Why is there still calcium deficiency? Calcium supplementation for middle-aged and elderly people. come here

Author: Luo Siyan, primary pharmacist of Guangdong Pharmaceutical Society, Huadu District People's Hospital of Guangzhou.

Calcium is one of the important nutrient elements in human body, and bone calcium accounts for about 99% of the total calcium in human body, which plays an important role in nerve medium transmission, muscle contraction and cell secretion. Calcium deficiency can cause muscle spasm, osteomalacia, osteoporosis and arrhythmia.

According to the data of China Nutrition Society, the daily calcium intake of the elderly over 65 years old should be 800- 1000 mg, with a maximum of 2000 mg. However, due to the weakening of gastrointestinal activity, the decrease of gastric acid and the slow gastric emptying, the functions of some active transport systems in the gastrointestinal tract decline, such as iron, calcium, vitamin B 1, B6, B 12 and so on.

So how should middle-aged and elderly people supplement calcium? Here are some suggestions:

Eat nutritious food

Food is the best choice to meet human calcium intake. Middle-aged and elderly people can eat more foods rich in calcium and protein, such as dairy products, bean products, fish and shrimp.

Take tonic to strengthen your physique.

Influenced by our country's eating habits, it is difficult to meet the demand for calcium nutrition only by daily diet, so it is a feasible choice to supplement calcium from other ways to achieve a suitable supply level. At present, there are many kinds of calcium preparations on the market, and calcium preparations with high calcium content, easy absorption in gastrointestinal tract, high safety, good taste and convenient administration should be the first choice when supplementing calcium.

Clinical application of calcium can be divided into three categories:

① Inorganic calcium: including calcium carbonate, calcium phosphate, calcium oxide, calcium chloride, etc. It is characterized by high calcium content, but low absorption rate, poor solubility, great stimulation to the stomach and easy to cause constipation.

② Calcium organic acid: including calcium gluconate, calcium citrate and calcium lactate. Its characteristics are slightly better solubility and better absorption efficiency than inorganic calcium, but its calcium content is low and its daily dosage is large.

③ Molecular organic calcium, namely calcium amino acid: including calcium L- threonate and calcium L- aspartate. Its characteristics are high absorption rate and few adverse reactions.

Middle-aged and elderly people should choose molecular organic calcium, followed by organic calcium and finally inorganic calcium.

Appropriate vitamin d supplementation

The function of active vitamin D3 is to promote the absorption of calcium ions by intestinal mucosa and increase the reabsorption of calcium and phosphorus by renal tubules; At the same time, it is directly involved in bone mineral metabolism and bone cell differentiation after liver and kidney hydroxylation. Generally speaking, the hydroxylation function of vitamin D in middle-aged and elderly people decreases, which affects the absorption of calcium. If necessary, it should be supplemented appropriately. The daily intake of vitamin D3 for middle-aged and elderly people is 400-800IU. You can also eat more foods rich in vitamin D, such as eggs and citrus fruits, and bask in the sun for about 20 minutes every day.

Calcium supplement skills

Protein and phosphopeptide can promote the absorption of calcium, especially phosphopeptide decomposed by casein hydrolase, which can isolate calcium and other cations from combining with intestinal anions (such as phosphate radical) to produce precipitation, so that calcium remains soluble all the time, which is beneficial to the positive diffusion of calcium, so it is best to take protein when supplementing calcium.

Phytic acid, oxalic acid and tannic acid can combine with calcium to form insoluble complex, which reduces the absorption of calcium, and the absorption of calcium is also affected by the lack of high fiber diet in dairy products. Therefore, when supplementing calcium, don't eat it with a diet rich in phytic acid, oxalic acid, tannic acid and high fiber, such as spinach, strong tea and cereals.

● Chew when taking it. Chewing to increase the surface area of tablets is beneficial to absorption, and drinking more water can improve the solubility of calcium; At the same time, we should pay attention to supplement vitamin D to promote the absorption and metabolism of calcium.

● It should be taken separately from nutrients such as zinc and iron, because it will compete with calcium ions and interfere with each other's absorption; In addition, exercise can be properly strengthened to promote calcium deposition to bones.

● Long-term maintenance of adequate calcium intake can increase bone mineral density, which is superior to short-term high-dose calcium supplementation.

Excessive calcium is harmful to the body, such as constipation, calcification of cardiovascular system, urinary calculi, peptic ulcer, acute pancreatitis, bone pain and pathological fracture. Therefore, drug calcium supplementation should be carried out in strict accordance with the doctor's advice, fully aware that calcium deficiency is not good for the body, and excessive calcium supplementation is not good for the body. Choosing a regular food calcium source will not cause excessive calcium.

Reviewer: Wang Haokui, pharmacist in charge of Huadu District People's Hospital of Guangzhou, Guangdong Pharmaceutical Association.

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