Body pH on Bone Calcium levels

One issue needs clarification that crops up every so often. The coral calcium issue raised it to a higher level.

There are two types of acid/alkaline (acid-base) or body pH levels that need to be regulated. The body acid /alkaline regulation is different from the regulation of the blood plasma pH level through calcium regulation. Calcium needs to be maintained at a specific amount or percentage in the blood for muscles to contract and nerves to fire, etc. To limit any fluctuation in blood calcium level involves the body with increasing calcium intake or elimination, including the storage of excess calcium into bone and taking calcium out of bones when needed.

Overall body pH regulation is mostly under control by the Kidneys and production of bicarbonate. Yes, certain minerals arriving in food and stored in the body also help, such as Phosphorus, Potassium, Sodium, as well as Calcium and Magnesium. The majority of pH regulation is needed for body metabolism and cellular processes, such as energy production in cells, and fortunately, bicarbonate provides most of this needed buffering. Many cells lining the stomach produce bicarbonate to help control stomach acids.

Bicarbonate originates from the combining of CO2, an element in air and produced by the body, with elements from water molecules, H2O. The body constantly creates acid that needs to be quickly neutralized. Sodium bicarbonate is the element the body uses to control excess acids, and after this function, the bicarbonate is recycled back whole again to be used over and over. This allows Calcium and other alkaline minerals more freedom to perform their many other important functions so they do not have to play a larger role in balancing body pH. The preservation and storage reserve of alkaline minerals is an important aspect for maintaining the body's overall health. This is one of the chief advantages of so-called alkaline diet, other than it abundantly supplies many needed nutrients. Eat your vegetables and some fruits to balance but not completely eliminate proteins and other acid producing whole foods.

Here is an excerpt on this subject from the classic university nutrition textbook,

1966 edition of "Nutrition and Physical Fitness" by Bogert, Briggs, and Calloway. The first edition was published in 1931.  

"Although there is no doubt that eating generous quantities of fruits and vegetables makes for good health in the long run, these foods supply vitamins and fiber along with base-forming elements and their beneficial effects may be due to a combination of all these factors." Base-forming minerals are sodium, potassium, calcium, and magnesium. Acid-forming are sulfur, phosphorus, and chlorine.

"The body normally maintains a certain store of basic elements, known as the alkali reserve. The chief disadvantage of ingestion of too much acid-forming foods or of formation of too great amounts of acids in metabolism is not in the danger of blood or tissues actually becoming acid, but in the fact that under these conditions the excess acid must be neutralized by drawing on the alkali reserve, and that the body store of base-forming elements may become depleted. When base-forming foods predominate in the diet, not only is there no need to draw on the alkali reserve, but this reserve of basic elements is built up to a point where it is at least a safeguard for the tissues and may be a factor in promoting health."

Remember, the Kidneys control pH by either holding onto certain minerals or eliminating them or others plus forming bicarbonates to neutralize acids. It is in other areas of the body that this change in mineral supplies might compromise health that is under question, not the pH of body fluids. There are still many unanswered questions about pH regulation and effects on bone and body functions. ref

Bones - More than just Calcium

Bone building is a team effort. Calcium is just one member of the team. Some of the other nutrients may actually be more important since Calcium is now supplied in many fortified foods other than diary, such as orange juice and the many milk alternatives, like almond and rice drinks. 

Here is a current reference showing the value of some of those other nutrients, especially magnesium. Some of these other nutrients not only help in the bone building process, but also prevent bone loss which may be just as important as the building process. Another benefit from vitamins like C and B12.

While milk is a rich source of calcium, some other elements in milk must interfere with bone building over the long term. Research shows that milk drinkers have higher risks from fractures. Yes, this is counter to the message from the Dairy Industry. Check out this study.

Another study reveals a very interesting fact. Calcium and vitamin D reduce osteoporosis but do not necessarily reduce fracture risk. Why this difference? The answer probably is connected to the physiology of bones. There are two parts to consider. One is density, the other structure. The marriage or coupling of these two together relates more to fracture prevention than either by themselves. Oh, there is some improvement occasionally in some studies, but simply increasing density while ignoring the building of a stronger structure appears to be the model for mainstream medicine. One that fails most of the time.

For more facts, article.

Below copied from the Harvard Medical website:

"Problems with (Calcium) supplements 

Acid rebound. Calcium carbonate may cause acid rebound: the stomach overcompensates for the high dose of calcium carbonate, which is alkaline, by churning out more acid. For that reason, people with a history of stomach ulcers are advised that they may not tolerate it and may have to switch to calcium citrate.

