CALCIUM

Presented By: Pregnant and Lactating

Group
 Overview
Distribution Effects of Deficiency

Function Effects of Excess

Calcium Intake
Utilization

Food Sources
Recommended Nutrient Intake
 DISTRIBUTION

Of the total body weight, approximately 1.5-2.2% is calcium

(approx. 22 g/kg fa free body weight). Of this, 99% is present
mostly in the bones and teeth and the remaining 1% is found
in the soft tissues and body fluids and serves a number of
important functions unrelated to bone structure.
 FUNCTIONS
a. Bone and teeth formation d. Nerved transmission

e. Enzyme activation and catalyst

b. Muscular contractions for biological reactions

c. Blood coagulation f. other potential functions

 FUNCTIONS
a. Bone and teeth formation
Calcium combines with phosphorus to form calcium
phosphate, the hard material of the bones and teeth. The
calcium in the form of hydroxyapatite causes the hardening of
the protein matrix of the bone (collagen) as a result of the
deposition and growth of the calcium crystals known as
ossification or calcification.
 FUNCTIONS
b. Muscular contractions
In the ionized form, calcium participates in muscular
contraction and relaxation. The muscle fibers contain
contractile units called myofibrils which are in turn composed
of the muscle proteins, myosin and actin. Calcium which is
bound to the reticulum found along side each myofibril is
released, ionized and mobilized when contraction occurs.
 FUNCTIONS
c. Blood coagulation
Calcium promotes blood coagulation. When cells are injured,
calcium ions (Ca) stimulate the release of a certain factor that
activates the enzyme thrombokinase. Thrombokinase plus
(Ca") and other accelerating factors catalyze the conversion of
prothrombin to thrombin. Thrombin is needed in the
polymerization of fibrinogen to fibrin, the blood clot.
 FUNCTIONS
d. Nerved transmission

The formation and breakdown of acetylcholine necessary for

the transmission of an impulse from one fiber to the next is
dependent on calcium.
 FUNCTIONS
e. Enzyme activation and catalyst
for biological reactions
Some enzyme like the adenosine triphosphatase (ATPase)
needed in the energy release for muscle contraction, the
pancreatic lipase needed for splitting fat and the absorption of
cobalamin (vitamin B) are activated by calcium.
 FUNCTIONS
f. Other potential functions
Calcium lowers hypertension in individuals with low plasma
renin activity, low serum ionized calcium and dietary salt
insensitivity. The effect may be through its effect on
phosphate metabolism, or by its influence on vascular smooth
muscle cell membranes.
 Utilization
A. B. C.

Absorption Metabolism Excretion

 Utilization
Absorption

Takes place chiefly in the proximal part of the intestinal tract

(duodenal area) by active transport. This process requires energy.
Of the total calcium ingested in the diet, about 20-40% is
normally absorbed.
 Utilization
Factors which influence calcium absorption
- Mental stress or emotional instability has been found to decrease absorption and increase excretion.

- Medication like theophylline, thiazide diuretics and tetracycline can exert depressing effect on calcium
absorption.

- Alcohol. Intake among alcoholics may cause decreased calcium absorption because of steatorrhea and
altered vitamin D metabolism.

- Estrogen has been known to inhibit bone resorption and to improve efficiency of calcium absorption
through an increase in the parathyroid hormone which in tur stimulates the kidney to synthesize more
vitamin D
 Utilization
Metabolism

When food calcium is absorbed in the small intestine, the absorbed

calcium is transported to the fluids bathing the tissues of the body and
to the cells where it is used whenever needed. Most of the absorbed
calcium is utilized in the skeleton where it is in equilibrium with the
calcium in the blood.
 Utilization

Metabolism
 Utilization
Excretion

Most of the unabsorbed calcium is found in the stools and

some in the urine. This is the leftover amount absorbed
from the gut and also in the sweat especially during
extreme heat although the latter amount is insignificant.
 Food Sources
Foods supply 1/2 of RNI
Kuhol (snail)
Gatas (milk)
Hipon tagunton (shrimp fry)
Talangka (tiny crabs) Sardines
Dried dilis (anchovies)
Foods that supply 1/3 of RNI
Cheese, Yogurt Seaweeds
Smallfishes (galunggong, bia) Dried
hibe (tiny shrimps)
Malunggay leaves
Saluyor and other green leafy
vegetables
 Food Sources
Other good sources of calcium are: soybean curd (tokwa, tofu); fishes eaten
with bones (canned salmon, canned bangus, and legumes (munggo, soybean,
black beans, etc.)

Remember that when one says "dairy products" as good sources of calcium, it
does not include butter and cream cheese, but includes yogurt, cottage cheese
(kesong puti) and other cheeses. Also, many of green vegetables may contain
oxalic acid that interferes with absorption.
 Recommended Nutrient Intakes

(19 to 49 years old) RNI is 0.75 g or 750 mg

calcium per day.
Pregnant women need higher amount at
0.8 g/day
 Recommended Nutrient Intakes

Recent studies support the increase of calcium

requirements among the older persons or senior
citizens due to the prevalence of osteoporosis. The
RNI for persons 65 years and above is 0.8 g/day.
Calcium supplements in the form of carbonates (e.g.,
Tums) provide the least expensive and the most
bioavailable source of calcium, but always use with a
physician's approval.
 Effects of Deficiency
Rickets
- caused by lack of calcium, or phosphorus, or vitamin D.
Among adults, the disorder is called osteomalacia ("adult
rickets"). There is softening of the bones due to the
reduction of its mineral content.
Rickets
 Effects of Deficiency
Tetany
-is another deficiency disorder characterized by uncontrolled reaction of
muscle tissue and increased excitability of the nerves due to lack of
circulating ionized calcium.

"Premature or pre-term infants without supplemental calcium,

phosphorus, and vitamin D can develop rickets."
Tetany
 Effects of Deficiency
Osteoporosis is not the same as osteomalacia: The former is due to a long-
standing lack of calcium intake, estrogen, and exercise or active physical
activity. There is increased rate of bone resorption and bone mass in
osteoporosis.

Genetic and environmental factors could hasten the onset of osteoporosis.

These include: race (Caucasian more at risk); sex (females more at risk), age
(older persons); early menopause, alcohol abuse, cigarette smoking, and high
caffeine intake.
Osteoporosis
 Effects of Excess Calcium Intake

A high intake of vitamin D and a high ratio of phosphorus to

calcium may lead to hypercalcemia. Vitamin D causes the
mobilization of minerals from the bones. When calcium levels
rise above normal, the muscle fibers enter into a state of tonic
contraction known as calcium rigor.
Hypercalcemia
 Effects of Excess Calcium Intake

Hypersensitivity to vitamin D.
-the symptoms are: vomiting, loss of appetite, and wasting
Calcium toxicity among infant
- may be caused by overdose of calciferol or from a of muscle
tissues. Among adults, excess calcium will be deposited in soft
tissues. This may occur in cases of chronic renal disease,
sarcoidosis, and hyperparathyroidism.
Thank You