Market Mixx Blog Home

Nutrition Advice for “Young” Seniors



Feb 21st, 2014

Senior Couples

Calcium: Which Form Is Best?

Also indexed as:Coral Calcium
Calcium: Which Form Is Best?: Main Image

Related Topics

For adults, dairy products supply 72% of the calcium in the U.S. diet, grain products about 11% and fruits and vegetables about 6%.1Milk drinkers get 80% more calcium in their diet compared to non-milk-drinkers.2 Apart from total calcium content, foods and supplements should be evaluated in terms of the bioavailability of the calcium they contained (in other words, how much of it is actually absorbed and utilized by the body.) Calcium absorption from various dairy products is similar, at about 30%.3 However, many people choose alternatives to milk and dairy products for health reasons, such as the prevention of atherosclerosis or food allergies. A variety of calcium-fortified nondairy beverages are now available. However, the bioavailability of calcium in these beverages may differ from that of milk. A study of calcium-fortified soy milk found that the calcium in it was absorbed at only 75% of the efficiency of the calcium in cow’s milk.4 While cow’s milk and fortified soy milk are therefore not equivalent as calcium sources, the difference can easily be overcome by either consuming more of the fortified soy beverage, or by consuming soy beverages fortified with proportionally higher amounts of calcium.

Dietary supplements may contain one of several different forms of calcium. One difference between the various calcium compounds is the percentage of elemental calcium present. A greater percentage of elemental calcium means that fewer tablets are needed to achieve the desired calcium intake. For instance, in the calcium carbonate form, calcium accounts for 40% of the compound, while the calcium citrate form provides 24% elemental calcium.

Many medical doctors recommend calcium carbonate because it requires the fewest pills to reach a given level of calcium and it is readily available and inexpensive. For people concerned about cost and only willing to swallow two to three calcium pills per day, calcium carbonate is a sensible choice. Even for these people, however, low-quality calcium carbonate supplements are less than ideal. Depending on how the tablet is manufactured, some calcium carbonate pills have been found to disintegrate and dissolve improperly, which could interfere with absorption.5 The disintegration of calcium carbonate pills can be easily evaluated by putting a tablet in a half cup of vinegar and stirring occasionally. After half an hour, no undissolved chunks of tablet should remain at the bottom.6

Calcium carbonate may not always show optimal absorption, but it clearly has positive effects. For example, calcium carbonate appears to be as well absorbed as the calcium found in milk.7 In fact, some studies indicate that calcium carbonate is absorbed as well as most other forms besides calcium citrate/malate (CCM).8, 9 For example, a recent study found absorption of calcium from calcium carbonate to be virtually identical to absorption of calcium from calcium citrate.10

For people willing to take more pills to achieve a given amount of calcium (typically 800 to 1,000 mg), calcium carbonate does not appear to be the optimal choice, because other forms have been reported to absorb better (however, they do require more pills per day because each pill contains less calcium). For this reason, some doctors recommend other forms of calcium, particularly CCM. Research shows that CCM is absorbed better than most other forms.11, 12, 13 CCM may also be more effective in maintaining bone mass, than some other forms of calcium supplements.14 Because of their similarity in both name and structure, CCM can be confused with calcium citrate, but they are not the same.

CCM is not the only form of calcium that might be absorbed better than carbonate. For example, most,15, 16 though not all,17 studies suggest that calcium citrate might have some absorption advantage over calcium carbonate. However, no evidence suggests that calcium citrate is as well absorbed as CCM.

Microcrystalline hydroxyapatite (MCHC), a variation on bonemeal, has attracted attention because of studies reporting increases in bone mass in people with certain conditions18 and better effects on bone than calcium carbonate.19 Similar positive studies exist using CCM.20 However, unlike CCM, MCHC has only occasionally been compared with other forms of calcium. In limited research that does make comparisons, MCHC fared poorly in terms of solubility, absorption, and effect on calcium metabolism.21, 22

Remarkably little is known about the relative efficacy of amino acid chelates (pronounced “kee-lates”) of calcium. In the only commonly cited trial, absorption was measured for an amino acid chelate called calcium bisglycinate and compared with absorption from citrate, carbonate, and MCHC.23 In that trial, the amino acid chelate showed the best absorption and MCHC the worst. Although CCM was studied in that trial, it was taken under different circumstances than the chelate (with meals), so drawing definitive conclusions is not possible.

Recently, coral calcium has been claimed to be a vastly superior form of calcium, even though its calcium content is primarily calcium carbonate. One small, controlled human study reported that coral calcium was better absorbed than ordinary calcium carbonate.24 However, the method used in this study to measure calcium absorption has been criticized as much less sensitive than other methods 25. No research has compared coral calcium to calcium citrate or to CCM. There is little evidence at this time that coral calcium is superior to other forms of calcium.

Whatever the form, calcium supplements typically are absorbed better when eaten with meals.26 Moreover, research indicates that taking calcium with meals may reduce the risk of kidney stones and supplementing with calcium between meals might actually increase the risk.27

Besides how to take calcium supplements, scientists have also been studying when to take them. Supplementing calcium in the evening appears better for osteoporosis prevention than taking calcium in the morning, based on the circadian rhythm of bone loss.28 In order to not increase the risk of forming kidney stones, most doctors tell people to take calcium supplements only with food.