Constipation. Calcium supplements can have a mild binding effect but by themselves don’t usually cause serious constipation. But if you’re taking another supplement or medication that binds the stool, the addition of calcium supplements could cause a problem.

Too much calcium. Although it doesn’t happen often, some people have taken so much calcium that it causes hypercalcemia, an above-normal level of calcium in the blood. Hypercalcemia may cause nausea, vomiting, confusion, and other neurological symptoms.

Drug interactions. Large doses of calcium interfere with the absorption of a variety of drugs. You should avoid consuming large amounts of calcium — either in food or as a supplement — within 2–4 hours of taking a tetracycline or quinolone antibiotic. After taking alendronate (Fosamax), risedronate (Actonel), or another one of the bisphosphonate drugs for osteoporosis, you should wait at least 30 minutes before consuming a large amount of calcium. People taking calcium-channel blockers or beta blockers should discuss taking calcium with their doctors because it can reduce the effectiveness of these drugs."

Sidebar: Also this fact should be mentioned here. Larger calcium intakes, while they might not generate hypercalcemia, they could and probably do interfere with the absorption of other minerals in the same meal. While the body realizes the value of calcium and has a built-in active absorption process for it, any excess over body needs then competes with all the other minerals in a free for all to get absorbed. Excess calcium from sheer numbers often wins out and blocks many of the other major minerals and especially the minor ones. Nature likes balance and even though she has many compensating options available to aid the mineral balance, they use up vital energy and divert elements from other vital body functions.

Calcium Intake (How Much)

CALCIUM JUNGLE  (continuation of opening article)

UPDATE: To benefit immediately from new research, limit calcium supplementation to no more than 600mg. Since the safest total amount (diet and supplements) is between 600 mg to 1000 mg per day. Over 1400 mg total per day potentially increases CVD risk. ref  With so many foods fortified with extra calcium, like orange juice and cereals, 600mg may actually be a little high for some.** To be fair, here is another study around the same time that arrived at what appears to be an opposite heading, that higher calcium is protective. BUT, look at the dosages for the higher and the truth is revealed (lower <458 mg/d for men, <417 mg/d for women versus the highest quartile of dietary calcium intake (>762 mg/d for men, >688 mg/d for women). ref   Here is another study showing longer term benefits against osteoporosis but not for 3 year fracture prevention. ref  (Note that the long term benefits were assumed and not a verified fact using just the measument of increased bone density at 3 years.)    

Somehow, over a period of time, simple logic (and Science) lost out to marketing rhetoric in telling the bone health calcium story. At fault, science is not even following it's own scientific protocol in examining theories for credibility. The Calcium saga is one of the most complex jargon jungle issues of our time. (Extreme view with merit under medical supervision- ref) More is not always better. ref  General Calcium info from Harvard Medical, ref   Bone info, ref       

THE BODY IS SIMPLY NOT DESIGNED TO CONSUME LARGE AMOUNTS OF CONCENTRATED CALCIUM AT ONE TIME. FOODS GENERALLY CONTAIN SMALLER AMOUNTS OF CALCIUM WITH MANY BUFFER ELEMENTS THAT SLOW BODY RESPONES TO CALCIUM THAT ARE MISSING FROM MOST CALCIUM SUPPLEMENTS TO FURTHER LIMIT AND REGULATE ABSORPTION. Even taking large amounts of calcium with food still does not supply enough minerals to balance. While Dairy does contain a rather large amount of calcium, it is not designed to be consumed past a few years of age. Babies need greater quantities of calcium to change soft cartilage like bones into hard bones to support upright walking and increasing body weight. 

Calcium is vital to health. So why call it a jungle?   

What you think are calcium facts are really marketing stories not entirely based on science, or at least not the whole picture but just small segments. Unless you have an understanding of the principles involved and correctly apply them, you are doomed to suffer the consequences of CALCIUM jungle fever. Bones are just the tip of the iceberg for calcium actions, and while difficult to believe, calcium is not even among the top few recommendations from science for healthy strong bones. ref ref  Does the cow look out of place in a jungle? Or is this a cow feeding paradise?

Here is a key bone basic from the US Surgeon General's report ref: "The bony skeleton is a remarkable organ that serves both a structural function, providing mobility, support, and protection for the body, and a reservoir function, as the storehouse for essential minerals."

