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Calcium & Weight loss

Dietary Calcium has recently been associated with weight loss. More specifically, it may facilitate fat loss, excretion of dietary fat, the reversal of gradual weight gain, the prevention of fat storage, raising metabolism, increasing high density lipoproteins, and the reduction of both kidney stones and symptoms of PMS. Plus it just may be more effective than most common weight-loss drugs on the market today!

In a recent 16-week study, a very high calcium diet produced greater weight loss than the average weight loss shown in one year in studies using weight loss drugs. International Journal of Obesity & Related Metabolic Disorders, Sept. 16, 2003

Robert Heaney, M.D., one of the foremost calcium and vitamin D researchers states: “Only 1000 mg of additional calcium daily can result in a 17.6 pound difference in your body weight.” Davies, KM, Heaney RP, Recker RR, Lappe JM, Barger-Lux MF, Rafferty K, Hinders S. Calcium intake and body weight. J Clin Endocrinol Metab. 2000 Dec;85(12):4635-8.

“Increasing calcium intake can be estimated to reduce the prevalence of overweight by perhaps as much as 60 to 80 percent.” Heaney RP. Normalizing calcium intake: projected population effects for body weight. J Nutr. 2003 Jan;133(1):268S-270S.

CALCIUM & WEIGHT LOSS

The Experts Weigh In: Validation from Medical Journals

Currently, the weight-loss effect of calcium has been receiving a great deal of attention. More exciting is that reliable scientific research has been catching up with the observations:

A diet consisting mainly of high calcium foods resulted in an average weight loss of 24.6 pounds in 16 weeks. This is greater than the average weight loss in one year in trials using weight loss drugs such as dexfenfluramine, sibutramine or orlistat. (Even if the drugs rivaled the calcium diet for weight loss, they have serious side effects: sibutramine increases blood pressure and pulse rate; orlistat causes gastrointestinal side effects; and dexfenfluramine results in serious respiratory and cardiovascular complications.) International Journal of Obesity & Related Metabolic Disorders, Sep 16, 2003 / Hopkins PN, Polukoff GI. Risk of valvular heart disease associated with use of fenfluramine. BMC Cardiovasc Disord. 2003 Jun 11;3(1):5.

Test animals were placed on a diet high in sucrose and increased fat, including lard. As anticipated, these animals quickly became obese. But when given high levels of calcium, they stopped gaining weight and, instead, began to lose weight. Even though the caloric intake of the two sets of animals was identical, those on a low calcium diet gained weight, while those on a high calcium diet lost weight. Calcium helps to suppress a substance that would normally increase adiposity (fat) with a calorie-dense meal. By increasing dietary calcium, the result is a significant reduction in adipose tissue - accelerating weight loss and body fat loss. Zemel MB . Role of dietary calcium and dairy products in modulating adiposity. Lipids. 2003 Feb;38(2):139-46.

High-calcium, low-calorie diets helped test animals lose weight at rates double those given low levels of calcium. Experimental Biology 2000, Conference, San Diego, April 21, 2000.

Overweight patients with high blood pressure were asked to consume two cups of yogurt daily to increase their calcium intake in order to lower their blood pressure. No other changes were made in their diet or exercise routines. An average of 10.56 pounds was lost in one year simply by adding the yogurt. Zemel MB , Shi H, Greer B, Dirienzo D, Zemel PC. Regulation of adiposity by dietary calcium. FASEB J. 2000 Jun;14(9):1132-8.

A two-year study found that young women who had the highest intakes of calcium lost the most weight and body fat on weight control programs, regardless of exercise level. Lin YC, Lyle RM, McCabe LD, McCabe GP, Weaver CM, Teegarden D. Dairy calcium is related to changes in body composition during a two-year exercise intervention in young women. J Am Coll Nutr. 2000 Nov-Dec;19(6):754-60.

