Will calcium make you lean or at least help you to stay lean?
Calcium intake has been associated with lower body mass index and adiposity (body fatness) for decades and supporting evidence from epidemiological studies is abundant (see references 1-15). If you take a look the highly opinionated paleosphere, the most recent consensus on calcium and the most prominent (I did not say best ;-) dietary calcium source, dairy, is however that dairy is the devil and calcium supplements are made of the devil's excrements... and in fact, at least the latter may be dead-on. After all, one of the purported mechanisms that could explain the associations of high(er) calcium intakes and low(er) body fat levels is directly related to excrements - the fat content of your excrements, to be precise, of which a handful of studies have shown that it is increased (see references 18-21) in response to calcium supplementation / increases in dietary calcium.
The subsequent decrease in fatty acid and thus energy absorption can yet not fully explain the observed weight loss effects. According to Christensen et al. the latter would amount to roughly 2g/day and thus no more than 0.7kg of body fat per year (Christensen. 2009)! The data of the study be Zemel et al. (see red box), on the other hand, shows an absolute increase in weight loss of 4.5kg within no more than 24 weeks, which highlights the importance of other mechanisms such as...
Sufficiently powered and well-conducted trials support the epidemiological data: As Trowman et al. pointed out in another systematic review of the literature (Trowman. 2006), most trials did not adequately make up for biases that may have been introduced by weak allocation methods and the only "adequately powered" study that was specifically designed to identify the effects of calcium supplementation on weight loss on an energy restricted (-500kcal) diet over a sufficiently long time period (24 weeks) by Zemel. et al. yielded a highly significant increases weight and fat loss for both supplemental and dairy calcium (see figure 1). An effect, of which the researchers state that it is most likely mediated by the inhibition of the 1,25-dihydoxyvitamin D increases with which our body reacts in response to low-calcium diets and thus stimulate adipocyte Ca2+ influx and, as a consequence, lipogenesis, while simulataneously suppressing lipolysis, and increasing lipid accumulation.
|Figure 1: When added to a regular calorically reduced diet supplemental and even more dairy calcium ramp up its efficacy (data based on Zemel. 2004).|
- the aforementioned (see red box) reduction in 1,25-dihydroxyvitamin D expression and its pro-adipogenic (=promoting fat storage) and anti-adipolytic (=inhibiting fat burn) effects, or
- lower parathyroid hormone (PTH) levels and subsequently increased insulin sensitivity and sympathetic nervous system activity, which will in turn increase dietary induced thermogensis and fatty oxidation rates, and lastly
- gastrointestinal effects of dietary calcium (and dairy) on the release of peptides and hormones in the GI tract
|Figure 2: Effects of chronic (top) and acute (bottom) high calcium intake on fat oxidation, as well as weighed averages (lower right); Ca2+, calcium; DA, dairy (based on Gonzales. 2012)|
Two reasons why you should prefer dietary (dairy) calcium: Efficacy and safety
Despite the fact that the difference is not statistically significant, the data Gonzales et al. collected and my own cursory review of pertinent studies, both suggest that contrary to the effects on fatty acid oxidation, which are, as Gonazeles et al. point out apparently slightly more pronounced in response to supplemental calcium (could simply be an effect of insufficient adherence in the dietary calcium groups; popping a pill is easier and above all more convenient than eating 2-3x servings of dairy), dietary calcium sources elicit greater weight- and fat-loss effects than supplements. It stands to reason that part of this may be explained by confounding factors such as
|Table 1: High calcium foods with a calcium to phosphorus ratio of 1:0.14 (Turnip) to 1:0.7 (Celery); data adapted from parrottalk.com; eating those foods will also shift your often too low calcium to phosphorus ratio in the "right" direction|
- the satiety effect - someone who has already eaten a cup of calcium-rich broccoli (1 cup: 178mg Ca) and a yogurt (6oz = 170mg: 350mg) will be less likely to have another 300g of pasta (100g, cooked: 1mg)
- the nutrient matrix effect - especially dairy, but also other calcium rich foods, contain other nutrients which exert anti-obesity effects, think of the bioactive peptides in milk (1 cup: 300mg Ca), for example, or Chinese cabbage (1 cup: 400mg Ca; cf. "Lose Weight, Improve Your Blood Lipids, Reduce Estrogen, Protect Yourself Against Chromosomal Damage and Defeat Prostate Cancer With Cabbage.")
Update: I forgot to mention a previous article of mine on potential toxicity issues with many commercially available calcium supplements which could be a hitherto overlooked confounding factor in the etiology of heart disease - see "Alarmingly High Levels of Lead in Calcium Supplements: Pb Content per Serving Up to 18x Over 'Acceptable Levels'"
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