
have at her current age. Calcium plays an important role in both. Calcium requirement
varies with stage of growth, with physiological drains (e.g., pregnancy and lactation),
and with factors that influence absorption and excretory loss (e.g., gonadal hormone
status and sodium and protein intakes). The evidence is strong that prevailing calcium
intakes contribute to the low bone mass component of osteoporotic fragility and that
increases in intake would reduce the osteoporotic fracture burden. At the same time it
needs to be emphasized that bone health is a multifactorial affair and that meeting
calcium requirements alone will neither guarantee optimal bone growth nor protect against
bone loss if other critical factors are missing. For example, calcium affords only minimal
protection against either immobilization or estrogen withdrawal bone loss. Thus, while
assuring an adequate calcium intake remains a sound strategy, it cannot be considered a
total preventive for osteoporosis.
- Language of Publication
- English
- Unique Identifier
- 92034350
- MeSH Heading (Major)
- Calcium, Dietary [*AD]
Osteoporosis [*PC]
- MeSH Heading
- Adolescence
Adult
Aged
Bone Density [PH]
Child
Estrogens [PH]
Human
Middle Age
- Publication Type
- JOURNAL ARTICLE
REVIEW
REVIEW, TUTORIAL
- ISSN
- 0171-967X
- Country of Publication
- UNITED STATES
- Number Of References
- 33
- CAS Registry/EC Number
- 0 (Calcium, Dietary)
0 (Estrogens)
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Of Viewpoint #1
Document: 15
- Title
- Effect of calcium on skeletal development, bone loss, and risk of fractures.
- Author
- Heaney RP
- Address
- Creighton University, Omaha, Nebraska.
- Source
- Am J Med, 91: 5B, 1991 Nov 25, 23S-28S
- Abstract
- In assessing the role of calcium, it must be stressed that calcium is not the cause of
bone health but simply a necessary condition for it. It is mechanical usage that is of
primary importance for bone. In just the same way iron is essential for hemoglobin
synthesis and protein is essential for muscle mass, but neither is sufficient by itself.
What, then, ought we to expect from a high calcium intake? Can we prevent
estrogen-withdrawal bone loss? No. Calcium is not a substitute for estrogen, anymore than
it is a substitute for exercise. Will calcium slow the remodeling loss that occurs with
aging? Yes, to some extent; as calcium slows remodeling, it will inevitably slow
remodeling-related loss. But most importantly, a high calcium intake will prevent
calcium-deficiency bone loss. The only question, therefore, is the extent to which calcium
deficiency loss may contribute significantly to bone fragility in various populations. The
bone loss and fracture data reviewed briefly here indicate that an important portion of
the osteoporotic fracture burden is calcium-related. What that portion is will be a
function of the fraction of the population with inadequate intakes in any given country.
Better than half of all adult American women have calcium intakes less than 500 mg/day,
whereas only a small fraction of Dutch or Danish women, for example, would be under that
level. Hence, a population-wide program to increase calcium intake in the United States
would be likely to yield a greater benefit than in either the Netherlands or Denmark. That
does not mean, of course, that there could not be substantial benefit to individuals with
low intakes in all countries. Calcium intakes of greater than or equal to 1,500 mg are
both safe and natural. While not all bone loss and low trauma fractures are due to low
calcium intake, some almost certainly are. Adaptation to low intakes does occur, but it is
seldom sufficient to compensate for the low intake. We cannot easily distinguish those who
need more calcium from those who need less, and for that reason it makes good sense to
ensure an adequate calcium intake for the entire adult population. What should that intake
be? During adolescence, 1,500 mg will come close to ensuring the achievement of
genetically programmed levels of peak bone mass.(ABSTRACT TRUNCATED AT 250 WORDS)
- Language of Publication
- English
- Unique Identifier
- 92087759
- MeSH Heading (Major)
- Bone and Bones [*ME]
Calcium [AD/*ME]
Fractures [*PC]
Osteoporosis, Postmenopausal [*ME/PC]
- MeSH Heading
- Female
Human
Menopause [ME]
Risk Factors
- Publication Type
- JOURNAL ARTICLE
REVIEW
REVIEW, TUTORIAL
- ISSN
- 0002-9343
- Country of Publication
- UNITED STATES
- Number Of References
- 38
- CAS Registry/EC Number
- 7440-70-2 (Calcium)
-
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Of Viewpoint #1
Document: 16
- Title
- Isotopic exchange of ingested calcium between labeled sources. Evidence that ingested
calcium does not form a common absorptive pool.