Additional sophisticated peer-reviewed trials continue to indicate that high-calcium diets are associated with lower body weight. And, in a study published in the Journal of Nutrition, researchers estimated that only 1,000 milligrams of additional calcium intake daily can result in a 17.6 pound difference in your body weight. Davies KM, Heaney RP, Recker RR, Lappe JM, Barger-Lux MJ, Rafferty K, Hinders S. Calcium intake and body weight. J Clin Endocrinol Metab. 2000 Dec;85(12):4635-8.

Higher levels of calcium intake may prevent fat storage, and more calcium may raise metabolism, thus burning more calories. Southwestern Medical Center Report, 2003.

Each 300 mg increment in regular calcium intake is associated with approximately 1 kg less body fat in children and 2.5-3.0 kg lower body weight in adults. Increasing calcium intake could reduce the risk of overweight substantially, perhaps by as much as 70 percent. (1 kilogram is equal to 2.2 pounds.) Heaney RP, Davies KM, Barger-Lux MJ. Calcium and weight: clinical studies. J Am Coll Nutr. 2002 Apr;21(2):152S-155S.

Calcium may play a role in increasing levels of high density lipoprotein (HDL, the good kind), reducing kidney stone recurrence, reducing symptoms of premenstrual syndrome, and promoting weight loss. Moyad MA. Osteoporosis. Part III--Not just for bone loss: potential benefits of calcium and vitamin D for overall gen eral health. Urol Nurs. 2003 Feb;23(1):69-74.

Women at midlife gain an average of about one pound a year (with one-sixth of them gaining at the rate of 2.5 pounds a year) if they are on low calcium intakes. By contrast, women who take the RDI amount of calcium show a slight negative weight gain each year. Davies KM, Heaney RP, Recker RR, Lappe JM, Barger-Lux MJ, Rafferty K, Hinders S. Calcium intake and body weight. J Clin Endocrinol Metab. 2000 Dec;85(12):4635-8.

If you are overweight and not watching your diet, increasing dietary calcium results in significant reductions in fat tissue, and if you are on a calorie-restricted diet, the calcium will accelerate your weight loss and body fat loss. Zemel MB . Role of dietary calcium and dairy products in modulating adiposity. Lipids. 2003 Feb;38(2):139-46.

Growing evidence supports a relationship between increased calcium intakes and reductions in body weight specific to fat mass. The impact of calcium intake on weight loss or prevention of weight gain has been demonstrated in a wide age range of Caucasian and African Americans of both genders. Teegarden D. Calcium intake and reduction in weight or fat mass. J Nutr. 2003 Jan;133(1):249S-251S.

Girls who consume more calcium tend to weigh less and have lower body fat than those with low calcium consumption, although it is not important whether the calcium comes from food or supplements. Experimental Biology Meeting, San Diego, Oct 2003.

Low calcium diets impede body fat loss. Zemel MB . Role of dietary calcium and dairy products in modulating adiposity. Lipids. 2003 Feb;38(2):139-46.

An increase in calcium consumption can reduce the risk of obesity. International Obesity Symposium, Toronto, Sep 2003 / McCarty MF, Thomas CA. PTH excess may promote weight gain by impeding catecholamine-induced lipolysis-implications for the impact of calcium, vitamin D, and alcohol on body weight. Med Hypotheses. 2003 Nov-Dec;61(5-6):535-42. / Moyad MA. The potential benefits of dietary and/or supplemental calcium and vitamin D. Urol Oncol. 2003 Sep-Oct;21(5):384-91.

Additional Selected Abstracts

Regulation of adiposity and obesity risk by dietary calcium: mechanisms and implications

Zemel MB J
Am Coll Nutr. 2002 Apr;21(2):146S-151S.

