Calcium Deficiency among the Elderly

Calcium Deficiency among the Elderly

  Calcium Deficiency among the Elderly

Calcium is one of the most important nutrients in the body and significantly contributes to bone health. Hejazi points out that 99% of the calcium requirement of the body is stored in the bones (1). Calcium requirement in the body is dependent on age as those aged 50 years and above are recommended to have 1200 mg/day as compared to about 1000 mg/day for men and women with less than 50 years (2). Calcium is an essential nutrient that is needed throughout the life cycle.

The process of aging is characterized by loss of appetite resulting in decreased food intake. The decline in the ability to ingest an adequate amount of food, as a consequence makes the elderly not able to meet their recommended nutrient requirement (2). Among individuals aged 65 years and above calcium intake is insufficient leading to the decline of serum calcium levels in the body to causes a series of consequences. First, it causes increased secretion of parathyroid hormone (PTH) that results in the resorption of bones and release of their content to the blood inhibiting the reduction of the serum calcium level (1). The continuation of these phenomena decreases BMD and increases the risk for osteoporosis.

Calcium deficiency causes a significant major health issue among the elderly as it leads to osteoporosis. Osteoporosis is a systematic skeletal disease characterized by the loss of bone mass density (BMD) and damage to the microstructure of bone tissue leading to bone susceptibility and risk of fracture. In Australia, osteoporosis is a health condition affecting approximately 4% of the population (3).

The elderly require calcium as their skeleton loses it due to age (1). Most women lose more calcium from their bones in the 5-10 years around the age of menopause. However, both men and women lose bone mass as they grow older and need to make sure that they get enough calcium in their diet to offset the losses. Older patients need to understand that a high diet of calcium cannot reverse age-related bone loss but can slow down the process (2).

The impacts of Calcium Deficiency

Osteoporosis is a major healthcare issue specifically affecting the elderly as it is an issue of concern as; The condition causes morbidity and mortality among older people (1). It also imposes a profound financial burden on the healthcare system every year. Today, osteoporosis is an epidemic in some societies with the rapid growth of elderly people (1).

The prevalence of Osteoporosis

The prevalence of Osteoporosis in Australia in those aged 75 years and above (Australian Bureau of Statistics National Health Survey).

Year

Female (%)

Male (%)

2001

15.1

3.2

2005

26.2

4.7

2008

31.1

8.6

2012

29.0

7.8

2015

25.8

7.2

2018

29.0

10.3

 

The statistics confirms that women have higher chances of suffering from osteoporosis than men aged 75 years and above.

Risk factors

Osteoporosis is a multi-factor disease in which genetics, age, gender, race, weight, consumption of certain medications such as corticosteroids and thyroid hormones, and other diseases such as rheumatoid arthritis and gastrointestinal disorders affect BMD (1). Besides, lifestyle also significantly affects bone density and calcium intake in the body (4).

How Lifestyle can affect bone strength

Some of the factors that reduce calcium reabsorption in the bones while lowering bone density include

·       High salt-diet.

·       More than 6 drinks per day of caffeine-containing drinks such as coffee, cola, or energy drinks.

·       Excessive alcohol intake (4).

·       Very low body weight.

·       Smoking.

·       Very high intake of fibre (More than 50 g per day from wheat bran).

·       Low levels of physical activity and low levels of vitamin D

 

Role of calcium in the body

      i.         Calcium plays a vital role in strengthening bones and teeth,

     ii.         Calcium regulates muscle functioning such as vascular contraction and relaxation (5).

   iii.         Calcium plays a role in regulating heart functioning.

   iv.         Calcium plays a significant role in blood clotting.

     v.         Calcium helps in the transmission of nervous system messages (5).

   vi.         Calcium aids in enzyme function.

Dietary sources of Calcium

      i.         Dairy products account for a mere 40% of calcium intake largely due to the popularity of dietary supplements and the declining intake of cow’s milk (6). Milk and Milk products such as yogurt, cheese, and buttermilk. For instance, one cup of milk, a 200g tub of yogurt, or 200 ml of calcium-fortified soymilk provides around 300 mg of calcium. Besides, calcium-fortified milk can provide large amounts of calcium in a smaller volume of milk ranging from 280 mg to 400 mg per 200 ml of milk.

     ii.         Leafy green vegetables such as broccoli, collards (cabbage family), bok choy, Chinese cabbage, and spinach (7). For instance, one cup of cooked spinach contains 100mg although about 5% of this may be absorbed. This is due to the high concentration of oxalate, a compound in spinach that reduces calcium absorption. In contrast, one cup of cooked broccoli contains about 45 mg of calcium but the absorption is higher at around 50-60%.

   iii.         Other food types rich in calcium include soy and tofu, fish, nuts, and seeds such as almonds where 15 almonds contain 40 mg of calcium. Sardines and canned salmons and their bones are included as the fish types that yield adequate calcium (7). For instance, half a cup of canned salmon contains 402mg of calcium.

   iv.         Besides, calcium-fortified foods like breakfast cereals, fruit juices, bread, and some plant-based kinds of milk also supplement calcium intake in the body.