What is the relationship between calcium supplements and stomach acid? Years ago, researchers reported that people who do not make hydrochloric acid in their stomachs cannot absorb calcium adequately when the calcium is taken alone.29 In that report, adding hydrochloric acid restored normal calcium absorption. Although researchers have subsequently confirmed these findings, they have also discovered that these same people absorb calcium normally if they take it with meals. In addition, researchers have noted that giving these people hydrochloric acid does not further improve absorption during meals.30 Others have confirmed that hydrochloric acid, either from pills or from the stomach, is unnecessary for the absorption of calcium, as long as the calcium supplement is taken with meals.31, 32, 33, 34

Some doctors have expressed a concern that antacids that contain calcium (like Tums®) or calcium supplements that also act as antacids, interfere with the body’s absorption of calcium. However, this is not the case. Calcium carbonate, the principal ingredient in both Tums and many calcium supplements provides significant (though not optimal) absorbable calcium, as discussed above. Other forms of calcium that might be more bio-available, such as calcium citrate, also act as antacids. The form of calcium associated most consistently with best bio-availability, CCM, is itself, an antacid despite the fact it is used almost exclusively as a source of calcium.

Other concerns about the antacid effect of most calcium supplements (particularly when taken by people who do not need and are not seeking an antacid) are voiced by some doctors because stomach acid is needed to protect against bacterial infection and also to help digest protein. In theory, calcium supplements with antacid activity could at least temporarily interfere with these processes. However, to date, these concerns remain hypothetical.

Copyright © 2014 Aisle7. All rights reserved.

Learn more about Aisle7, the company.

Learn more about the authors of Aisle7 products.

Information expires June 2015.

20 Responses to Nutrition Advice for “Young” Seniors

  1. google plus app for windows 8 27/03/2014 at 8:43 pm

    Great article. I’m dealing with a few of these issues as well..

  2. best acoustic guitar brands 19/04/2014 at 8:50 pm

    Today, I went to the beachfront with my children.
    I found a sea shell and gave it to my 4 year
    old daughter and said “You can hear the ocean if you put this to your ear.” She put the shell to her ear and
    screamed. There was a hermit crab inside and it pinched her ear.
    She never wants to go back! LoL I know this is entirely off topic
    but I had to tell someone!

  3. Sushi lunch 22/04/2014 at 8:13 am

    This post offers clear idea in support of the
    new users of blogging, that actually how to do running a blog.

  4. African Mango 24/04/2014 at 7:01 am

    Excellent, what a web site it is! This blog provides useful information to us, keep it up.

    • Customer Care Customer Care 24/04/2014 at 9:47 pm

      Thank you for being our cheerleader, African Mango! We’ll work hard to continue to provide you with fun and informative suggestions! Please enjoy your Thursday evening! ~Shasta

  5. Garcinia Cambogia Extract 25/04/2014 at 11:07 pm

    continuously i used to read smaller posts which as well clear their motive,
    and that is also happening with this article which
    I am reading now.

  6. best skate shoes 28/04/2014 at 11:28 pm

    Useful info. Lucky me I discovered your website
    accidentally, and I am shocked why this accident didn’t came about earlier!
    I bookmarked it.

  7. Meladerm Reviews 03/05/2014 at 8:22 am

    Hello, I wish for to subscribe for this website to get most
    up-to-date updates, so where can i do it please help.

    • Customer Care Customer Care 03/05/2014 at 7:43 pm

      Thank you for your interest in our Blog, Meladerm. There is currently not an option to subscribe to the Blog updates. I would recommend bookmarking the site so that you can visit when you want to check for new entries. ~Victor

  8. best air purifier for dust 04/05/2014 at 4:16 am

    I’m not sure why but this weblog is loading incredibly slow for me.
    Is anyone else having this issue or is it a issue on my end?
    I’ll check back later on and see if the problem still exists.

  9. best rated washer and dryer 05/05/2014 at 8:27 am

    I was suggested this web site through my cousin. I am now not certain whether
    this post is written by him as no one else know such detailed about my difficulty.
    You are incredible! Thanks!

  10. Fat Loss Diet 16/05/2014 at 7:38 am

    Thanks for any other excellent post. Where else could anybody get that type of information in such a
    perfect way of writing? I have a presentation subsequent
    week, and I am on the look for such info.

  11. Ralf 26/06/2014 at 2:04 pm

    Your style is unique in comparison to other folks
    I’ve read stuff from. I appreciate you for posting when you’ve got the opportunity,
    Guess I will just book mark this page.

  12. Cassandra 06/09/2014 at 2:23 pm

    Good day I am so delighted I found your weblog, I really found you by error, while I was searching on Digg for something else, Anyways
    I am here now and would just like to say kudos for a fantastic post and a all round enjoyable
    blog (I also love the theme/design), I don’t have time to go through it all at the minute but I have bookmarked it and also included your RSS feeds,
    so when I have time I will be back to read a great deal
    more, Please do keep up the awesome work.

  13. Running reflective vest 19/09/2014 at 7:12 pm

    I am genuinely pleased to read this website posts which
    contains lots of helpful facts, thanks for providing these kinds of information.

  14. Vikki D. Osequera 20/09/2014 at 8:22 am

    I’m pretty pleased to uncover this website. I want to to thank
    you for ones time just for this fantastic read!!
    I definitely enjoyed every little bit of it and I have you bookmarked to see new things in your web site.

  15. Edward 29/09/2014 at 1:01 am

    Hello, I believe your blog could be having web browser compatibility issues.
    When I take a look at your blog in Safari, it looks fine but
    when opening in IE, it’s got some overlapping issues.
    I merely wanted to provide you with a quick heads up!

    Aside from that, wonderful site!

  16. superior singing method scam 29/09/2014 at 9:32 am

    Hello, this weekend is good in favor of me, since this time i am reading this wonderful educational post here
    at my house.

  17. 29/09/2014 at 4:16 pm

    I am truly grateful to the holder of this website who has shared this wonderful paragraph at at this time.

  18. 16 ounce healthfuls 22/10/2014 at 5:32 pm

    Heya i’m for the first time here. I found this board and I to find It really helpful
    & it helped me out a lot. I’m hoping to offer one thing back and aid others like you
    aided me.

Leave a Reply