Adolescence is an important period of life in which dietary requirements are increased for growth and development. Adolescents grow at the greatest rate as compared to other stages of life after infancy and accumulate 37% of their total bone mass during this growth spurt because during adolescence, maximum bone mass is acquired by teenagers. About 99% of the body’s calcium is stored in bones, and the remaining 1% is found in blood, muscle, and other tissues. The calcium deposited at this phase of adolescence determines the risk of osteoporosis and fracture in adulthood.
At Puberty, there are a lot of hormonal changes happening in the adolescent body which promote greater mineral utilization, so needs to be satisfied with suitable calcium consumption. Bone mass is dependent on intake of calcium, exercise, growth and development during adolescence and genetic and racial factors also. Unfortunately, during this time of tremendous calcium need, most of the adolescents are not taking a diet rich in calcium.
Deficiency of calcium in girls are twice as compared to boys because of various reason like unhealthy lifestyle, eating packaged food outside, consumption of junk food, lack of calcium rich food at home. Some of the other factors contributing to poor bone mineralization include adolescent pregnancy, excessive exercise, anorexia nervosa and various chronic medical conditions.
According to RDA 2020 published by ICMR NIN (Indian council of Medical Research, National Institute of Nutrition), calcium intake for both girls & boys are the same. RDA value for calcium according to age group is:-
10-12 years : 850 mg/d
13-15 years : 1000 mg/d
16-18 years : 1050 mg/d
Thus, the recommended amounts of calcium must be taken according to age group.
Functions of Calcium
Calcium is essential for maintaining total body health. It is not only for keeping your bones and teeth strong for a lifetime but to ensure proper functioning of muscles and nerves. Calcium plays an important role in in the following ways:-
Formation of bones & tissues
Calcium is an essential element that plays numerous biological functions in the body and it is one of the most important micronutrients for skeletal mineralization. Calcium is the major component of the bone, where it is present at more than 99% as calcium-phosphate complexes, and provides the skeleton strength and structure, making the bone a metabolic reservoir to maintain the intra- and extracellular calcium, therefore bones are the main storage site of calcium in the body. Calcium is the part of the mineral hydroxyapatite, deposited into the organic matrix of the skeleton, which is necessary for tissue strength, rigidity and elasticity.
Control Nerves Impulse
Calcium (Ca2+) is like a messenger inside our cells, and it helps in many important activities. In our bodies, it plays a crucial role in passing messages between nerve cells. Think of it as a signal that helps our brain communicate with the rest of our body. Nerve cells, also known as neurons, have special pathways to use calcium signals for their work. Inside the cells, proteins help control the amount of calcium, and our cell’s energy factories, called mitochondria, also play a role. Calcium even boosts our energy production. So, calcium isn’t just good for our bones; it’s essential for our nerves to talk to each other and keep our body working smoothly.
Helpful for muscle contraction
Calcium regulates muscle contraction of the body. In the body, motor neuron generates action potential & propagates on the muscle cell surface, activates voltage-gated calcium channels and allows calcium flow into the muscle cell. Calcium helps the actin & myosin filaments of the muscle to slide into each other, triggering the contraction of the entire muscle fiber. So, it is necessary for the maintenance of the integrity of the skeletal muscles.
Regulate Heartbeat
Calcium plays a crucial role in making our heart beat in a coordinated way. Here’s how it works:
When our heart receives a signal to beat, it’s like a chain reaction starting in our heart cells. This signal causes special channels to open up, allowing calcium ions to flow into the heart muscle cells. Imagine these calcium ions as tiny messengers inside our heart cells. As these calcium ions rush in, they trigger a series of events. They help release even more calcium from special storage areas inside the heart cells. This extra calcium binds to proteins, like troponin C, which are like switches in our muscle cells. When these switches are turned on by calcium, they allow the muscle fibers in our heart to contract.
This contracting and relaxing of the heart muscle is what makes our heart beat. Calcium essentially acts as the signal that tells our heart muscles when to contract and when to relax. Without the right amount of calcium, our heart wouldn’t beat properly, affecting our overall health. So, calcium isn’t just important for our bones; it’s also a heart’s best friend, ensuring it beats steadily and keeps us alive and well.