Dietary calcium plays a pivotal role in the regulation of energy metabolism; high calcium diets attenuate weight gain during periods of overconsumption and preserve thermogenesis during caloric restriction, thereby markedly accelerating weight loss... Moreover, we have recently demonstrated that the increased calcitriol released in response to low calcium diets stimulates Ca2+ influx in human adipocytes and thereby promotes adiposity. Accordingly, suppressing calcitriol levels by increasing dietary calcium is an attractive target for the prevention and management of obesity... Further, low calcium diets impede body fat loss, while high calcium diets markedly accelerate fat loss in transgenic mice subjected to caloric restriction. These findings are further supported by clinical and epidemiological data demonstrating a profound reduction in the odds of being obese associated with increasing dietary calcium intake.

Low calcium intake: the culprit in many chronic diseases (ADSA Foundation Lecture)

Heaney RP, Barger-Lux MJ.
J Dairy Sci. 1994 May;77(5):1155-60.

...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... At least 14 intervention studies have established the skeletal benefit of increased calcium intake during growth and among women in the late postmenopause...

The role of calcium intake in preventing bone fragility, hypertension, and certain cancers

Barger-Lux MJ, Heaney RP.
J Nutr. 1994 Aug;124(8 Suppl):1406S-1411S.

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... 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...

Calcium supplements: practical considerations

Heaney RP.
Osteoporos Int. 1991 Feb;1(2):65-71.

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... 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. (note: study excluded sodium-insensitive hypertension patients, etc.)

Calcium, dairy products and osteoporosis

Heaney RP.
J Am Coll Nutr. 2000 Apr;19(2 Suppl):83S-99S.

...Of 52 investigator-controlled calcium intervention studies, all but two showed better bone balance at high intakes, or greater bone gain during growth, or reduced bone loss in the elderly, or reduced fracture risk. This evidence firmly establishes that high calcium intakes promote bone health... While most of the investigator-controlled studies used calcium supplements, six used dairy sources of calcium; all were positive. Most of the observational studies were based on dairy calcium also, since at the time the studies were done, higher calcium intakes meant higher dairy intakes... All studies evaluating the issue reported substantial augmentation of the osteoprotective effect of estrogen by high calcium intakes... (note: there are some extensive recent studies that find that milk does not protect the skeletal system.)

Calcium needs of the elderly to reduce fracture risk.

Heaney RP
Creighton University, Osteoporosis Research Center.

...Supplemented intakes to a total in the range of 32.5-42.5 mmol (1300-1700 mg)/day have been shown to arrest age-related bone loss and to reduce fracture risk in individuals 65 and older and intakes of 60 mmol (2400 mg), to restore the setting of the parathyroid glands to young adult values... Accordingly, suppressing calcitriol levels by increasing dietary calcium is an attractive target for the prevention and management of obesity...

The cellular ionic basis of hypertension and allied clinical conditions.

Resnick L
Prog Cardiovasc Dis. 1999 Jul-Aug;42(1):1-22.

...a unifying "ionic hypothesis" is proposed, in which steady-state elevations of cytosolic free calcium and suppressed intracellular free magnesium levels, characteristic features of all hypertension, concomitantly alter the function of many tissues. In blood vessels this causes vasoconstriction, arterial stiffness, and/or hypertension; in the heart, cardiac hypertrophy; in platelets, increased aggregation and thrombosis; in fat and skeletal muscle, insulin resistance; in pancreatic beta cells, other endocrine tissues, and sympathetic neurons, potentiated stimulus-secretion coupling resulting in hyperinsulinemia, increased sympathetic nerve activity, and so on...

New Key Study!

Effect of short-term high dietary calcium intake on 24-h energy expenditure, fat oxidation, and fecal fat excretion

Jacobsen R, Lorenzen JK, Toubro S, Krog-Mikkelsen I, Astrup A.
Int J Obes Relat Metab Disord. 2005 Mar;29(3):292-301.

