MINERALS –

CALCIUM

Dr Yogesh K Singhal
MBBS, MD-PSM, MBA-HHSM, FICM
Associate Professor
Department of Community Medicine
American International Institute of Medical Sciences
Udaipur, Rajasthan
MINERALS
> 50 chemical elements in human body.
For growth, repair and regulation
3 major groups
1) major minerals – Ca, Pho, Na, K
2) trace elements – Iron, I, Zn, Cu
3) trace contaminants with no known
function – Pb, Hg, Ba, Bo, Al
MACRO MINERALS
those which constitute more than 0.01%
of body weight
Or
Mineral whose requirement is more than
100mg per day”.
Calcium, phosphorous, magnesium,
sodium, potassium,
chloride, sulphur
MICRO MINERALS
those comprising less than 0.01% of total body
weight
Or
those which are needed in a concentration of
less than 1ppm
Iron, zinc, iodine, Copper, manganese,
molybdenum, selenium, chromium and
fluorine,
cobalt, nickel, tin, silicon, vanadium, arsenic,
cadmium, boron, aluminium***
MINERALS
Function
Clinical situation
Need
Bioavailability
Diet– veg/ non-veg / omni
Supplements
CALCIUM
Major element
1.5 – 2% of adult body weight
Average 1200 g (98% from bones)
Blood – 10 mg/dl
Fetus need 30 gm
Equilibrium between blood, bone,
intestine, kidney
Vit D, PTH, Calcitonin
Function
Bone formation
Blood Coagulation
Muscle Contraction
Cardiac Action
Milk production
Nerve conduction – synapse, retina
As a cofactor : for a number of enzymes
e.g. lipase
Sources
Best natural sources are milk and milk
products, eggs, fish (if eaten whole)
Ragi, dried fruits, such as raisins, apricots
and dates, and betel leaves with lime,
pulses and tofu
 1 litre cow milk – 1200mg, human milk
– 300mg
Milk – calcium caseinogenate – easy
assimilation
Sources
Green leafy veg - oxalate – calcium
oxalate – insoluble - ??
Cereals – phytic acid – interefere –
calcium phytate
Water 200mg/day
Absorption
20-30% dietary calcium easily absorbed
Enhanced by Vit D
Interfered by oxalates, phytates, fatty
acids, phosphates, tannins, salt, alcohol
rye and wheat contain an enzyme phytase
Requirement
600 mg calcium for adult
Physiological requirement is higher in
children,
1-9 y– 600
10-17 y – 800
pregnancy(2), lactation(2).
Blood calcium regulation
Deficiency
Plasma calcium levels are tightly controlled and are
not usually affected by dietary insufficiency in
healthy adults.
Reduction in the level of circulating ionised calcium
produces a clinical condition known as tetany. This
is characterized by twitching of muscles of face,
hand and feet. Cardiac arrhythmias may also result.
 A long term calcium deficiency during the bone
formative age can cause stunted skeletal growth and
a low bone density. Vitamin D deficiency leads to
rickets in children due to poor calcium absorption
Deficiency
Osteoporosis is an abnormal thinning of bones. It
is not due to a primary calcium deficiency but
results from conditions leading to chronic calcium
deficiency.
These factors are inadequate calcium intake, poor
absorption, abnormal hormone levels, upsetting
the calcium homeostasis and subnormal physical
activity.
Osteoporotic bones are more likely to get
fractured with trivial injuries (falls), as commonly
seen in post-menopausal women and the elderly.