Clotting of Blood
When you get injured & blood starts to flows from the cut, then calcium plays an important role in blood clotting. Calcium is an essential component that plays an important role in blood clotting. In the presence of calcium ions, prothrombin (inactive form) converted into thrombin (active form). Thrombin converts fibrinogen to fibrin. Formation of blood clot is done by fibrin only. The blood cells and plasma are involved in the network of fibrils to form clots. It decreases cellular permeability. So, calcium appears to serve as a constituent of the intercellular cement.
Prevent colon cancer
Calcium is like a protective shield against colon cancer, a common and dangerous type of cancer. It helps by stopping harmful substances in our intestines from causing damage. Calcium binds to fats and bile acids in our large intestine, preventing them from causing harm and stopping the growth of excessive cells that can lead to cancer. Scientists have studied this in animals and found that when animals have extra calcium in their diet or water, it reduces the chances of developing colon cancer. So, having enough calcium in our diet can be good for our colon health.
Regulate blood pressure
Calcium helps to regulate blood pressure. Low calcium intake has been associated with high blood pressure because calcium intake may regulate blood pressure by modifying intracellular calcium in vascular smooth muscle cells and by varying vascular volume through the renin–angiotensin–aldosterone system (RAAS). Low calcium intake produces a rise of parathyroid gland activity. Intracellular calcium in vascular smooth muscles increases by this parathyroid hormone which resulting in vasoconstriction. Therefore, calcium maintains blood pressure.
Calcium Deficiency
Deposition of calcium into bone is an ongoing process throughout childhood and into adolescence, reaching maximal accretion during puberty because of growth spurt. Adolescents who do not get enough calcium in their diet, do not grow to their full potential height & causes many health issues.
Types of calcium deficiency
Deficiency of calcium is usually due to an inadequate intake of calcium when blood calcium levels drop too low, the vital mineral is borrowed from the bones. If an individual’s diet is low in calcium, there may not be sufficient calcium available in the blood to be returned to the bones to maintain strong bones and total health of the body.
There are two types of calcium deficiency
• Dietary calcium deficiency: It is a condition in which there is an inadequate calcium intake, which can lead to depleted calcium stores in the bones, thinning and weakening of the bones, and increases the risk of bone fractures in adulthood & osteoporosis in later life.
• Hypocalcemia : It is a condition in which low levels of calcium are found in the blood. Usually, this disease happens when large amounts of calcium are excrete out when you urinate, or too little calcium enters your blood from your bones. This could be caused by certain factors like:-
Causes of hypocalcemia
Hypocalcemia may be due to various factors like:-
•Insufficient amount of calcium intake
If calcium is not enough in your diet or have some disorders that interfere with absorption of calcium in your body, this can cause hypocalcemia.
•Deficiency of Vitamin D
Vitamin D acts as a hormone that helps to maintain normal calcium levels. If the amount of vitamin D level becomes low then your body’s calcium absorption levels also drop. This happens if you are not on a vitamin D rich diet & do have enough sun exposure.
•Hypoparathyroidism
The parathyroid glands are located near the thyroid gland at the back of the neck. The parathyroid glands make a hormone called parathyroid hormone (PTH), which regulates the amount of calcium in your body. Hypocalcemia happens when Parathyroid glands make lower levels of PTH as compared to the requirements therefore deficiency of calcium occurs.
•Medications that may decrease calcium absorption
Drugs like rifampin (an antibiotic), phenobarbital (anti-seizure drugs) and phenytoin can cause hypocalemia. Medicines that fight with bone issues & bone cancer are also linked with hypocalcemia.
•Certain genetic factors
When people being born without parathyroid glands. This condition in which parathyroid glands are absent in an individual is called DiGeorge syndrome. In this syndrome, part of chromosome pair 22 are missing. so it affects amount of calcium in your blood.
.•Kidney issues.
If any kidney failure or disease present in the body, then it may cause hypocalemia by draining the levels of calcium in your blood.
Common symptoms of hypocalcemia
Muscle problems
Due to calcium deficiency, People experience muscle aches, spasms & cramps. People who have Hypocalcemia can also suffer from pain in the arms and thighs while walking or moving. Numbness and tingling in the arms, legs, hands,feet and around the mouth can also happen. More extreme sensations can indicate a more severe deficiency, which can also lead to arrhythmias (a condition in which heart beats with an abnormal rhythm) and death.