Observational studies have shown an inverse association between dietary calcium intake and body weight, and a causal relation is likely. However, the underlying mechanisms are not understood... 10 subjects participated in a randomized crossover study of three isocaloric 1-week diets with: low calcium and normal protein (LC/NP: 500 mg calcium, 15% of energy (E%) from protein), high calcium and normal protein (HC/NP: 1800 mg calcium, 15E% protein), and high calcium and high protein (HC/HP: 1800 mg calcium, 23E% protein). RESULTS: The calcium intake had no effect on 24-h EE or fat oxidation, but fecal fat excretion increased approximately 2.5-fold during the HC/NP diet compared with the LC/NP and the HC/HP diets (14.2 vs 6.0 and 5.9 g/day; P < 0.05). The HC/NP diet also increased fecal energy excretion as compared with the LC/NP and the HC/HP diets (1045 vs 684 and 668 kJ/day; P < 0.05). There were no effects on blood cholesterol, free fatty acids, triacylglycerol, insulin, leptin, or thyroid hormones. CONCLUSIONS: A short-term increase in dietary calcium intake, together with a normal protein intake, increased fecal fat and energy excretion by approximately 350 calories per day. This observation may contribute to explain why a high-calcium diet produces weight loss, and it suggests that an interaction with dietary protein level may be important.

2005 Study on Calcium & Reduced Colorectal Cancer: Calcium from diet and supplements is associated with reduced risk of colorectal cancer in a prospective cohort of women

Flood A, Peters U, Chatterjee N, Lacey JV Jr, Schairer C, Schatzkin A.
Cancer Epidemiol Biomarkers Prev. 2005 Jan;14(1):126-32.

We investigated the association between calcium intake and colorectal cancer in a prospective cohort of 45,354 women without a history of colorectal cancer who successfully completed a 62-item National Cancer Institute/Block food-frequency questionnaire. Women were followed for an average of 8.5 years, during which time 482 subjects developed colorectal cancer. We used Cox proportional hazards models, with age as the underlying time metric, to estimate risk of colorectal cancer... For increasing categories of calcium from supplements, the risk ratios (and 95% CI) relative to no supplement use were 1.08 (0.87-1.34), 0.96 (0.70-1.32), and 0.76 (0.56-1.02), P(trend) = 0.09. Simultaneously high consumption of calcium from diet and calcium from supplements resulted in even further risk reduction, RR = 0.54 (95% CI, 0.37-0.79) compared with low consumption of both sources of calcium. These data indicate that a difference of < 400 to > 800 mg of calcium per day was associated with an approximately 25% reduction in risk of colorectal cancer, and this reduction in risk occurred regardless of the source of the calcium (i.e., diet or supplements)

Abstract of Negative Findings:

Effect of calcium and dairy foods in high protein, energy-restricted diets on weight loss and metabolic parameters in overweight adults.

Bowen J, Noakes M, Clifton PM.
Int J Obes Relat Metab Disord. 2005 Feb 15; [Epub ahead of print]

OBJECTIVE: To compare the effects two high-protein (HP) diets that differ in dietary calcium and protein source on weight loss, body composition, glucose and lipid metabolism, markers of liver function, fibrinolysis and endothelial function and blood pressure. DESIGN:: Randomized, parallel study (12 wk of energy restriction, 4 wk of energy balance) of high dairy protein/high-calcium (DP, 2400 mg Ca/d) and high mixed protein/moderate calcium (MP, 500 mg Ca/d) diets (5.5 MJ/d, 34% protein, 41% carbohydrate, 24% fat). SUBJECTS:: In all, 50 healthy, overweight (age 25-64 y; body mass index 25-35 kg/m(2);) males (n=20) and females (n=30). RESULTS:: Loss of total weight (-9.7+/-3.8 kg), fat mass (-8.3+/-0.4 kg) and lean mass (-1.6+/-0.3 kg) were independent of dietary group. Improvements in fasting insulin, lipids, systolic/diastolic blood pressure, and markers of liver function, fibrinolysis and endothelial function were independent of dietary intervention. CONCLUSIONS:: Increased dietary calcium/dairy foods in an energy-restricted, HP diet does not affect weight loss or body composition. Weight reduction following increased protein diets is associated with beneficial metabolic outcomes that are not affected by protein source.