- Author
- Weaver CM; Heaney RP
- Address
- Department of Foods and Nutrition, Purdue University, West Lafayette, Indiana.
- Source
- Calcif Tissue Int, 49: 4, 1991 Oct, 244-7
- Abstract
- We studied the extent of salt dissociation during absorption of calcium from sources of
differing absorbability by measuring fractional absorption from loads in the range of
200-300 mg in healthy adult women. Sources were labeled both intrinsically and
extrinsically with 45Ca and 47Ca, respectively, and were fed alone and in combination with
one another. We first confirmed our previous observation of superior absorbability of
calcium oxalate over spinach calcium in a randomized cross-over design in 20 women.
Spinach calcium exhibited only half the absorbability of the same load of calcium
presented as the oxalate. Then, in 14 women fed spinach with both an intrinsic and an
extrinsic label, apparent absorption of the extrinsic label averaged 0.130 +/- 0.041 and
of the intrinsic label, 0.029 +/- 0.023. Thus, the extrinsic tag was partially, but not
completely, bound by the spinach. In the same 14 women, milk absorption averaged 0.331 +/-
0.092 when ingested alone. However, when co-ingested with spinach, apparent milk calcium
absorption fell to 0.267 +/- 0.079 and apparent spinach calcium absorption rose to 0.111
+/- 0.039. Thus, there was significant but incomplete label exchange between the two
sources, indicating that at least some of the calcium from both sources enters a common
preabsorptive, ionic pool. By contrast, we had previously shown no tracer exchange when
labeled oxalate was co-fed with labeled milk. We conclude that (1) the presence of calcium
as the oxalate in spinach is not a sufficient explanation for the poor absorbability of
spinach calcium; and (2) oxalate calcium and spinach calcium are absorbed by different
mechanisms, one involving a common preabsorptive pool and the other not.(ABSTRACT
TRUNCATED AT 250 WORDS)
- Language of Publication
- English
- Unique Identifier
- 92103566
- MeSH Heading (Major)
- Calcium Oxalate [*PK]
Calcium, Dietary [*PK]
- MeSH Heading
- Administration, Oral
Adult
Animal
Calcium Radioisotopes [PK]
Female
Human
Intestinal Absorption
Middle Age
Milk [AN]
Spectrophotometry, Atomic Absorption
Support, U.S. Gov't, P.H.S.
Vegetables [CH]
- Publication Type
- CLINICAL TRIAL
JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0171-967X
- Country of Publication
- UNITED STATES
- CAS Registry/EC Number
- 0 (Calcium Radioisotopes)
0 (Calcium, Dietary)
25454-23-3 (Calcium Oxalate)
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Document: 17
- Title
- Calcium supplements: practical considerations [editorial]
- Author
- Heaney RP
- Source
- Osteoporos Int, 1: 2, 1991 Feb, 65-71
- Abstract
- The preferable source of calcium is a balanced diet, but medicinal supplements are
sometimes necessary if patients are to reach desired intakes. A divided dose regimen
(4x/d; i.e., with meals and at bedtime) results in substantially greater absorption of a
supplement than does 1x/d dosing. However, differences in chemical solubility between
supplement preparations are of little importance, with calcium carbonate preparations, for
example, being absorbed as well or better than some much more highly soluble salts.
Gastric acid is not necessary for absorption of even poorly soluble preparations, so long
as they are taken with meals. Because typical patients exhibit a wide range of absorption
efficiencies, it is desirable to assess absorption fraction before beginning a supplement
regimen. (Some patients will need three times as large a dose as others to absorb the same
amount of calcium.) Calcium intakes up to at least 62.5 mmol (2500 mg) are safe for
virtually all patients.