Extreme fatigue
People who have Low levels of calcium may face extreme fatigue and feel sluggish all the time. It can also lead to insomnia. Fatigue due to calcium deficiency can lead to dizziness, lightheadedness and brain fog, which can also lead to lack of focus, confusion & forgetfulness.
Nail and skin problems
Calcium deficiency for the long term can lead to dry and brittle nails, dry skin, coarse hair, skin itchiness, eczema, skin inflammation, and psoriasis (a skin disease that causes a rash with itchy, scaly patches).
Osteopenia and osteoporosis
Our bones store calcium well. When Calcium level becomes low in the body then the body can divert calcium from bones & makes the bone brittle and prone to injury. Calcium deficiency over time can lead to osteopenia (a reduction of mineral density in the bones) which can lead to osteoporosis further & leading the bones to thin and becoming vulnerable to fractures.
Severe Premenstrual Syndrome
Low levels of calcium in women’s bodies have been linked to severe premenstrual syndrome (PMS). A study reveals in 2019 that low levels of vitamin D and calcium during the second half of the menstrual cycle might contribute to symptoms of PMS.
Dental problems
When the body has low levels of calcium, then the body pulls calcium from teeth. Deficiency of calcium can lead to dental problems like brittle teeth, tooth decay, and weak tooth roots and irritated gums.
Depression
Studies have suggested that deficiency of calcium may be linked with depression also. More research in this field are needed to confirm the results.
How can hypocalcemia be prevented?
You can prevent hypocalcemia by following this steps:-
Take calcium rich diet
Include calcium rich food in your diet every day. Take diet plan or consultation from Dietitian who can help you to cure this disease with the help of modification in your diet according to your need.
Take calcium Supplement
First, Consult from doctor or physician & follow prescription of doctor. Take supplements & multi-vitamins by the consultation of your doctor.
Factors that affect calcium absorption
Some of the factors that can reduce calcium in bones and lower bone density (weaken the bones) include:
• High-salt diet
Taking a high salt diet decreases the absorption of calcium in the body because salt breaks up into sodium and chloride. Chloride is an acid. When you consume excess chloride, the kidney removes this chloride and when the kidney can no longer keep up with the load, the body takes calcium from the bone to maintain a balance. Due to this, loss of calcium occurs from the body and contributes to kidney stones, osteoporosis and loss of muscle mass. This imbalance of calcium affects cardiovascular function and contributes to stroke & high blood pressure.
•Caffeine-containing drinks
Coffee, cola and energy drinks (and, to a lesser extent, tea) as well as most sodas acts as a mild diuretic, so that valuable calcium is excreted before the body can make use of it. If you want to consume these drinks, take in small quantities not in excessive use because it can lead to reduced absorption.
•Diet high in phytic acid & Oxalic acid
Foods that contain oxalic acid in high amounts such as spinach, chocolate can reduce calcium absorption because Oxalic acid binds with the calcium to form a salt crystal named calcium oxalate which cannot be absorbed in the body. A diet high in phytic acid also decreases the absorption of Calcium. Phytic acid is present in the bran coating of whole grains, in which phytic acid binds calcium and other minerals, to make them insoluble and not absorbable in the intestines so calcium passes out of the body without being absorbed.
•Insufficient vitamin D
Vitamin D is critical to regulating calcium absorption. People who are housebound or cover their bodies completely when they are outside are at increased risk of calcium deficiency.
• Smoking & alcohol consumption
Research showed that smoking reduced bone mass. The reason is not well understood, but it appears that smoking & Alcohol interferes with the absorption of calcium in the intestines.
•Celiac Disease
Celiac Disease is an inherited autoimmune disease. It is characterized by gluten intolerance. In this disease, lining of the intestine changes and impacts absorption of fat-soluble vitamins and minerals, such as vitamin D and calcium. If you have celiac disease, then you have a risk for calcium deficiency.
•Stress
Stress creates a negative effect on HCl production in the stomach and it can affect normal digestive behavior in the body. Therefore it can decrease the absorption of calcium.
•Phosphorus
When too much phosphorus is present in your diet then it can cause precipitation of calcium in the form of calcium phosphate.
•Lack of exercise
Lack of exercise can cause decrease in absorption of calcium because physical inactivity leads to demineralization of bones with attendant increase in urinary calcium loss.