Editor's Comment: In our opinion, high protein diets would mitigate against calcium's weight loss effects as explained and demonstrated in the Jacobson, et al. abstract. The difference reported for the normal protein diet versus the high protein diet was attributable to a fecal fat and energy excretion of 350 calories per day.

Calcium critics* must consider the large scale calcium deficiencythat exists across various populations

Calcium Deficiency Firmly Established

KELLEY'S TEXTBOOK OF INTERNAL MEDICINE

Osteopenia (loss of bone density) is a very common and costly disorder in the United States that affects 25% of elderly women and, at a given age, half as many men as well. The cause is multifactorial, with several nutritional factors playing important roles in calcium balance. Almost all nutritional surveys indicate that calcium intake in the elderly is far less than the RDA (which was recently increased from 800 mg to 1,200 mg for persons over age 50). Still higher intakes of 1,500 mg per day were recommended for men and women over age 65 by a 1994 National Institutes of Health consensus panel on optimal calcium intake. The NHANES II study found mean calcium intakes of 596 and 475 mg per day in older men and women, respectively, and NHANES III found that virtually all elderly had intakes below 800 mg per day. Calcium intake is also inadequate in younger women, with 66% of women 18 to 30 years old and 75% older than 35 years similarly consuming less than 800 mg per day. Reduced consumption at these early ages may be critical because peak bone mass is attained during early adulthood. Of interest, a recent large randomized trial found that supplemental calcium (1,200 mg per day) also decreased the risk of colorectal adenomas, providing another potential rationale for calcium supplementation beyond its beneficial effects on bone. Absorption of calcium supplements appears to be most efficient at individual elemental calcium doses of 500 mg or less and when taken between meals (except for persons with reduced gastric acid production, in whom calcium citrate may be preferable to more commonly used calcium carbonate supplements).

Kelley's Textbook of Internal Medicine, Fourth Edition, Chapter 470, pg.3111, Lippincott Williams & Wilkins, 2000.

Normalizing Calcium Intake: Projected Population Effects for Body Weight

Robert P. Heaney
American Society for Nutritional Sciences, 2003, p. 268S-270S

Discussion Excerpts: The data presented in this analysis suggest that the prevalence of obesity (or weight gain) in women could be reduced by 60-80% by the simple strategem of ensuring population-wide calcium intakes at the currently recommended levels...

...Also reassuring in this regard is the analysis of the NHANES-III data earlier reported by Zemel, et al.(1) After adjusting for age, sex, race and energy intake, they found a stepwise reduction in risk of obesity for each quartile of calcium intake. At the highest quartile (approximately equal to current recommendations for calcium), the risk of being in the highest BMI quartile was reduced by about 80%...

...The observation, both evident here and previously noted (2), that mean weight gain at midlife is effectively zero if calcium intake is at currently recommended levels is a fortuitous confirmation of the approximate adequacy of those recommendations. It is fortuitous in the sense that the currently recommended intakes were pegged to a skeletal endpoint, and there is no prior reason to expect that all systems would exhibit the same requirement. It is also interesting to note that, despite the established bone protective benefit of an adequate calcium intake, the data presented here suggest that the effect on obesity prevalence-unrecognized until recently - is likely to be as large as, or larger than, the corresponding effect on osteoporosis prevalence...

... Low calcium intakes in this case are so widespread in the North American population today that virtually everyone is exposed to that influence. If, as seems increasingly likely, these low intakes are inadequate, then correcting calcium intake at a population level would produce benefits for many body systems. Furthermore, some of the factors currently considered to be causative of the diseases concerned will likely turn out to be only predisposing or triggering factors, operating by exaggerating or uncovering the effects of the real cause, inadequate calcium intake.

1. Zemel MB, Shi H, Greer B, Dirienzo D, Zemel PC. Regulation of adiposity by dietary calcium. FASEB J. 2000 Jun;14(9):1132-8.

