The Relationship between Dietary Calcium Intake, Calcium Ratio, and Bone Mass

The Relationship between Dietary Calcium Intake, Calcium Ratio, and Bone Mass

Osteoporosis is an illness where the density and quality of bone are low, resulting in a weak skeleton and high risk of fracture, especially of the spine, hip, and wrist. Bone loss has no signs, and usually, the first symptom of osteoporosis is a fracture. Despite the fact that genetic factors highly influence the likelihood of a person developing the disease, lifestyle factors, for example, a better diet and exercise contribute to the growth of bones during early years, which assist in minimizing bone loss in adults and the elderly. Luckily, the lifestyle factors are open to change, and people can decide to make their bones strong and minimize their chances of developing the disease. Cases of osteoporosis and osteoporotic fractures have increased globally. In 2010, the incidence of osteoporosis and reduced bone mass in adults above 50 years was 10.3% in the United States (Kyung-Jin et al., 2014). Furthermore, cases of osteoporotic fractures are more than 1.5 million yearly and are likely to increase to 6.3 million in 2050.  Despite the fact, the osteoporosis has been concentrated mainly on postmenopausal women, osteoporosis in men is now a public health concern. It is because age-specific cases of the fracture of the hip in males are half compared with those in females. Taking the required amount of calcium enhances bone health. The present study examines how dietary calcium intake and dietary calcium ratio are related to bone mass in adults.

Nutrition and Bone Health

Just as other body organs, the skeleton requires a balanced diet that has macronutrients and micronutrients for growth as well as maintenance. Nevertheless, in well-fed people, the two main nutrients that enhance healthy bones are the mineral calcium and vitamin D. Firstly, calcium is the main structural element of bone tissue whereas the skeleton functions as a pool of calcium for retaining calcium amounts in the blood. Suggested calcium consumption for each day differs among nations. Regarding diet, milk, as well as other dairy foods, contains a lot of calcium. Some green vegetables, such as broccoli, total-preserved fish with bones like sardines, and nuts are sources of calcium. Foods and drinks that contain calcium, such as bread and orange juices are prevalent in some nations.

Vitamin D is also vital for the growth and protection of bones. It helps in calcium absorption from the gut and promotes the right regeneration and mineralization of bone tissue. The synthesis of vitamin D takes place in the skin when it comes into contact with sunlight, and though it is often enough for many people, nutritional vitamin D is particularly essential in winter periods for people living in northern latitudes as well as the elderly who rarely go outside and who also have low capability of skin synthesis of vitamin D. The lack of vitamin D in the elderly raises the chances of developing osteoporosis, falls, and fractures (Gómez, Rubió, Curiel, & Pérez, 2011).

The Influence of Calcium on Bone Mass and Fracture Risk

Calcium plays a key role in the growth and preservation of bones. Approximately, 99% of calcium in the body is located in the bones. Additionally, calcium mixes with different minerals, forming hard crystals that strengthen bones. Some calcium is absorbed into the blood, which enables the heart, muscles, blood and nerves to operate appropriately. Bones serve as a calcium depository, and failure to consume sufficient calcium from diet makes the body extract calcium from the ‘bone bank’ to be utilized by several body parts. The body’s withdrawal of calcium more than it deposits slowly weakens bone density (bone strength), increasing the chances of developing osteoporosis. Since many individuals do not acquire enough calcium from the normal dietary intake, calcium supplementation is necessary for attaining the full benefit of osteoporosis medications. The average Americans above 65 years of age take in less than half of the suggested daily calcium consumption (Li Vecchi et al., 2012).

Several studies have proved the significance of diet for bone health in human beings of different ages. Research conducted in babies and teenagers reveal that supplementation with calcium increases the rate of acquiring bone mineral than the control groups that were not supplemented. Generally, the intervention trials led to the rise of the regular calcium consumption of the supplemented children. Research conducted among young women of between 30 to 42 years indicated that improving the diet with dairy foods averted the bone loss in the spine in comparison with subjects who never increased their nutritional calcium consumption. In postmenopausal women and the elderly, numerous kinds of research have indicated that calcium supplementation decelerates the rate of bone loss. In an investigation conducted in healthy, elderly women staying in nursing homes, calcium and vitamin D supplementation for more than 18 months lowered the risk of hip fractures and other non-vertebral fractures. Therefore, sufficient consumption of calcium is a significant component in the maintenance of bone health and needs to be fostered among people of different ages (Rabiei, Masooleh, Leyli, & Nikoukar, 2013).