Due to the above factors mentioned, calcium is unable to be absorbed by the body. Instead of taking a calcium rich diet, keep these pointers in mind while taking a calcium diet. Although you can also increase the absorption of calcium by following this:-
Factors Increasing Absorption of Calcium
There are some factors which influence calcium absorption in the body, these factors are:-
Vitamin D: Vitamin D absorbs calcium into the bloodstream from the walls of the duodenum in the digestive tract. It helps to maintain normal blood calcium levels. So it helps in the absorption of calcium.
Parathyroid Hormone: At the bone, Parathyroid hormone inhibits osteoblast activity and stimulates osteoclast activity. This leads to bone breakdown and calcium release. At the kidneys, Parathyroid hormone increases calcium reabsorption and blocks phosphate reabsorption from the tubules.
Acid Environment: In the stomach, Hydrochloric acid secretes during the process of digestion. It is required for the absorption of calcium in the duodenum. Take Calcium supplements with magnesium at bedtime or between meals because an acidic environment is needed in the stomach to assimilate the calcium. Always take supplements by the consultation of a doctor.
Amino Acids: Supplements of calcium are chelated or combined with protein molecules known as amino acids. It helps the body to absorb calcium during digestion. For example Lysine and arginine increase calcium absorption.
Exercise: Exercise along with Vitamin D helps in calcium absorption. So, it strengthens the bones. Moderate physical activity positively affects calcium and bone metabolism by enhancing bone mineralization and checking urinary calcium loss.
Adolescents can obtain calcium through food or supplements. Recent research highly suggests it is better to obtain calcium through a diet than a supplement. To avoid calcium deficiency & enhance functioning of the body, Adolescents should include calcium rich food in their diet.
•Include Good sources of Calcium are:
Dairy Products – yogurt, milk, cheese, fortified dairy alternatives, such as soy milk, sardines and salmon, tofu, Green leafy vegetables, such as kale, broccoli, turnip leaves & watercress, many fortified breakfast cereals, fortified fruit juices, nuts and seeds, especially sesame, almonds, and chia seeds, legumes and grains, cornmeal and corn tortillas.
In which Milk, yogurt, and cheese are rich sources of calcium and are the major food contributors of this nutrient. Tofu, cottage cheese, orange juice, greens and legumes are also excellent sources of Calcium.
•Avoid the food which hinders absorption of Calcium
Don’t consume high salt, avoid caffeine containing drinks like tea, coffee, sodas & food which has oxalic acid & phytic acid. If you typically consume a lot of whole-grain bread and cereal, you may take calcium-fortified products.
•Take sufficient amount of vitamin D
Include vitamin D rich food in your diet. For vegetarians – cheese, mushrooms, fortified milk, fortified cereals & juices. For Non- Vegetarian:- fatty fish, such as salmon, mackerel, and tuna, egg yolks, beef liver & Teenagers should spend 15 to 30 minutes outdoors, soaking up sunlight two or three times a week. This helps make enough vitamin D in the body
•Do Exercise
Adolescents should participate in Sports & physical exercise daily for their proper growth. Exercise also promotes absorption of calcium in the body because according to the research, Physical activity maintains bone mineral density through the effects of mechanical loading on bone metabolism.
In this blog, we comprehend that the body cannot naturally produce calcium. Instead, it relies on the calcium derived from the food you consume or supplements recommended by healthcare professionals. Fitandcure, a renowned nutritionist brand, emphasizes the significance of calcium in various bodily functions. Whether obtained through a well-balanced diet or through expert-recommended supplements, ensuring an adequate intake of calcium is crucial.
Insufficient calcium in your diet or poor absorption by your body can lead to weakened bones and improper growth. Calcium plays a pivotal role in muscle contraction, the development of strong bones and teeth, blood clotting, nerve impulse transmission, regulating heartbeat, and maintaining fluid balance within cells. This nutrient is particularly vital for adolescent growth and development.
A calcium-rich diet, as advocated by Fitandcure, contributes essential nutrients in both quality and quantity, facilitating optimal bone mass development. Regularly incorporating such a diet into your daily routine is key to preventing and addressing calcium deficiency. Trusting the expertise of Fitandcure ensures that your nutritional needs are met, supporting overall health and well-being.
References
https://www.betterhealth.vic.gov.au/health/healthyliving/calcium
https://www.researchgate.net/publication/274708965_Calcium_and_its_Role_in_Human_Body
https://und.edu/student-life/dining/_files/docs/fact-sheets/calcium.pdf