2. Heaney RP, Davies KM, Barger-Lux MJ. Calcium and weight: clinical studies. J Am Coll Nutr. 2002 Apr;21(2):152S-155S.

*We have found that some of the leading authorities in nutrition are against calcium supplementation.

Editor's Note on Calcium Supplementation

Of all the ideological conflicts in nutritional medicine, one area where there is huge disagreement is whether to supplement with calcium or not.

Leaders and opinion makers I respect have criticized supplementation of additional calcium despite increasing RDA's and dozens of studies showing benefits for osteoporosis prevention. Evidence exists that higher intakes of calcium minimize expression of such conditions as cancer of the colon and breast, and hypertension and obesity, all of which are multifactorial in causation and have a calcium deficiency component. The higher RDA's are a result of studies showing that higher levels are required to maintain calcium balance. J. Nutrition. 133: 249S-251S 2003

If we go back to the very basic issues, calcium deficiency is firmly established, as summarized from Kelley's Textbook of Internal Medicine (Fourth Edition, Chapter 470, pg. 3111, 2000) as presented on page 8. We are a population deficient in calcium, as defined by federal based requirements. It is one of the most significant nutritional deficiencies that exist. Other paramount nutritional deficiencies that are talked about here include vitamin D, magnesium and vitamin K, especially vitamin K2. Since all of these nutrients work together to optimize calcium biochemistry, and since calcium is such a critical structural and regulatory molecule, functional problems associated with deficiencies are likely be much greater, as clinical effects are compounded by multiple deficiencies of these related nutrients. The odds are that most of us are deficient in one or more of these nutrients.

Why do we need so much calcium when other cultures don't? There are some other cultures that exhibit much lower calcium consumption and lower osteoporosis? Our culture wastes calcium via high protein, high phosphorus and acidifying diets. These are big factors and cannot be overlooked. Jaffe R, Brown S. Acid-Alkaline ba lance and its effect on bone health. Intl J Integrative Med, 2001; 4 (6): 7-18.

Also, our consumption of pasteurized milk, being our major food source of calcium, may exaggerate magnesium deficiency because the ratio of calcium to magnesium is so high at 9:1. As I will show, magnesium deficiency compromises some of calcium's function, so milk may be worsening both calcium and magnesium deficiency in some patients. There are also recent findings that suggest that milk may not be the best source of calcium for healthy bones, as seen in the Nurse's Study done at Harvard, although numerous other studies show benefit for bones.

So why are leading orthomolecular doctors, who are opinion leaders, and internationally-known authoritative figures, anti-calcium or let's say, calcium antagonists? Because these doctors are concerned about calcium accumulation in the vascular system and in soft tissues over many years, and they blame dietary calcium. Also, these doctors are well aware of the vast magnesium deficiencies that exist and are afraid that supplemental calcium will compete with magnesium for absorption.

I will quote from the very prestigious textbook Modern Nutrition in Health and Disease (9th Edition, edited by Maurice Shils, James Olson, Moshe Shike, Catherine Ross. 1999, Lippincott Williams & Wilkins). (All quoted text is italicized.)

With advancing age, humans commonly accumulate calcium deposits in various damaged tissues, such as atherosclerotic plaques in arteries, healed granulomas, and other scars left by disease or injury, and often in the rib cartilages as well. These deposits are called dystrophic calcifications and rarely amount to more than a few grams of calcium. These deposits are not caused by dietary calcium, but by local injury, coupled with widespread tendency of proteins to bind to calcium.

Our opinion is that higher dietary calcium, via the calcium paradox, and magnesium and other minerals such as boron, and especially vitamin K, will prevent much of the dystrophic calcification.

Calcification, which usually occurs intracellularly in tissues other than bones and teeth is generally a sign of tissue damage, cell aging and cell death. As cells lose control of calcium regulation and are unable to maintain low intracellular calcium, cellular function must degenerate.