Recommendations

Good nutrition plays a significant role in osteoporosis prevention and treatment. This can be achieved through several interventions.

      I.         Maintenance of an adequate protein intake is important in the preservation of musculoskeletal function in men and women over 50 years of age (8).

    II.         The use of protein supplements in patients with hip fracture help in lessening bone loss, reducing the risk of infection, diminishing the length of hospital stay, and increases in functional recovery. The endorsed protein intake is 1.2g/kg daily (8).

  III.         Undertaking lifestyle modifications within the population-based strategies can help in having an adequate intake of calcium and sufficient intake of vitamin D such as proper dieting and sun exposure.

  IV.         In instances of deplorable state, the elderly can take a minimum dose of 400 IU of vitamin D which is desirable in the blood levels at a rate of 30-50 ng/mL.

    V.         The endorsed calcium intake is 1000-1200 mg daily with a preferable intake through dieting. However, supplementation can be provided not to exceed 500-600 mg per dose (2).

  VI.         Additionally, exercises with weight, balance, and resistance load are recommended to help improve mobility, strength, and physical performance as a way of reducing the risk of fragility fracture through the prevention of falls which can be attained through supervision such as physical therapy.

 


 

Reference List

1.     Hejazi J, Davoodi A, Khosravi M, Sedaghat M, Abedi V, Hosseinverdi S, Ehrampoush E, Homayounfar R, Shojaie L. Nutrition and osteoporosis prevention and treatment. Biomedical Research and Therapy. 2020 Apr 26;7(4):3709-20.

2.     Kaur D, Rasane P, Singh J, Kaur S, Kumar V, Mahato DK, Dey A, Dhawan K, Kumar S. Nutritional interventions for elderly and considerations for the development of geriatric foods. Current aging science. 2019 May 1;12(1):15-27.

3.     Smith, L., & Wilson, S. (2022). Trends in osteoporosis diagnosis and management in Australia. Archives of Osteoporosis17(1), 97.

4.     Reid IR. Bone-friendly lifestyle and the role of calcium or vitamin D supplementation. Climacteric. 2022 Jan 2;25(1):37-42.

5.     Chauhan RC. Calcium as a boon or bane for athlete: A review. Asian Journal of Research in Marketing. 2022;11(1):1-8.

6.     Hodges JK, Cao S, Cladis DP, Weaver CM. Lactose intolerance and bone health: the challenge of ensuring adequate calcium intake. Nutrients. 2019 Mar 28;11(4):718.

7.     Vishvakarma P, Mandal S, Verma A. A REVIEW ON CURRENT ASPECTS OF NUTRACEUTICALS AND DIETARY SUPPLEMENTS. International Journal of Pharma Professional’s Research (IJPPR). 2023;14(1):78-91.

8.     Coronado-Zarco R, de León AO, García-Lara A, Quinzanos-Fresnedo J, Nava-Bringas TI, Macías-Hernández SI. Nonpharmacological interventions for osteoporosis treatment: Systematic review of clinical practice guidelines. Osteoporosis and sarcopenia. 2019 Sep 1;5(3):69-77.

 


Calcium Deficiency in Older People

Calcium Deficiency is a common issue in older people aged 65 years and above.


key facts

 

 

prevalence of osteoporosis

The prevalence of Osteoporosis in Australia in those aged 75 years and above (Australian Bureau of Statistics National Health Survey).

Year

Female (%)

Male (%)

2001

15.1

3.2

2005

26.2

4.7

2008

31.1

8.6

2012

29.0

7.8

2015

25.8

7.2

2018

29.0

10.3

LIFESTYLE AFFECTS CALCIUM INTAKE

Some of the lifestyle practices that reduce calcium reabsorption in the body that lowers the bone density include;

ROLE OF CALCIUM IN THE BODY

DIETARY Sources of calcium

·       Dairy products- For instance, one cup of milk, a 200g tub of yogurt, or 200 ml of calcium-fortified soymilk provides around 300 mg of calcium.

·       Leafy vegetables such as one cup of cooked broccoli contains about 45 mg of calcium.

·       Other food types rich in calcium include soy and tofu, fish, nuts, and seeds such as almonds where 15 almonds contain 40 mg of calcium.

·       A half cup of canned salmon contains 402mg of calcium.

 

recommendations

·       Good nutrition plays a significant role in osteoporosis prevention and treatment. This can be achieved through several interventions.

 

BEWARE CALCIUM DEFICIENCY CAUSES FATIGUE AND DISRUPTIONS IN THE METABOLIC RATES.

THANK YOU!!

 

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