Thursday, October 27, 2011

Calcium, Osteoporosis, Hypertension And Colorectal Cancer

Calcium, Osteoporosis, Hypertension And Colorectal Cancer 

Summary

The results of epidemiological studies on the relationship between dietary calcium intake and bone tissue function have concluded that the increase in the intake of this mineral minimizes bone loss that occurs with age. Because of this nutritional recommendation has risen in some countries up to 1 200 mg / d for adolescents and discussed the proposal by international organizations.
The increase in bone density, reducing the risk of osteoporosis, hypertension and colorectal cancers observed in populations with adequate or high levels of osteoporosis calcium in the diet, expand the sphere of influence of this mineral in disease prevention recognized chronic influence on morbidity and mortality table currently in force for many countries. Notwithstanding the proven evidence of the relationship of calcium with these chronic diseases, the recommendation does not intend to unilaterally raising their consumption with the diet, but built to promote a healthy lifestyle, including consumption reduction salt, animal protein, alcohol and caffeine, increased physical activity and exposure to sunlight, maintaining proper body weight, and effective therapeutic management of hormonal changes in adulthood.

Subject headings: osteoporosis, hypertension, colorectal neoplasms, CALCIUM.

The supply of calcium nutritional requirements of populations and their relationship to the incidence of some chronic diseases is an emerging issue of nutrition in recent decades. The currently available evidence on the relationship of dietary calcium intake with the development of osteoporosis, hypertension and neoplastic diseases of the lower digestive tract are based on epidemiological, biochemical and morphological. In all of them have shown a direct association of adequate intake and calcium retention in the body with decreased risk for these diseases.

Requirements and bioavailability
The retention of calcium in the human body increases to a value beyond which additional intakes do not cause increases in the retention or bone mass. In bone tissue during childhood, daily calcium retention is 150 to 200 mg and can reach levels up to 400 to 500 mg in the period of pubertal growth spurt. The fractional absorption during this time is very efficient and it is estimated around 40%.

A publication of the National Institute of Health in the United States indicated that the requirement of calcium for postmenopausal women treated with estrogen, is between 1 000 and 1 500 mg / d. Through regression analysis it is estimated that 989 mg / d is the mean intake required to obtain the balance in premenopausal and postmenopausal women treated with estrogen 1.5 g / d for women without estrogen therapy. This suggests that calcium requirements for the perimenopausal period may be substantially higher than current dietary recommendations. The positive correlation between usual intakes of calcium and calcium balance suggest that women with high intakes should have less bone loss.

Young men can be obtained in positive calcium balance with a daily intake of 800 mg, but higher levels result in increased body retention. At the level of intake of 1 200 mg / d is usually obtained a plateau and therefore, it was concluded that this must be the nutritional recommendation for teens and up to 25 years of age.

Normal young adults require an average net bioavailability of 150 mg to match urinary losses, a value that corresponds to the ingestion of 540 mg of calcium and to achieve the nutritional recommendation to be placed in at least 800 mg / d.

The existing results are contradictory. Some studies suggest that high calcium intakes result in an increase in bone mass and reduced bone loss rates, while others found no relationship. One possible cause of these contradictions is perhaps the difficulty of measuring exactly retrospectively dietary calcium dietary intakes in open populations.

Current dietary recommendations for calcium are perhaps not high enough to reach peak bone mass is genetically determined and repeatedly recommended the formulation of new figures of recommendation. The recommendation established for women ages 19 to 25 years is probably too high and the adults probably very low. It should answer some questions about the relationship of calcium intake and bone mass development and the effect of other factors like heredity and physical activity or the influence of dietary protein, sodium, alcohol and caffeine on the daily requirement of osteoporosis calcium. The maintenance of bone mass should not therefore be the only criterion that evaluates the nutritional recommendations for change.

The retention of calcium in the body with respect to their intake is linear, it includes an indicator which is the average maximum retention, which is much lower than the daily intake. The daily intake of 1 200 mg in adolescents generates a deduction is only 57% of the maximum retention achieved. With 1 300 mg / d retention time reaches 100%, but it is assumed that the maximum retention values ​​may continue to rise in intake levels above 2 g / d.