Presently, there are four main groups of medications employed in treating osteoporosis: bisphosphonates, recombinant human parathyroid hormone (PTH), calcitonin, and selective oestrogen receptor modulators. Many people have reduced calcium supplements since they believe that the drugs are effective in curing osteoporosis. However, that is not the case because the effectiveness of all osteoporosis drug treatments is founded on adequate consumption of calcium (Souza, Morais, dos Santos, Martinez-Huitle, & Fernandes, 2013).




Benefits of Calcium Supplements

Bone Density

Digestion of a calcium bolus, mostly in a supplement form, highly raises the flow calcium concentrations and lowers parathyroid hormone levels as well as markers of bone resorption, with reduced bone formation markers after 2-3 months. This is advantageous to bone density of approximately 1.5-1% in the hip and spine, mainly within the first year of treatment. Several experiments that were conducted by experts did not establish any association between people’s baseline nutritional calcium consumption and their bone density response. Some findings indicate that calcium supplements serve as weak anti-resorptive agents, lowering bone turnover, whatsoever the baseline calcium consumption, and generating a special gain in bone density because of filling in certain osteoclastic resorption positions. Nevertheless, this does not yield increasing benefits when it comes to bone mass (Li Vecchi et al., 2012).


A study carried out to experiment the anti-fracture effectiveness of calcium (with vitamin D) indicated that at 18 months, hip fractures decreased by 43% in a broader examination, which likened to a 26% reduction in fracture rate on an intention-to-treat basis. There was a similar effect at 36 months. Additionally, the numbers of non-vertebral fracture reduced by 25% and 17% at 18 months and 36 months respectively. From the study, it was concluded that calcium and vitamin D were a significant part of osteoporosis management because of their evident anti-fracture effectiveness as well as supposed safety (Tan, LaMontagne, English, & Howard, 2016).

Recommended Calcium Dietary Intakes or Dietary Goals

Low consumption of calcium contributes to low bone density. Such factor makes osteoporosis distinct from the classical deficiency diseases. Normally, recommendations for populace consumption of nutrients are known as recommended dietary intake (RDIs) when denoting a deficiency disease relationship, and dietary goals when signifying a chronic disease relationship. According to the National Health and Medical Research Council Working Party, RDIs and dietary goals should be separated. However, this is possible where increased consumption of the nutrient increases the risk of the associated chronic disease. Calcium works differently whereby increased consumption in older women decelerates the development of the chronic illness. Therefore, at this phase, it is not possible to describe calcium consumption that will lead to zero balance and avert bone loss. Additionally, it is uncertain how the normal perception of an RDI could be applied if there is no level of calcium consumption that can manage to cancel out the effects of estrogen loss. Thus, the present RDI for calcium consumption in older women could be perceived more as a temporary nutritional goal compared to a traditional RDI. Despite having been described as provisional, it is intended for recognizing the probable function of calcium in preventing post-menopausal osteoporosis without going beyond the boundaries of what is nutritionally workable and appropriate (Raj, Oommen, & Paul, 2015).

The multi-factorial state of osteoporosis as well as other chronic illnesses implies that individuals should be careful when discussing the subject of prevention to the society. For instance, in a certain study, the joint dose of calcium and cholecalciferol `prevented’ one-third of hip fractures in elderly French women; however, it never prevented all hip fractures. This shows the difference between prevention directed to a population (reducing the number of cases) and the one directed to an individual (a total assurance that a person will not develop the disease). A declaration, such as ‘reducing serum cholesterol prevents heart disease’ applies at the population level but not at the individual level. This is because such action reduces but does not eliminate the individual’s risk. Likewise, it would not be right to state that increasing (or sufficient) calcium consumption prevents osteoporosis; however, it would be right to say that increasing (or sufficient) calcium consumption lowers the risk of osteoporosis. Moreover, this varies from the classical deficiency illness case where it is right to say that enough vitamin C consumption prevents scurvy (Raj, Oommen, & Paul, 2015).

