Relationship Between Calcium Intake and Anthropometric Indices

Abstract

An emerging body of literature suggests that dietary calcium may play a role in the regulation of body weight and body fat. Literature has shown inverse relationships between calcium intake and body fat percentage and body mass index (BMI) of children and adults of different ethnic groups. In some studies, however, no association between dietary calcium intakes and body weight, BMI or fat mass was found. The aim of this study was to assess the association between dietary calcium intakes and anthropometric indices in different age groups and people from different ethnic groups worldwide. Results of cross-sectional studies of the relationship between calcium intake and anthropometric indices indicate inverse associations between calcium intakes and BMI among adolescents and adults. These associations were not found consistently, especially not in groups with a relatively low calcium intake. In most studies adjustment was made in statistical analyses for age, gender, total energy intake and smoking, but adjustment was seldom made for physical activity, which could have an important effect on the body mass index and skinfold thickness of the study participants and could be a confounder in the association between dietary calcium intakes and body composition. Longitudinal studies in children and young adults indicate an inverse association between dietary calcium intake over time and body fat or sum of skinfolds. Randomised controlled intervention trials showed inconsistent results and a meta-analysis of 13 randomised controlled trials showed no association between dietary calcium intake and body fat. In a cross-over clinical trial where the effects of low and high calcium diets were compared fecal fat excretion increased 2.5-fold when the participants took the 1,800 mg calcium diet with 15% of energy from protein compared to a 500 mg calcium diet. The authors proposed that increased fat and energy excretion over time may contribute to a decreased gain in fat mass, or a loss of body fat. Other plausible mechanisms include higher fat oxidation or protection against fat gain by creating a balance of lipolysis over lipogenesis in adipocytes. High calcium intake depresses 1,25-dihydroxy vitamin D leading to decreases in intracellular calcium, thereby inhibiting lipogenesis and stimulating lipolysis. Available data do not unequivocally support the hypothesis that a causal relationship exists between high dairy food intake and/or high dietary calcium intake and lower fat mass deposition. Daily calcium intake should, however, be encouraged to achieve optimal health.