Women's Nutrition & Fitness

Calcium Deficiency in Women

By now we all know that women have very different physiological needs than men. In her lifetime a woman has to transform herself with every milestone. From the time of birth to the start of her first menstrual cycle, getting married, pregnancy and then menopause, at every stage of her life her body’s physiological needs keep changing.

The food women consume has to provide them with all the necessary nutrients they require to sustain these life phases. Both the macro and micronutrients play an important role in preparing a woman’s body for the various roles she has to play. And if these nutrients are not in sufficient quantities, it disturbs the normal functioning of her body. One such micronutrient is calcium.

Although calcium is a micronutrient it plays a vital role in the body, especially in women and the deficiency of this mineral can cause long-term deteriorating effects. Let us understand why calcium should be made an integral part of the women’s daily diet in the article below.

Calcium and its RDA

Calcium is one of the major minerals required by the body. It is also the most abundant mineral in the body. It is recommended that women should consume approximately 600 mg of calcium per day. During pregnancy and lactation, this requirement almost doubles to 1200 mg/day (1).

Dietary Sources of Calcium

While milk is the best source of biologically available calcium, milk products like cheese, khoa, skimmed and whole milk powder also contains calcium in considerable amounts. Cereals and legumes like ragi, Bengal gram (whole), horse gram (whole), rajma, and soybean also provide the body with calcium and should be included in the daily diet.

Apart from these green leafy vegetables like amaranth, cauliflower greens, curry leaves, knol-khol leaves, agathi, colocasia leaves, and nuts and oilseeds like dry coconut, almonds, mustard seeds, cumin seeds, and sunflower seeds are also rich calcium sources. Fish is a good source of calcium too.

Role of Calcium in the Body

Calcium forms a large part, 99% of the hard tissues of the body like teeth and bones. Bones and teeth are formed of a tough protein material into which minerals are deposited and calcium is one of these minerals among others. A liberal intake of calcium, with increased mobility and exposure to sunlight, is known to improve the strength of bones and thus reduce their fragility.

The remaining 1% of calcium is present in the soft tissue and blood and is responsible for many regulatory functions like (2):

Normal muscle contraction, which includes heartbeat.
Control of the transmission of nerve impulses.
Maintenance of permeability of cell membranes to permit movement of material in and out of the cells.
Help normal clotting of blood.
Activate the action of enzymes, e.g., pancreatic lipase as a cofactor.
Ensure the absorption of vitamin B12.

Calcium is essential, both during pregnancy and lactation, for the proper formation of bones and teeth of the offspring as well as for the secretion of calcium-rich breast milk.

Calcium Deficiencies in Women

The deficiency of calcium is called hypocalcemia. It manifests itself, only after years of insufficient intake. When sufficient calcium is not supplied, pregnant women lose calcium from their body tissues to supply the needs of the foetus. Similarly, nursing mothers lose calcium and phosphorus in the formation of milk. Calcium deficiencies in women manifest in various ways that include the following.

Osteoporosis

If adequate calcium is not provided in the diet, during pregnancy and lactation, the bones of women get porous. This is commonly referred to as osteoporosis. This condition may even occur in post-menopausal women as the body absorbs and retains less calcium after menopause.

A large percentage of Indian women, especially from the low-income strata, suffer from osteoporosis. In later years of life, these women may also suffer from loss of stature, bent backs, and high susceptibility to fractures of the hip and wrist. These conditions are due to loss of bone mass, which results in bending, and compression of vertebrae.

Osteoporosis is a complex ailment. The factors, which contribute to the weakening of the bone structure, especially in post-menopausal women include-

• Changes in lifestyle, leading to reduced movement,
• Lack of weight-bearing exercise,
• Poor absorption of calcium and phosphorus due to staying indoors (lack of vitamin D synthesis).

The best way to prevent osteoporosis is to maintain adequate calcium intake, physical activity to reduce loss of bone mass with age, and exposure to sunlight to ensure vitamin D synthesis to aid calcium absorption (2).

Preeclampsia

Another serious complication related to calcium that women may suffer from is preeclampsia. It is a serious complication of late pregnancy. Symptoms include high blood pressure and high levels of protein in the urine (3). For prevention of pre-eclampsia, WHO 2013 guidelines recommend the inclusion of routine prenatal calcium supplementation in high doses (>1 gm/day), especially in those areas where dietary calcium intake in women is low (4).

Other symptoms of hypocalcemia in women include:

Muscle cramps or weakness
Numbness or tingling in fingers, feet, or face
Abnormal heart rate
Poor appetite
Fractures
Brittle nails
Slow hair growth
Confusion or memory loss
Insomnia
Weight loss

Factors Related to Calcium Deficiencies in Women

Hormones

In women, the hormone estrogen plays a vital role in calcium metabolism as it decreases the bone-degrading cellular activity of the cells. The decrease in this hormone during menopause makes women susceptible to calcium deficiencies. This susceptibility increases if women undergo premature menopause, experiences irregular periods, or start having their period at a later stage as well as if they have had their ovaries removed at any age.

Hypoparathyroidism, a condition that decreases the production of parathyroid hormone in the body may also cause calcium deficiency in women as this hormone controls the calcium levels in the blood.

Calcium deficient diet

Malabsorption or malnutrition can also cause calcium deficiencies in women. Less calcium in the diet over a long period of time also leads to calcium deficiencies in women in their later ages.

Lactose intolerance

A dietary intolerance to calcium-rich foods especially milk and milk products, as in lactose-intolerant people will deprive them of the best sources of calcium. This can contribute to low calcium in a woman’s body.

Medicines and drugs

Medications like corticosteroids that are used to treat hypercalcemia or high blood calcium levels if taken in wrong doses or for a prolonged period of time may decrease calcium absorption and cause calcium deficiency.

Vitamin D deficiency

Vitamin D aids in calcium absorption in the body. Hence, a decrease in the levels of vitamin D in the body also results in calcium deficiency.

How To Prevent Calcium Deficiency in Women?

A balanced diet rich in all the sources of calcium can help prevent calcium deficiencies. Supplements are also a great dietary source of calcium for women whose daily calcium requirements may not be met. Some calcium supplements, available as over-the-counter drugs, have up to 1000 mg of calcium per tablet, which represents the nutritional requirements for most adults (4). It is recommended that post-menopausal women get themselves tested regularly for serum calcium levels so as to start with supplements if prescribed by their physicians.

Women need to be aware of such deficiency disorders that may not only hamper their daily activities but may also have serious consequences. Remember that your health is in your hands and you need to understand your body’s requirements.

If you want to read more such articles related to women’s health let us know in the comments section below.

Author: Dr Pooja Nilgar (Content writer and editor)

References

Manual, A., 2011. Dietary guidelines for Indians. Nat Inst Nutrition, 2, pp.89-117.
Mudambi, S.R., 2007. Fundamentals of foods, nutrition, and diet therapy. New Age International.
National Institutes of Health (2016) ‘Calcium fact sheet for consumers’, Office of Dietary Supplements, pp. 1–4. Available at: https://ods.od.nih.gov/pdf/factsheets/Calcium-Consumer.pdf.
Maternal Health Division Ministry of Health and Family Welfare (2014) ‘Designed and printed with support from UNICEF’, (December). Available at: http://www.nrhmorissa.gov.in/writereaddata/Upload/Documents/National_Guidelines_for_Screening_of_Hypothyroidism_during_Pregnancy.pdf.
Cormick, G. and Belizán, J. M. (2019) ‘Calcium intake and health’, Nutrients, 11(7), pp. 1–16. doi: 10.3390/nu11071606.

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