Up to 80% of the Spanish population does not take the necessary amount of calcium, an even higher percentage in the case of children and adolescents. This is stated in a 2017 study prepared by the Spanish Nutrition Foundation (FEN), the Ibero-American Nutrition Foundation (FINUT) and the Spanish Federation of Nutrition, Food and Dietetics Societies (FESNAD).
The report recalls that one of the reasons why such a high percentage of the population does not reach the calcium levels recommended by the WHO (about 1,000 mg daily in women and 1,200 mg in men) is the drastic reduction in milk consumption. Thus, according to researchers, milk and its derivatives continue to be the best source of calcium in the diet based on two fundamental criteria: the quantity they contain and their quality per serving.
Therefore, the proliferation of vegetable drinks to replace milk, without seeking alternative sources of calcium, means that many people have, without knowing it, a deficiency of this mineral. The number of diagnoses of lactose intolerance, as well as the fact that some people have abandoned lactose intake voluntarily, contribute to aggravating this situation, according to the report.
It should be noted, however, that no food is 100% essential and that you can have a healthy diet with a correct supply of calcium even if you do not consume dairy products, as long as it is designed correctly to ensure its presence. We must not forget that calcium is also present in foods of plant origin such as dried figs, almonds, chickpeas, sardines, sesame or broccoli, to name just a few. Dietitian-nutritionist Daniel Ursúa explains it: “The human body has an enormous capacity for adaptation and is capable of obtaining essential nutrients from different foods, so we can always find alternatives if there are some that we want to avoid, whether for taste, due to circumstances or due to some pathology.”
Calcium is essential for numerous functions of the body. According to Xavier Nogués, head of the Internal Medicine service at the Hospital del Mar in Barcelona, ??this mineral “provides the cells of our body with an electrical charge that favors their mobility and that the body uses for various functions, including, for example , conductivity at the cardiac level”. This means that “the calcium that the body needs for its proper functioning, a figure that is around 1200 mg per day, is found in the cells and is stored in the bones.”
To use a simple metaphor, the doctor points out that “the skeleton is a granary in which calcium is stored and this grain is found in the blood.” It can happen, and in fact it is quite common, that by not reaching the daily consumption that the cells need to perform their functions correctly, “they draw on the calcium reserve of the skeleton and this is when diseases occur that can range from osteoporosis to osteomalacia, the latter being rare in the West”.
When this situation occurs, “the skeleton deteriorates little by little, so if it is suspected that the intake is not adequate, it is advisable to review it in an analysis and take the necessary measures in the event that there is a deficit.” These measures involve better designing the diet, taking into account that if dairy products are not included, other sources must be sought and that, if they are consumed, a sufficient amount must be ingested, taking into account that a glass of milk contains about 200 mg of calcium. . It is advisable to be especially rigorous in the case of women, since “the imbalance in estrogen that occurs during menopause can lead to a calcium deficiency, so it may be advisable to take enriched foods that can alleviate this situation,” says Dr. Nogués. In the case of men, “this deficit also occurs, but later.”
Therefore, keeping in mind that a glass of milk has, as we said, 200 mg of calcium, a milk enriched with calcium can reach 320 mg, so that if the diet includes few dairy products, one is in a period. of menopause in the case of women or blood tests indicate a calcium deficiency, you can choose to consume these products. “The ideal is that dairy products can be combined in the diet with some vegetable sources of calcium, but sometimes it can be difficult for vegetarians to meet their needs only with a plant-based diet,” says the doctor, who Remember that although sesame, for example, contains a good amount of calcium, it is difficult to achieve a high intake. In these cases, “a study must be carried out and the possibility of supplementing it if necessary be considered.”
An important factor that determines having adequate levels of calcium is vitamin D. Therefore, when determining whether there is a risk of deficiency, it is important to assess the levels of this vitamin. “Without vitamin D, calcium is not absorbed correctly, so if there is a sustained deficiency this can also affect the bones,” explains Dr. Nogués.
Although it is found in certain foods, such as oily fish, eggs or red meat, among others, this vitamin is synthesized mostly through sunlight, so sun exposure is essential. Taking into account that the population is increasingly aware of the negative aspects of the sun and tends to protect the skin when exposed, cases of vitamin D deficiency among the Spanish population are increasing. According to the article Vitamin D deficiency in Spain. Reality or myth?, published in the Journal of Osteoporosis and Mineral Metabolism, with the available data “it is confirmed that there is an insufficiency and even frank deficiency in the Spanish population at all ages studied and in both sexes, similar to that existing in throughout the world, including very sunny regions and that existing in other countries in the Mediterranean basin with similar possibilities of exposure to the sun.
This situation translates into worse treatment for osteoporosis: “the available evidence indicates that, in addition to an insufficient supply of calcium, inadequate serum levels of vitamin D potentially decrease the response to treatments for osteoporosis,” the study notes. Specifically, 4 out of every 10 inhabitants under 65 years of age and 8 out of every 10 among those over this age suffer from a vitamin D deficiency, according to the Hormone D study in 2021. Challenges and strategies in the face of the generalized deficit in the population, driven by Fundamed, with the collaboration of FAES Farma.
One of the first signs of possible osteoporosis is fractures. “Wrist breaks after a fall, especially in women, can be a symptom of osteoporosis. This can be diagnosed after a densitometry and, based on the results, a treatment can be prescribed,” explains Dr. Nogués, who among the factors of risk for osteoporosis points to “a low calcium intake, alcoholism or smoking.” As for osteomalacia, which is the softening of bones that is mainly caused by a deficiency of calcium and phosphorus, it is less common and usually requires a transversal treatment that usually includes supplementation of these minerals, as well as vitamin D.