The nutritional status and metabolism of calcium and vitamin D, of gestation and lactation, play a crucial role in the bioavailability and balance of calcium in the body. Factors that increase the retention of calcium include calcitriol, the luminal concentration of ionized calcium, sodium, solvent drag, dairy products such as lactose, casein phosphopeptides and calcium citrate derivatives. Other substances such as phosphorus, fat, alcohol, hormones (glucocorticoids, calcitonin, and thyroxine), genetic influences and thiazide diuretics, and phenothiazines reduce the efficiency of calcium absorption. Dietary fiber also reduces the absorption of calcium, 35 g / d are negative balance, but 15 to 20 g / d favor the bioavailability of calcium. The secretion of calcium can also be modified by expansion of extracellular fluid volume or plasma (sodium overload), diets low in calcium and hormones (somatostatin).

For over 20 years discussing the deleterious effect of elevated gastric pH on the absorption of calcium, important factor for bioavailability supplements for older individuals. Recent studies indicate that the effect of this elevation of pH, as observed in atrophic gastritis in the elderly, is only apparent when ingested calcium, low solubility, after an overnight fast. The soluble calcium sources, such as citrate or from milk, are absorbed properly by the elderly with atrophic gastritis. Moreover, the calcium from insoluble salts such as calcium carbonate, is well absorbed, even for patients with atrophic gastritis, when it is ingested together with meals.

The tracking of calcium intake during adolescence and their possible effect on the prevention of osteoporosis in adulthood is discussed in detail today. In the study of growth and health of Amsterdam, a group of 84 men and 98 women were followed for 15 years from 13 to 27 years old. The intake of calcium and dairy products was measured 6 times a dietary surveys. The average calcium intake was relatively high and increased with time (30%). Tracing the effect of dairy intake from adolescence to adulthood was measured in individuals of both sexes (the correlation between inadequate calcium intake and the occurrence of osteoporosis in men was 0.43 and 0.38 in women). The predictive power for calcium intake over time does not seem to be a strong enough indicator to identify adolescents capable of maintaining an inadequate calcium intake in adulthood. Therefore, the identification and treatment of subjects with low calcium intake can not be limited to the period of adolescence and should be extended to adulthood.

Calcium and osteoporosis

The human aging causes a decrease in calcium intake and vitamin D, decreased exposure to sunlight, skin production of vitamin D3 renal production of 1,25-dihydroxyvitamin D3, intestinal calcium absorption and the ability to adapt to changes in intake of both nutrients. As a result there is a secondary hyperparathyroidism, which contributes to the loss of bone mass and increased susceptibility to fractures. Humans begin to lose bone as they age. In most cases, this process is slow and gradual. Tissue loss is established at an age between 30 and 40. The reduction in circulating levels of estrogen in menopause, smoking, physical inactivity and alterations in the bioavailability of calcium and vitamin D13 are individual factors directly associated with bone loss.

The role of calcium in the prevention and treatment of osteoporosis has been debated for more than 3 decades. Calcium intake at all ages, has a beneficial effect on bone mineral density (BMD). The elevation of the calcium intake of 800 to 1 200 mg / d in young women increases BMD at 6%. In postmenopausal women, meta-analysis studies show that calcium supplementation (average of 1 200 mg / d) decreases bone loss at 0.8% per year and enhances the positive effect of estrogen on BMD (Nieves JW. Calcium is beneficial to bone mineral density in conjuction with alone and Treatment for osteoporosis. 1st World Congress on Calcium and Vitamin D in Human Life, 8-12 October 1996, Rome, Italy, Abst Nr 29, p.37).

In recent years it has become clear that calcium supplementation slows, but does not eliminate postmenopausal bone loss and this only has an effect on BMD, when its previous supply has been a limiting factor for bone balance in the body (Reid IR. Calcium supplementation in postmenopausal women Op cit: 36).

Low calcium intake in Asian countries seems to be compensated by increased intestinal absorption and low levels of phosphorus and protein intake. The pattern of alleles for the vitamin D receptor, which restricts the adaptation to low intakes of calcium and observed in 20% of Caucasian women, only appears in 1% of women in Japan and Korea (Fujita T. Osteoporosis in Asia. Op cit. 35).

In the Mandinka people of Gambia found that calcium intake of adult women was only 300 to 400 mg / d, mainly from cereals, fish and nuts. Your bone mineral status was low, hypertension in pregnancy was a major problem, but despite the lack of calcium in the diet, osteoporotic fractures were rare and supplementation studies did not demonstrate a positive effect. The existence of low levels of urinary calcium and high efficiency of intestinal absorption were indicative of an adaptation to the low calcium intake (Prentice A. Calcium intake in Developing Countries. A Gambian perspective. Op cit. 57).