It is worth explaining that calcium binds to a large number of cell proteins, which result in the activation of their function. By binding with oxygen atoms of glutamic acid and aspartic acid residues projecting from the peptide backbone, calcium stiffens the protein molecule and fixes its tertiary structure. Hence the cell keeps cytoplasmic concentration very low, and when it wants to activate these calcium-associated enzymes, it allows calcium to enter and uses calcium in a regulatory manner. When calcium generally "leaks" into cells it means the cells are sick and failing to regulate calcium and this will initiate a further loss of function of the cell.

These calcium-associated proteins range from those involved in cell movement and muscle contraction to nerve transmission, glandular secretion, and even cell division. In most of these situations calcium acts as both a signal transmitter from the outside of the cell to the inside, and an activator of the functional proteins involved. In fact, ionized calcium is the most common signal transmitter in all of biology. It operates from bacterial cells all the way up to cells of highly specialized tissues in higher mammals.

There is concern that high calcium intake would produce relative magnesium deficiency, and this has been observed in rats but not humans. Calcium intake does not affect magnesium retention in humans. However the reverse, hypocalcemia, can occur as a result of magnesium deficiency. (Summarized in Shils, et al., Modern Nutrition in Health and Disease, 1999.)

Hypercalcemia refers to an elevation of calcium in blood and is generally reported wherein there is large consumption of calcium to raise the pH in peptic ulcer disease, but not for the normal diet. In Africa, the nomadic pastoral Masai tribe diet consists mostly of milk from the herds and flocks, and they consume 5000 mg of calcium per day or more, which is 5 or more times what the industrial population consumes. The Masai tribe are not known to have unusually high incidence of hypercalcemia or kidney stones. (Shils, et al., Modern Nutrition). They probably have another good source of magnesium.

The theory presented by Heaney and others that prehistoric man consumed a lot of calcium is also presented in the Shils text and referenced to in Eaton's New England Journal of medicine article. (Eaton SB, Konner M. N. England J. Med. 1985:312 283-289) Therein it is stated that:

Early man derived calcium from roots, tubers, nuts, and beans in quantities believed to exceed 1500 mg per day, and perhaps twice this amount when consuming food to meet the caloric demands of a hunter/gatherer of contemporary body size.

Such a well-known text and nutritional source as Modern Nutrition presents generally accepted nutritional concepts which must be accepted by a wide range of experts. So their opinions represent a consensus of academic thinking. In these cases, the concepts generally agree with the citations from Dr. Westin Price's work, the Okinawa program by Willcox B, Willcox C, and Suzuki M., and the theoretical and research conclusions from a host of other researchers presented in this newsletter.

The health benefits of pasteurized milk have become highly questioned due to significant research correlations with cardiovascular risk, prostate cancer, MS, bovine leukemia virus and more. The exact cause is still uncertain, but proteins altered by the heat of pasteurization and other potential causes are cited. Raw milk and yogurts are probably better choices. It is interesting to note that much of civilization grew up surrounded by flocks of goats and other milk-bearing animals. Such animals have fed hungry families for millennium, and our genetic constitution must have adjusted to some degree. (The Untold Story of Milk, Ron Schmid, N.D., 2003, NewTrends Publishing).

Calcium critics should probably direct their concerns towards commercial milk and milk products rather than the calcium they contain.

Responses to Common Criticisms of Calcium Supplementation:

Criticism: None of the studies strongly support calcium supplements as contributing to weight loss. They do support dairy calcium, meaning calcium found in non-fat diary.

