A link between dietary calcium and weight management in humans has been hypothesized. Data from the third National Health and Nutrition Examination Survey (NHANES III), which is representative of the US civilian non-institutionalized population, have been recently re-evaluated. Data have suggested that after controlling for energy intake and physical activity, contrary to common thought, an adequate calcium intake may actually be associated with a reduced likelihood of being in the highest quartile for adiposity.57 Zemel et al. reported an almost 80% difference in obesity rates between those Americans in the lowest quartile of dietary calcium intake versus those in the highest quartile.57 Several studies have reported an impact of supplemental dietary calcium on weight loss and have suggested that diets low in calories but high in calcium may provide some better protection against obesity. Experimental data in animals and in humans have also suggested a possible role of dietary calcium in regulating body fat, and an increase in lipolysis with a high-calcium/ low-fat diet, consistent with an increase in energy metabolism.58 61 Data from six observational studies and three controlled trials in which calcium intake was the independent variable (and either bone mass or blood pressure the original outcome variable) have been reanalyzed to evaluate the effect of calcium intake on body weight and body fat. Heaney et al. suggested that dietary calcium intake of at least 1200 mg/day was associated with a nearly fivefold reduction in the proportion of individuals who were overweight, compared to those consuming less than 500 mg of dietary calcium/day, and that an increased calcium intake across the population could reduce overweight and obesity prevalence by 60-80%, respectively.62 The latter part of previous sentence is ambiguous: Are both overweight and obesity reduced by 60-80% or otherwise? Analysis reveals a consistent effect of higher calcium intakes, expressed as lower body fat and/or body weight, and reduced weight gain at midlife.62,63 The Coronary Artery Risk Development in Young Adults (CARDIA) documented 30 and 65% reductions in the development of obesity and hypertension, respectively, in young overweight adults from increased dairy food intake over a 10-year period, but noted that as dairy intake increased, intake of fruit, vegetables and grains also tended to rise.64
Thus, the available evidence indicates that increasing calcium intake may substantially reduce the risk of being overweight, although long-term, large-scale prospective clinical trials need to be conducted to confirm and better clarify this association.
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