The intake of calcium, although crucial, is only one of many risk factors involved in the pathogenesis of osteoporosis and include: genetic determination (Cosmi EV. Genetic and Environmental Factors in prevention of osteoporisis. Op cit. 62), family history (Peacock M. Genetic Differences in the determination of peak bone mass. Op cit. 63), sex hormone levels, low body mass index, early menopause, 18 vitamin D intake or exposure to light sunlight (Holick MF. Vitamin D Requirements THROUGHOUT life. Op cit. 21), alcohol and caffeine (Gallagher JC. Effects of Alcohol and caffeine on calcium metabolism. Op cit: 28), calcium content of drinking water (Nappi V , P. Prevention of osteoporosis Calcaterra: Importance of calcium in water. Op cit. 38), lifestyle, sedentary lifestyle and physical exercise.

In the intervention cohort study in Nottingham postmenopausal women (EPIC), 21 was not found for either the calcium in the diet or for any other nutritional variable, a significant correlation with bone mass density.

In another study conducted in 9704 white women 65 or older from 4 U.S. metropolitan areas could not find any association between dietary calcium intake and risk of hip fractures, femur, humerus, wrist and vertebrae.

Using dual photon absorption technique in Buddhist religious followers and Taiwan, we studied the bone mass density in the lumbar spine and the femoral head of 258 vegetarian women. The regression also showed no association between dietary calcium intake and bone density.

Osteoporosis as a systemic disease characterized by loss of bone mass, altered bone microarchitecture and increased likelihood of bone fractures is an entity whose treatment is usually directed towards the stimulation of osteogenesis and inhibiting bone resorption, but more than one way to increase calcium intake, it would be appropriate to recommend a lifestyle change that includes, along with the rise in consumption of foods rich in calcium, restricting salt intake, animal protein, alcohol and caffeine, increased physical activity and exposure to sunlight, maintaining proper body weight and effective therapeutic management and scientifically based on hormonal changes in men and women after the fourth decade of life (Nordin BEC . Conclusions and Recommendations. Op cit. 42).

Dietary calcium and hypertension

Dietary recommendations for reducing blood pressure to normal in 35-40% of hypertensive patients was limited before 1945, only a diet low in sodium and diet of rice and fruits. After 1945, there were many studies on the effect of alcohol, water hardness, obesity, moderate restriction of sodium intake, increased intake of calcium and potassium, decreased animal fat and increased consumption of unsaturated fat and dietary fiber. The main recommendations focused on long-term studies on the effects of a moderate restriction of sodium intake, increase potassium in the diet, weight reduction and increased physical activity in hypertensive patients, reduced fat intake and promotion of animal diets rich in polyunsaturated fats in patients with moderate essential hypertension.

The possible association between dietary calcium and blood pressure levels was the subject of over 15 epidemiological studies between 1975 and 1990.24 While the cross-sectional studies provide evidence for an inverse association, clinical trials and prospective studies were inconsistent . However, supplementation of populations reduced normotensive and hypertensive blood pressure levels.

The thesis that an increase in calcium in the diet protects against hypertension has been tested in epidemiological studies, animal experiments and clinical trials in humans. In 1992, the antihypertensive effect of calcium is attributed to the inhibition of parathyroid hypertensive factor (PHF), which induces hypertension by increasing intracellular calcium levels, by increasing its uptake by the smooth muscle of blood vessels. The effects of PHF are also blocked by antagonists of calcium channels. This explains the apparent paradox that crazy both calcium blockers and calcium channel blockers have an antihypertensive effect.

Nutritional recommendations promote increased calcium intake as a preventive of high blood pressure. Until 1994, more than 80 studies had reported in experimental models of hypertension, the effects of blood pressure reduction after an enrichment of the calcium diet. dietary supplementation with calcium is associated with reduced membrane permeability, an increased Ca (2 +)-ATPase and Na, K-ATPase and calcium influx into the cell. This could be a direct effect of calcium on smooth muscle cell or an indirect effect mediated hormonally. These studies concluded that diet-induced changes in calcium regulating hormones could influence blood pressure. Calcium may also exert their influence on blood through its modulatory effect on the sympathetic nervous system and alpha-adrenergic receptors perisféricos elevation or natriuresis, but this rise is not only responsible for all interactive effects of calcium and chloride sodium on blood pressure.

