There has recently been accumulating evidence to support the hypothesis that dietary calcium may play an important role in body weight regulation. Several reports have found inverse associations between calcium intake and body weight (Davies et al., 2000; Zemel et al., 2000; 2001, 2002, Heaney, 2003; Papakonstantinuo et al., 2003).
Initially, McCarron (Mcarron et al., 1984), analysed NHANES-I data, & noted an inverse association between calcium intake and body weight. The lack of any plausible basis for connecting these two variables effectively relegated this observation to the status of a curiosity or a chance association. Zemel et al. (2000), then analysed the NHANES-III database, to find a very strong inverse association between relative risk of obesity and calcium intake & these observations continued to be made. Teegarden et al. (1999), Carruth et al. (1999), and Skinner et al. (1999) have recently reported a similar inverse association between body fat gain and calcium intake in children and young women. Once Zemel et al. (1999, 2000a&b, Zemel, 1998) had established, a plausible physiological basis for the association, Davies et al., (2000) examined the 5 databases recorded in his studies with Heaney, and in particular the randomized controlled trials in which calcium supplementation was used for a skeletal end point, to see whether, in a different context, calcium intake was also associated with a weight effect, which it was.
Danish researchers have found that it is likely that in the intestine calcium binds fat, thereby increasing the amount of fat which is excreted from the body. The mechanism of action through which calcium assisted weight loss was not known. The most common hypotheses included the notion that calcium suppressed the appetite, or that calcium might have a role in fat metabolism, influencing fat oxidation, or that calcium could aid the excretion of fat. In this study Arne Astrup and colleagues from the Royal Veterinary and Agricultural University, Frederiksberg, Denmark, tested the second and third hypothesis mentioned above.
The study included ten healthy, moderately overweight subjects in a randomised crossover design. They were given three controlled diets. Week one’s diet included low calcium (500 mg) and normal protein (15% of energy). Week two’s diet included high calcium (1,800 mg) and normal protein. Week three’s diet included high calcium and high protein (23% of energy). Calcium intakes were mainly from low-fat dairy products.
Faecal fat excretion was 14.2 g per day for the high calcium, normal protein diet. For the low calcium diet it was 6 g/day and 5.9 g/day for the high calcium high protein diet. The high calcium diet also increased faecal energy excretion by 350 kJ/day. There were no effects on blood cholesterol, free fatty acids, triacylglycerol, insulin, leptin, or thyroid hormones.
The authors conclude that calcium does aid fat excretion from the body and speculate on whether it does this by forming an insoluble calcium fatty acid soap, thereby reducing fat absorption. It is however, noted that this may not be the only explanation since the effect of calcium on appetite was not tested in this experiment.
References
Carruth, B., Skinner, J., Coletta, F. (1999) Dietary and anthropometric factors predicting body fat in preschool children. Scand. J. Nutr. 43(Suppl 34):53S.
Davies, K.M., Heaney, R.P., Recker, R.R., Lappe, J.M., Barger-Lux, M.J., Rafferty, K., Hinders, S. (2000) Calcium intake and body weight. J. Clin. Endocrinol. Metab. 85 pp. 4635-4638.
Heaney, R.P. (2003) Normalizing calcium intake: projected population effects for body weight. J. Nutr. 133: 268S-270S.
Jacobsen, R., J K Lorenzen, S Toubro, I Krog-Mikkelsen, A Astrup (2005) Int. J. Obesity 29(3), pp 292-301
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Papakonstantinou, E., Flatt, W.P., Huth, P.J., Harris, R.B.S. (2003) High dietary calcium reduces body fat content, digestibility of fat, and serum vitamin D in rats. Obes. Res. 11 pp. 387-394.
Skinner, J., Carruth, B., Coletta, F. (1999) Does dietary calcium have a role in body fat mass accumulation in young children. Scand J Nutr. 43(Suppl 34):45S.
Teegarden, D., Lin, Y.-C., Weaver, C.M., Lyle, R.M., McCabe, G.P. (1999) Calcium intake relates to change in body weight in young women (Abstract). FASEB J. 13:A873.
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Zemel, M.B. (1998) Nutritional and endocrine modulation of intracellular calcium: implications in obesity, insulin resistance and hypertension. Mol. Cell Biochem. 188 pp. 129–136.
Zemel, M.B., Shi, H., Zemel, P.C., DiRienzo, D. (1999) Calcium and calcium-rich dairy products reduce body fat (Abstract). FASEB J. 13.
Zemel, M.B., Shi H, Greer B, DiRienzo D, Zemel PC. 2000a Regulation of adiposity by dietary calcium. FASEB J. 14 pp. 1132–1138.
Zemel, P.C., Greer, B., DiRienzo, D., Zemel, M.B. (2000b) Increasing dietary calcium and dairy product consumption reduces the relative risk of obesity in humans. Obesity Res. 8:118.
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