- Language of Publication
- English
- Unique Identifier
- 92163645
- MeSH Heading (Major)
- Calcium [*AD/TU]
- MeSH Heading
- Biological Availability
Human
Intestinal Absorption
Patient Compliance
Support, U.S. Gov't, P.H.S.
- Publication Type
- EDITORIAL
- ISSN
- 0937-941X
- Country of Publication
- ENGLAND
- CAS Registry/EC Number
- 7440-70-2 (Calcium)
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Document: 18
- Title
- Calcium in the prevention and treatment of osteoporosis.
- Author
- Heaney RP
- Address
- Department of Internal Medicine, Creighton University, Omaha, Nebraska.
- Source
- J Intern Med, 231: 2, 1992 Feb, 169-80
- Abstract
- Osteoporotic fractures have many sources. Low bone mass is one such, and inadequate
calcium intake, in turn, is one of the causes of low bone mass. Calcium intake may be
inadequate because it is low in its own right or, even if 'normal', it may not be
sufficient to compensate for exaggerated obligatory losses. Inadequate calcium intake may
cause bone mass to be low either because calcium intake during growth limits achievement
of genetically programmed skeletal mass, or because low intake later in life aggravates
involutional loss, or both. Ensuring a generous calcium intake throughout life will
prevent both of these consequences. However, it is important to stress that even a calcium
surfeit will not prevent or reverse bone loss due to inactivity, gonadal hormone
deficiency, alcohol abuse or, indeed, any other factor. Calcium is a nutrient, not a drug.
The only disorder it can be expected to alleviate is calcium deficiency. However, the
evidence suggests that calcium deficiency is prevalent among Western populations,
particularly in North America, and that it thereby contributes substantially to their
osteoporotic fracture burden. This component of that burden is therefore entirely
preventable.
- Language of Publication
- English
- Unique Identifier
- 92176910
- MeSH Heading (Major)
- Calcium, Dietary [ME/*TU]
Osteoporosis [DH/*PC/PP]
- MeSH Heading
- Aging [PH]
Human
Nutritional Requirements
- Publication Type
- JOURNAL ARTICLE
REVIEW
REVIEW, TUTORIAL
- ISSN
- 0954-6820
- Country of Publication
- ENGLAND
- Number Of References
- 65
- CAS Registry/EC Number
- 0 (Calcium, Dietary)
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Document: 19
- Title
- Hip fracture: a nutritional perspective.
- Author
- Heaney RP
- Address
- John A. Creighton University Professor, Creighton University, Omaha, Nebraska 68178.
- Source
- Proc Soc Exp Biol Med, 200: 2, 1992 Jun, 153-6
- Abstract
- Hip fracture is the most important skeletal problem confronting the developed nations.
In Finland, for example, it accounts for nearly 10% of all acute surgical beds and it
annually costs every Western nation in the range of 8 to 20 million U.S. dollars per
million population. These already high figures are certain to rise as the number of the
old elderly increase. Nutrition plays a role in this problem not simply through the effect
of calcium intake on bone mass, but in the falls that precede most fractures, in the
amount of soft tissue hip padding to cushion the impact of a fall, and in the recovery
both from the injury and from the even greater assault of its repair.
- Language of Publication
- English
- Unique Identifier
- 92253568
- MeSH Heading (Major)
- Hip Fractures [EP/*ET]
- MeSH Heading
- Aging
Human
Nutrition
Osteomalacia [EP]
Osteoporosis [ET]
Risk Factors
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0037-9727
- Country of Publication
- UNITED STATES
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Document: 20
- Title
- Bone mass, nutrition, and other lifestyle factors.
- Author
- Heaney RP
- Address
- Creighton University, Omaha, Nebraska 68178.
- Source
- Am J Med, 95: 5A, 1993 Nov 30, 29S-33S
- Abstract
- Since the proceedings of the last Consensus Conference on Osteoporosis were published as
a supplement to The American Journal of Medicine in November 1991, there has been a
plethora of well-documented studies reported in the literature. This article will address
some of the issues concerning the relation between bone mass and nutrition raised in those
studies.