In 1995, Pryer J and others analyzed 53 reports published between 1983 and 1993 on the relationship between calcium intake and blood pressure (33 in U.S., 3 Canadian, 1 in Puerto Rico, 9 in Europe, 5 in Asia , 1 in Australia and 1 in South Africa), 5 studies were prospective and 48 cross-section, of which only 4 had a longitudinal component. The sample used for analysis ranged from 55 to 58 000 individuals (median 885). Most of the studies controlled for age, sex and body mass index. He found numerous inconsistencies in the results, both intra-and inter studies and could not establish the association between calcium intake and blood pressure in 108 population samples, because of difficulties in the design or incompetence of the published results or methods of analysis.

In 1996 he published a meta-analysis of randomized clinical trials related dietary calcium to blood pressure. In this analysis we selected clinical trials in which dietary calcium intake varied in the intervention groups. The multivariate tests were not included in the analysis. We selected the final results from 22 clinical trials using the method of weighted averages. The total final sample comprised 1 231 people and included in the analysis normotensive and hypertensive individuals. The weighted estimates in this study showed a statistically significant reduction in systolic blood pressure with calcium supplementation, the diastolic pressure was affected and it was concluded that the observed effects were so weak they did not support the use of this mineral supplementation prevention or treatment of hypertension.

Another meta-analysis evaluated the results of several studies from May 1994-1996 and included only studies where supplementation had undergone at least two weeks. It took 33 studies involving a total of 2412 subjects. The weighted analysis also showed a reduction of -1.27 mm Hg systolic and -0.24 mm Hg diastolic and concluded that calcium supplementation may lead to a small reduction in systolic but not diastolic that these results do not exclude a major effect of calcium on blood pressure of subpopulations and that the hypothesis that inadequate calcium intake was associated with elevated blood pressure requiring additional studies.

A sustained low calcium intake in large populations has been found as a risk factor for the development of hypertension in epidemiological studies in general. The evidence that some calcium deficiency in hypertensive status has been supported by the positive results obtained with calcium supplementation in both essential hypertension and experimental. A high intake of calcium shows interactions with cellular and systemic metabolism of many electrolytes and promotes natriuresis without concomitant activation of the renin-angiotensin system. Calcium supplementation has also shown to have effect on local control of vascular tone and increased endothelium-mediated relaxation, which together with increased capacity to dilate the vascular smooth muscle, would be able to explain the reduction of arterial resistance. The positive balance of calcium induce subsequent changes in calcium regulating hormones in sympathomimetic tone with resultant vasodilation, decreased secretion of the vasoconstrictor hormones and high natriuresis. The elevation of neuronal peptide content of calcitonin gene has been postulated as another possible mechanism that promote arterial vasodilatation (Poersti Y. Lowering Blood pressure effects of calcium in experimental hypertension. Op cit. 42-3).

Recent reports on the existence of extracellular receptors, G protein-bound and sensitive to calcium concentrations in multiple cell types such as proximal tubules, distal and collecting of the kidneys, parathyroid cells and smooth muscle in blood vessels and arterioles speak in favor of the direct influence of calcium concentrations in the genesis of many of its side effects should not be mediated by hormonal changes (Brown MS. Role of a Ca2 +-sensing receptor in mineral ion and water Regulating metabolism. Op cit. 14).

According to the results of the study of Iowa women in the U.S. (Bostick RM, Kushi LH, Wu Y, Sellers TS, Meyer K, Folsom AR, et al. Calcium and Vitamin D and ischemic heart disease Mortality Among postmenopausal women. Op cit. 48), a high intake of calcium, not only favors the reduction of blood pressure levels but also decreases the risk of death from ischemic heart disease, at least in postmenopausal women.

A database of observational studies indicate that populations with low dietary calcium intake are at an increased risk of hypertension. Each of the 40 clinical trials in the last 12 years, related to calcium intake and hypertension has identified a significant benefit, although the magnitude of the results have varied from minimal to be clinically relevant.

Based on the fact of the enormous variability in the design and design of clinical trials, prospective studies and experimental tests with laboratory animals is to be hoped that the results also reflect this great variability. A large part of these trials were conducted in a small number of individuals, so it is possible that in them the effect is lost. Some have shown that the time for intervention must be at least 6 weeks to measure an effect.

The association between calcium intake and blood pressure is not linear but sigmoidal, which means there is a threshold for calcium intake, below which the risk of hypertension increases exponentially. Above this threshold additional calcium intakes have little effect on blood pressure. The effect on the sigmoidal character is also strongly dependent on the age and value of the threshold for young adults may be 400 mg Ca / d, but for older adults is 1 200 or 1 500 mg / d. This point is also defining a test to determine whether or not capable of showing a beneficial effect. If the population is analyzed, for example, already has a calcium intake that exceeds the threshold, it is expected then that the effect found is clearly low. This was the largest studies of meta - analysis performed to identify this relationship.

