Calcium range
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Understanding Calcium Range: Dietary Intake, Urine Excretion, and Serum Levels
Global Dietary Calcium Intake
Regional Variations in Calcium Intake
Calcium intake varies significantly across different regions of the world. A systematic review of national dietary calcium intake data from 74 countries revealed that average national dietary calcium intake ranges from 175 to 1233 mg/day. Many countries in Asia have average dietary calcium intake less than 500 mg/day, while countries in Africa and South America mostly have low calcium intake between about 400 and 700 mg/day. In contrast, Northern European countries have national calcium intake greater than 1000 mg/day .
Gender and Socioeconomic Differences
The review also highlighted that average calcium intake is generally lower in women than men. However, there are no clear patterns across countries regarding relative calcium intake by age, sex, or socioeconomic status .
Reference Ranges for Urine Calcium Excretion
Normal Ranges for 24-Hour Urine Calcium
A study on 959 black and white women established that the normal range for 24-hour urine calcium excretion varies by race and age. For white women, the range is 30-300 mg for younger women and 37-275 mg for older women. For black women, the range is 10-285 mg for younger women and 7-225 mg for older women. These findings suggest that clinical laboratories need to update their age- and race-specific ranges for 24-hour urine calcium excretion .
Correlation with Calcium Absorption and Vitamin D
The study also found that 24-hour urine calcium was significantly correlated with serum 1,25-dihydroxyvitamin D, calcium intake, and calcium absorption, but not with serum 25-hydroxyvitamin D .
Serum Calcium Levels
Corrected Calcium Concept
The concept of "corrected" calcium, which adjusts serum total calcium concentration for variations in serum albumin concentration, has been challenged. Individual regression coefficients for serum calcium concentration on serum albumin concentration vary widely, making it invalid to use an average regression coefficient for correction. Instead, an individual's own regression coefficient should be used to determine the corrected serum calcium concentration .
Reference Values for Plasma Total Calcium
A study of hospital patients determined that the normal ranges of plasma total calcium are 2.15-2.60 mmol/l for inpatients and 2.25-2.65 mmol/l for outpatients .
Calcium Requirements and Recommendations
Revised Reference Values
The nutrition societies of Germany, Austria, and Switzerland have revised the reference values for calcium intake. For infants, the recommended intake is 220 mg/day for those under 4 months and 330 mg/day for those aged 4 to 12 months. For children aged 1 to 4 years, the recommended intake is 600 mg/day, and for adolescents aged 13 to 19 years, it is 1200 mg/day. For adults, the recommended intake is 1000 mg/day .
Calcium and Bone Health
Maintaining extracellular calcium levels within a narrow range is crucial for normal physiological functions and bone health. Adults can adapt to a wide range of calcium intakes from 300 to 2000 mg/day. However, the evidence that low calcium intakes contribute significantly to osteoporosis development is weak, and increasing calcium intake does not significantly change fracture risk. Consequently, calcium supplements have a minor role in contemporary medical practice .
Conclusion
Understanding the range of calcium intake, urine excretion, and serum levels is essential for developing effective dietary and clinical guidelines. While regional and demographic variations exist, maintaining appropriate calcium levels is crucial for overall health, particularly bone health. Further research and updated clinical practices are necessary to ensure optimal calcium management across different populations.
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Most relevant research papers on this topic
Global dietary calcium intake among adults: a systematic review
Many countries have low average calcium intake, with Northern Europe having the highest intake, but recent, nationally representative data is mostly lacking.
Reference range for 24-hour urine calcium, calcium/creatinine ratio, and correlations with calcium absorption and serum vitamin D metabolites in normal women.
The normal range for 24-hour urine calcium in white women is 30–300 mg, while it is 10–285 mg in black women, with correlations to calcium intake and absorption.
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Calcium isotope fractionation between soft and mineralized tissues as a monitor of calcium use in vertebrates.
Calcium isotope fractionation in tissues can be used to assess calcium and mineral balance in vertebrates without introducing isotopic tracers.
Estimation of Serum Calcium Level in Peri and Postmenopausal Women: A Comparative Study.
Calcium supplementation is recommended to prevent long-term bone loss and decrease the risk of fracture and osteoporosis in postmenopausal women.
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