- Language of Publication
- English
- Unique Identifier
- 94078971
- MeSH Heading (Major)
- Bone Density
Life Style
Nutrition
Osteoporosis [*/EP/ET/PA/PC]
- MeSH Heading
- Adolescence
Adult
Aged
Calcium, Dietary [AD]
Child
Female
Fractures [EP/ET]
Human
Middle Age
Risk Factors
Support, U.S. Gov't, P.H.S.
Vitamin D [AD]
Vitamin K [AD]
- Publication Type
- CONSENSUS DEVELOPMENT CONFERENCE
JOURNAL ARTICLE
REVIEW
- ISSN
- 0002-9343
- Country of Publication
- UNITED STATES
- Number Of References
- 29
- CAS Registry/EC Number
- 0 (Calcium, Dietary)
12001-79-5 (Vitamin K)
1406-16-2 (Vitamin D)
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Document: 21
- Title
- ADSA Foundation Lecture. Low calcium intake: the culprit in many chronic diseases.
- Author
- Heaney RP; Barger-Lux MJ
- Address
- Creighton University, Omaha, NE 68178.
- Source
- J Dairy Sci, 77: 5, 1994 May, 1155-60
- Abstract
- Calcium is the fifth most abundant element in the earth's crust and is necessary for
both plant and animal life today. Moreover, the natural diets of all mammals are rich in
calcium. The diet of Stone Age human adults is estimated to have contained from 50 to 75
mmol of calcium (2000 to 3000 mg)/d, three to five times the median calcium intake of
present-day US adults. Human physiology has adapted to this environmental abundance with
an intestinal absorptive barrier and inefficient renal conservation of calcium. Although
mammalian physiology contains mechanisms by which organisms can adjust to temporary
environmental shortages, chronic calcium retention has a number of health consequences,
most notably bone fragility, high blood pressure, and colon cancer. Evidence indicates
that improvement in calcium intake (or in vitamin D status) prevents some portion of each
of these multifactorial problems. At least 14 intervention studies have established the
skeletal benefit of increased calcium intake during growth and among women in the late
postmenopause. Other evidence suggests that adequate calcium may protect against
salt-sensitive and pregnancy-associated hypertension and that high intakes of both dietary
calcium and vitamin D reduce development of precancerous changes in colonic mucosa.
- Language of Publication
- English
- Unique Identifier
- 94321582
- MeSH Heading (Major)
- Calcium [*AD/DF]
Chronic Disease
- MeSH Heading
- Colonic Neoplasms [ET]
Female
Human
Hypertension [ET]
Male
Osteoporosis [ET]
Support, U.S. Gov't, P.H.S.
Vitamin D [AD]
- Publication Type
- JOURNAL ARTICLE
REVIEW
REVIEW, TUTORIAL
- ISSN
- 0022-0302
- Country of Publication
- UNITED STATES
- Number Of References
- 42
- CAS Registry/EC Number
- 1406-16-2 (Vitamin D)
7440-70-2 (Calcium)
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Document: 22
- Title
- The role of calcium intake in preventing bone fragility, hypertension, and certain
cancers.
- Author
- Barger-Lux MJ; Heaney RP
- Address
- Creighton University School of Medicine, Department of Internal Medicine, Omaha, NE
68131.
- Source
- J Nutr, 124: 8 Suppl, 1994 Aug, 1406S-1411S
- Abstract
- This paper examines the evidence that connects calcium intake and vitamin D status to
bone fragility, hypertension, colon cancer, and breast cancer. Human calcium physiology,
with an intestinal absorptive barrier and inefficient conservation, reflects the abundance
of calcium in the primordial human food supply. The calcium intake of stone-age adults is
estimated at 50 to 75 mmol/d, three to five times the median calcium intake of present-day
U.S. adults. Long-term calcium restriction and/or insufficient vitamin D may promote the
development of bone fragility, high blood pressure, colon cancer, and breast cancer in
susceptible individuals. Conversely, improvement in calcium intake and/or in vitamin D
status may help to prevent these serious health problems. At least 12 intervention studies
have established the skeletal benefit of increased calcium intake among women in the late
postmenopause. Other reports suggest that adequate calcium may protect against
salt-sensitive and pregnancy-associated hypertension. High intakes of both dietary calcium
and vitamin D are associated with reduced development of precancerous changes in colonic
mucosa. Preliminary findings also suggest that vitamin D has a protective effect against
breast cancer.