Generally, it can be concluded that when calcium intake is increased in humans who are not normally consumed levels of nutritional recommendations, the numbers tend to decrease blood pressure, and as for many other nutrients, then you can ensure that if warranted, population groups can meet at least daily nutritional requirements of calcium, this step could generate substantial reductions in blood pressure levels (McCarron DA. Randomised trials of calcium intake and blood pressure control. Op cit: 46-7) .
Calcium and colorectal cancer

Individuals who consume diets rich in dietary fiber, calcium and vitamins have a lower risk of colon cancer. In a study conducted in Italy in 1953 cases of colorectal cancer, diagnosed by histology and 4 154 controls with no previous history cancer, there was an inverse association between this condition and calcium intake.

Generally, there are few results reported in the literature regarding an association between low calcium intake and the risk of colon cancer or on the protective effect of normal or high intake of this mineral on its incidence.

International comparisons do not support an association, since the incidence of colon cancer tends to be lower in poor countries of the Far East, where calcium intake is clearly low. These data, however, can not be regarded as conclusive, because of great nutritional differences between countries, expressed as consumption of red meat and dietary fiber, physical activity and body fat, which introduces important confounders.

The incidence of colon cancer in black fishermen from the west coast of South Africa is relatively low and coincident with a low intake of calcium, vitamin C, dietary fiber, fruits and vegetables. They found the largest associations with a high intake of omega

Numerous studies have found an inverse association between dietary calcium intake and this type of cancer, but others have not found any association. In order to clarify this relationship, prospective studies seem more promising, since they avoid the possible errors introduced by the retrospective dietary surveys after the occurrence of the disease.

In the study of Iowa women found a strong inverse relationship in the multivariate analysis, which remained significant after adjusting for other risk factors. In the cohort study of Dutch men and women in the 47 935 men Professionals Follow-up Study, conducted between 1986 and 1992, in 89 448 women studied between 1984 and 1992 in the Nurses Health Study by the Department of Nutrition School of Public Health at the Harvard or 50 535 men and women in the prospective study of the Norwegian National Health Screening Service between 1977 and 1983, no relationship was found.

Diets high in fat and sucrose and deficient in fiber and calcium, because of its effect on the fecal and enzymatic activity of bacteria in the colon, increase the activity of beta-glucuronidase, increased concentrations in the colon of ammonium and genotoxic risk generated by the 7-hydroxy-imidazole-quinoline metabolic biomarkers of colorectal cancer.

Fatty acids and secondary bile acids in the colon lumen act as cytotoxic surfactants capable of generating hyperproliferation in epithelial cells of the crypts. This hyperproliferative effect of dietary fat is inversely related to the amount of calcium in the diet . Calcium precipitates these cytotoxic surfactants and thus inhibits luminal cytotoxicity. In population groups fed diets with high risk of colon cancer, that is high in fat and sucrose and low in fiber and calcium regularly detected high stool levels of succinic acid, lactic, propionic and isovaleric, cresol, bacteria, clostridia and lactobacilli lecithinase negative. 49-50

Caco-2 cells grown in a medium rich in calcium show a reduced DNA synthesis in 50%, compared with those grown in a medium devoid of calcium. Extracellular calcium concentrations less than 0.25 mM increased cell proliferation, reduce alkaline phosphatase activity, stimulate the activity of protein kinase C and promote the mobilization of calcium from intracellular stores. In vivo, low intraluminal calcium concentrations increase the mitotic activity of colonocytes, activating possibly a membrane receptor sensitive to calcium (Cross HS. Antiproliferative effects of calcium and vitamin D metabolites in human colon cancer cell. Op cit. 53) .

The four major chemoprotection studies completed or under development have evaluated dietary supplementation with different doses of calcium: 1.2 g / d in the study of New Hampshire, 1.5 g / d in the study of Nottingham, 51 1.6 g / d with a mixture of antioxidants in the Oslo study 43 and 2 g / d in the European study. Preliminary results from Oslo and Nottingham do not suggest that calcium supplementation reduces the incidence of adenomas, but both are small studies, with only 116 and 79 subjects. The other two include a greater number of individuals (930 and 656 in New Hamspshire European study) and is expected to report its final results in late 1998 (Faivre J. Primary prevention of colorectal cancer-through calcium supplementation. Op cit. 54 ).
Situation in Cuba and alternative measures
Three chronic diseases of high incidence in Cuba have a demonstrated association with insufficient dietary intake of calcium. Multifactorial approach to health plans, aimed at the prevention of these diseases must include, inevitably, the regular promotion of positive calcium balance.