Response: The original study was made when yogurt was added to the diet of hypertensive patients with no other dietary changes. On average, over 10 lbs was lost by participants in one year. These results lead to an interest in calcium and weight loss. Shortly afterwards, animal studies in which calcium was increased from .1% to 2% resulted in a reduced weight gain in both lean and overweight Zucker rats. Extensive biochemistry studies followed to delineate the mechanism involved. Both calcium from milk products and calcium salts were used (summarized in Calcium Intake and Reduction in Weight or Fat Mass, Mass J. Nutr. 33: 249S-251S 2003). In a two year study, mineral bone mass was tested. 54 women completed a two year trial. Calcium intakes were low, 781+- 212 mg per day, compared to dietary reference of 1000 mg per day. The primary calcium source was dietary calcium from dairy (67%). Dietary calcium ratio to energy (calories) negatively predicted changes in body weight and body fat, but not for lean mass. This means the more calcium, the less fat accumulated without reductions in protein levels. Dairy calcium predicted the changes as well as did non-dairy calcium; the research on fat storing enzymes and alterations in body temperature by calcium works independent of the source of calcium.

Another very important point is that this relationship of lowered body weight to calcium intake occurs in low, but not high calorie diets.

"Calcium intake did not predict changes in weight or fat mass in the group with calorie intakes above the mean. On the other hand calcium, but not calories, negatively predicted changes in weight and fat mass in calorie intakes below the mean."

So you can't stuff yourself and expect calcium to protect you. This indicates that one should be moderate in food consumption in order to get calcium to work for your biochemistry.

"Clearly if dairy products are added to a diet without compensation for energy intake, one is likely to gain weight."

We would like to emphasize that this is not a magic bullet for immediate weight loss, but a long term solution which may generally aid patients to gain advantage over the slow weight gain that accompanies aging. Calcium could turn around that increase in girth, when consumed with a moderate diet, and even turn that to a slight weight loss, according to the researchers we cite.

However, aggressive interventions as described on page 1 might be tried under medical supervision, and may produce dramatic results as the study cited, with a milk diet.

Also, notable benefit may follow the use of a highly buffered form of calcium, magnesium and potassium formula in relationship to food cravings.

Criticism: The low incidence of obesity in ancient people and underdeveloped countries is directly proportional to activity levels and lack of food or lack of refined food.

Response: There are obviously many factors and exercise is certainly got to be a big one. The calcium effect is a statistical factor. We have tried to emphasize that by relying on some of the analysis in the abstracts. Not everyone will respond and this is a long term potential solution of potentially great magnitude. Also, one might appreciate OUR model that winter brings hibernation in hibernating animals. I suspect that we (humans) also have some of those hibernation characteristics. Perhaps because not enough vegetables and other rich sources of dietary calcium are being consumed, and less time is spent in the sun, humans may have retained the ability to conserve reserves by reducing fat burning, thereby conserving energy in the form of fat "for a sunny day" or for the spring and summer season. Just as the old adage goes, normally we save our resources "for a rainy day" and the body does the same by conserving fat and reducing fat burning when sunshine and calcium (a marker for vegetable consumption) are in short supply. There is data that vitamin D also has an inverse relationship to obesity. Hence, lack of vegetables (high in calcium) and sunshine would signal the body to go into a modified hibernation mode, slowing down metabolism for the winter season. So that's our hibernation theory.

We have presented expert "textbook" opinions on the safety of calcium supplementation, along with the probable explanation of the calcium paradox and clinical benefits from higher levels. However, more needs to be said on safety.

Certain medical conditions might be related to or worsened by increased dietary calcium, but this is not clear from the literature from what we have seen. It is plausible that in patients with renal failure there could be preferential mineralization in vascular tissue instead of bone. Kidney failure, as with other serious illness may require special consideration on a case by case basis. In other disease states, abnormal calcification of vessels and tissues as described in complex animal studies by Hans Selye ( Calciphylaxis, 1962, The University of Chicago Press) may occur, but again we think the weight of the evidence by far, suggests safety and benefit for RDA, and even somewhat higher levels for the general population.

Since we have presented statistical findings, we cannot appropriately determine which patients will respond. It is likely that a portion will not respond and this may well be related to metabolic type. Since some significant groups may not respond, the data for those that do respond would thus be understated, because it would represent average numbers (per individual). Hence a more profound response might be expected from responders.

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