- Language of Publication
- English
- Unique Identifier
- 94343025
- MeSH Heading (Major)
- Breast Neoplasms [*PC]
Calcium [DF/*PH]
Calcium, Dietary [*AD/TU]
Colonic Neoplasms [*PC]
Hypertension [*PC]
Osteoporosis, Postmenopausal [*PC]
- MeSH Heading
- Bone and Bones [DE]
Female
Human
Nutritional Requirements
Support, U.S. Gov't, P.H.S.
Vitamin D [AD]
- Publication Type
- JOURNAL ARTICLE
REVIEW
REVIEW, TUTORIAL
- ISSN
- 0022-3166
- Country of Publication
- UNITED STATES
- Number Of References
- 46
- CAS Registry/EC Number
- 0 (Calcium, Dietary)
1406-16-2 (Vitamin D)
7440-70-2 (Calcium)
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Document: 23
- Title
- Osteoporosis-2044 [editorial]
- Author
- Heaney RP
- Source
- Osteoporos Int, 4: 5, 1994 Sep, 233-7
- Abstract
- It is likely that by 2044 biomedical and public health forces will be able to control
bony fragility to a substantially greater degree than we have succeeded in doing today,
but that demographic and lifestyle forces already at work will offset those gains, perhaps
substantially. On the other hand, economic and social forces outside of our control will
decrease the prevalence of skeletal fragility--harshly, I fear--either by strengthening
old bones the hard way, or by decreasing the numbers of the elderly, or both. The final
outcome will be the algebraic sum of the effects of these countervailing forces, which is
impossible to estimate with any assurance. My guess is that osteoporosis will be less of a
problem in 2044, though, unfortunately, for the wrong reasons.
- Language of Publication
- English
- Unique Identifier
- 95111211
- MeSH Heading (Major)
- Osteoporosis [*/ET/PP/TH]
- MeSH Heading
- Bone and Bones [PP]
Demography
Fractures [PC]
Human
Life Style
- Publication Type
- EDITORIAL
- ISSN
- 0937-941X
- Country of Publication
- ENGLAND
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Document: 24
- Title
- Caffeine and the calcium economy revisited.
- Author
- Barger-Lux MJ; Heaney RP
- Address
- Creighton University, Omaha, Nebraska, USA.
- Source
- Osteoporos Int, 5: 2, 1995 Mar, 97-102
- Abstract
- We report an analysis of data from 560 calcium balance studies carried out on 190 women
aged 34.8-69.3 years at the time of study. The main purposes were to confirm a previously
observed association between caffeine intake and calcium balance, and to attribute the
association, if possible, to specific component(s) of balance. We found a caffeine
relationship such that for every 6 fl oz (177.5 ml) serving of caffeine-containing coffee,
calcium balance was more negative by 0.114 mmol/day (4.6 mg/day) (P < 0.001). The
relationship was localized to the input side of the balance equation, and both of its
components (i.e. calcium intake and calcium absorption efficiency) were independently and
inversely associated with caffeine intake. There was no evidence that the putative
caffeine effect is confined to, or is greater among, subjects with low calcium intakes or
those who are older or estrogen-deprived. The magnitude of the negative effect of caffeine
on calcium balance suggests that it can be offset by increasing calcium intake by about 1
mmol (40 mg) for every 177.5 ml serving of caffeine-containing coffee.
- Language of Publication
- English
- Unique Identifier
- 95322765
- MeSH Heading (Major)
- Caffeine [*PD]
Calcium [*BL/UR]
Calcium, Dietary [*PD]
- MeSH Heading
- Adult
Aged
Female
Human
Middle Age
Regression Analysis
Support, U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0937-941X
- Country of Publication
- ENGLAND
- CAS Registry/EC Number
- 0 (Calcium, Dietary)
58-08-2 (Caffeine)
7440-70-2 (Calcium)
Copyright ©1996
HealthGate Data Corp., All rights reserved.
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