In developed countries, dairy products supply over 50% of daily calcium intake, the remainder is filled with vegetables and other foods fortified products, among which, the soft bones of chicken and fish bones are very good sources often not taken into account. Water is a variable source of calcium salts and many antacid preparations may also be, but often are not registered.

The analysis of data from the National Food and Nutrition Surveillance from 1994 to 1997 shows that approximately 35% of children in child care centers, 70% of those attended boarding and semiboarding and about 80% of adults served in cafeterias receive less than 70% of the recommended daily amount of calcium.

The analysis of computerized dietary surveys conducted by the Institute of Nutrition in 1997 and 1998 in 211 adults and seniors who were surveyed as to their nutritional status, revealed that the mean percentage of compliance with the recommended dietary allowance of calcium was only 58% for adults and 53% for the elderly (range 9-252%). The 73 and 76% of them ate less than 70% of the daily recommendation, 61 and 54% less than 50%, and 23 and 29% respectively, less than a third of the daily amount of dietary calcium recommended by the Institute of Nutrition. The calcium: phosphorus was at values ​​of 0.45 and 0.56, really low for these age groups.

The main cause of this imbalance is caused by the absence of milk and dairy products in the Cuban adult diet, which puts the body in a state of permanent trend toward the passing demineralization and osteoporosis. A diet devoid of milk and dairy products barely covers a third of dietary recommendations for osteoporosis calcium, and the damages it has suffered its supply in our country since 1989 are the main contributing factor to the current values ​​of intake of this mineral found in the dietary records.

Proposed mitigation measures to increase calcium intake in the population are, first, to stimulate the recovery of supplying the public with milk and dairy products and in parallel encourage the use of additional sources of calcium in the diet such as the fortification of food (milk and soy yogurt, soy flour mixtures with cereal, wheat flour) with calcium carbonate, the recovery of the production of pharmaceutical preparations of calcium based on the use of national deposits of calcium carbonate (dolomite and oyster marine) and the development of dietary guidelines aimed at encouraging the use of alternative sources of calcium in the diet. The table shows foods rich in this mineral.

Table. Calcium and phosphorus content in foods (mg/100 g)
 

(Mg/100g)
Relationship
Food
Calcium
Phosphorus
Ca / P *
Fish (with bones)
732
197
3.72
Milk (2% fat)
120
85
1.41
White cheese
717
468
1.53
Cheddar cheese
700
54
1.18
Yogurt
120
100
1.20
Cream cheese
80
104
0.77
Butter
24
23
1.04
Soymilk
18
35
0.51
Amaranth (pigweed) (leaves)
267
67
3.9
Yucca
300
120
2.50
Beet
114
41
2.78
Turnip
137
29
4.72
Purslane
78
37
2.11
* Ideal value: 1.35. Recommended value: between 1 and 2.
Source: Handbook No. 8. Composition of Foods. Vegetable and Vegetable Products.
Nutrition Monitoring Division. And RH Matthews DB Haytowitz, USA, 1984.
NUTRISIS, Nutrition Institute, Havana, Cuba.

Summary

The results of Epidemiological Studies on the Relationship Between the intake of dietary calcium intake and the Functioning of the bone tissue Have Shown That the Increase in the intake of This bone loss reduced ore the Appearing With Age. As a result of This, the nutritional recommendation Has Been raised up to 1 200 mg / d for adolescents, and The Proposal is Discussed by international agencies. The Increase of bone density and the DECREASE of the Risk of osteoporosis, arterial hypertension and colorectal cancers are observed in groups That of Population with Adequate Levels or elevated calcium in the diet extend the sphere of incluence of This mineral on the prevention of chronic diseases That Affect the present rates of morbidity and Mortality in Many countries. Despite the evidences Obtained About the linking of calcium with chronic diseases thses, STI intake in the diet is not recommended unilaterally, But ITS use to Promote a healthy life, Including Reduction of salt intake the, of proteins derived from animals, of alcohol, and caffeine , as well as the Increase of physical activity and of Exposure to sunlight, the maintenance of an Adequate body weight, and the Therapeutic management of the hormonal Changes Occurring in adulthood.

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