The Relationship between Calcium Intake and Development of Osteoporosis

In several studies on calcium intake and bone mass, nutritional calcium consumption was positively associated with bone mineral density (BMD) for the femoral neck of men who were 50 years and above and for the entire body of premenopausal women. The link between nutritional calcium consumption and bone health has been addressed by several experimental and epidemiological types of research. A cross-sectional research carried out among Chinese freshmen revealed that sufficient consumption of calcium reduced the risk of acquiring osteoporosis. Numerous studies examining nutritional calcium consumption ratio and osteoporosis have been carried out in women.  Nutritional calcium consumption and nutritional calcium consumption ratio were positively linked to the bone mass in the radius of 18 to 22 years old women (Kyung-Jin et al., 2014). The amount of calcium consumed was directly linked to adequate minerals in the body and effective bone mass in women. Nevertheless, one of the studies showed only positive relation between nutritional calcium consumption and whole body BMD in premenopausal women. This was probably due to different components that impacted bone mass, such as thyroid hormone.


Dietary calcium intake and dietary calcium ratio enhances bone mass in adults. The effective way of averting osteoporosis is through having stronger bones. Additionally, calcium as well as vitamin D contributes to the acquisition of such stronger bones. Calcium carbonate is the widely-utilized calcium supplement. Sufficient consumption of vitamin D enables calcium absorption (after contact with sunlight) and is vital in lessening illnesses associated with bones. This information is essential to medical practitioners in preventing and treating osteoporosis in the society, which will save the lives of many people. Advances in the area of osteoporosis cure and prevention have resulted in the establishment of strong new medications. Patients and physicians believe that the medications are the solution in the management of osteoporosis. Unluckily, such perception has caused several individuals to ignore the significance of simultaneous calcium supplementation to guarantee maximum benefits from such drugs. Since several patients have failed to consume the least suggested nutritional calcium consumption, it is essential to endorse calcium supplements in order to increase the amount of calcium consumed daily, which is required in ensuring maximum effectiveness in treating osteoporosis.



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Kyung-Jin, L., Kyung-Soo, K., Ha-Na, K., Jin-A, S., & Sang-Wook, S. (2014). Association between Dietary Calcium and Phosphorus Intakes, Dietary Calcium/Phosphorus Ratio and Bone Mass in the Korean Population. Nutrition Journal, 13(1), 10-26.

Li Vecchi, V., Soresi, M., Giannitrapani, L., Mazzola, G., La Sala, S., Tramuto, F., & … Di Carlo, P. (2012). Dairy Calcium Intake and Lifestyle Risk Factors for Bone Loss in HIV-Infected and Uninfected Mediterranean Subjects. BMC Infectious Diseases, 12(1), 192-201.

Rabiei, M., Masooleh, I. S., Leyli, E. K., & Nikoukar, L. R. (2013). Salivary Calcium Concentration as a Screening Tool for Postmenopausal Osteoporosis. International Journal of Rheumatic Diseases, 16(2), 198-202.

Raj, J. P., Oommen, A. M., & Paul, T. V. (2015). Dietary Calcium Intake and Physical Activity Levels among Urban South Indian Postmenopausal Women. Journal of Family Medicine & Primary Care, 4(3), 461-464.

Souza, S., Morais, F., dos Santos, E., Martinez-Huitle, C., & Fernandes, N. (2013). Determination of Calcium Content in Tablets for Treatment of Osteoporosis Using Thermogravimetry (TG). Journal of Thermal Analysis & Calorimetry, 111(3), 1965-1970.

Tan, A. M., LaMontagne, A. D., English, D. R., & Howard, P. (2016). Efficacy of a Workplace Osteoporosis Prevention Intervention: A Cluster Randomized Trial. BMC Public Health, 16(1), 1-14.

Plagiarism Statement: I wrote this research paper and information borrowed from other sources has been properly cited