THE HOLLOW BONE SAGA

Vitamin Workshop PRE-ANALYSIS:  This is one possibility. Nutrition researchers had a dilemma to solve. How to prevent fractures due to thinning bones, called osteoporosis. Given the realities of the Standard American Diet, they could either correct the diet to prevent large amounts of calcium being eliminated out of the body, or they could recommend increasing calcium intake to compensate for this loss. Of course, this assumes they knew both of these options were in play, and they had proof that increased calcium intake did indeed prevent fractures. It now is evident that Science let the dairy industry dictate the direction of this answer resulting from very short term increased calcium as dairy increasing bone density. This assumption, in play for many years, even decades, is now in jeopardy and might actually be adverse to long term bone fracture prevention.

Only increasing calcium intake, from foods such as dairy or supplements, can lead to other problems in the body; pH regulation plus artery and soft tissue calcification (ref)associated with brain lesions and heart disease atherosclerosis. Thus it is not just the amount of calcium in the diet, but how it is delivered plus what happens to it once it is inside the body. ref How it is delivered affects the amount of calcium released at one time into the system. Too much can be quickly released from supplements which overwhelms the balance systems to over-respond. article  Nutritionists still to this day exhibit a lack of appreciation for nature's calcium balancing act. As you increase calcium intake, the body reduces the absorption percentage. Why do you think this happens? Absorption percentage is regulated by need. Is it wise to constantly overload the body with calcium?

The body needs just a certain amount of calcium each day to maintain the balance of the blood calcium level. This blood level is the true driver for calcium behavior. Excess or deficiencies of calcium intake cause changes in the body to compensate. This might mean taking calcium out of bone storage when dietary intake is low or preventing absorption, speeding up elimination, as well as packing more into bones when intake is high. If these were the only processes affected by calcium levels, this would be simple to measure and handle, but other hormones and their related activities are involved such as vitamin D activation with side pathways giving protection against infections and cellular DNA damage to cells. There is a domino effect at play that often challenges Scientists to get it right. The one thing about calcium supplements that most Nutritionists agree, DO NOT JUST INCREASE CALCIUM BY ITSELF. Other minerals play vital roles. And to this should be added, take smaller amounts of calcium at one time.  ref   ref

This reference gives a great review of all the healthy bone building needed nutrients. ref

NOTE: The calcium recommended dietary intake, RDI, in the USA is between 1000 to 1200 mg. Since the absorption of dietary calcium has been found to be about 20-30 percent, this RDI would yield between 200-360 mg. One quickly sees that this may not keep pace with the amount eliminated in some cases. Another fact that needs to be addressed if these facts are indeed true, how do people in other Countries survive with stronger bones when the daily consumption is under 500 mg? A true Scientific dilemma, or are there other facts that play significant roles to protect bones and calcium not often acknowledged. 

HOW DID THE CALCIUM BONE RELATIONSHIP GET OFF ON THE WRONG FOOT SO EARLY?

Scientists looking at the bone fracture situation thought correctly that since calcium is one of the major components of bone, if bones are showing a calcium loss leading to reduced density and bone fractures, increasing calcium consumption should fix the problem.  Early research, especially sponsored by the Dairy Industry, revealed that this appeared to be a correct theory since bone density increased.

Here is where this early research failed. They assumed that this early increase in bone density would lead to the prevention of fractures later in life. BUT, they did not continue with long term studies to verify. Thus, calcium and bone science was based on only short term research assumptions. Now, some 70 years later, most longer term studies have consistently shown that these early assumptions were NOT EXACTLY CORRECT. Increased Dairy source calcium may actually generate more fractures over the long term, NOT LESS according to the Nurses' Health Study out of Harvard Medical. The next following articles will explain why. ref

**There is a need to balance the amount of calcium needed for bone protection against the other effects of calcium such as in cardiovascular health. What good is having strong bones when suffering from heart disease. A common sense position is needed overall for how much supplementation is healthy. The above reference lists the ideal calcium to magnesium ratio as 2.0-2.5. The final ratio may be closer to 1.7, but could depend upon overall diet as well. More on this later. 

Current trend in osteoporosis treatment is to increase bone building cells rather than just in the past to slow down bone tearing down cells. ref

Critical Note: No nutrient in the body operates in a vacuum. For proper calcium supplement amount, it is necessary to know some things about other related nutrients. Magnesium and calcium are linked together not only for bone building but also for cellular activities, especially in muscle and nerve functions. There is an ideal ratio (within 1.7 to 2.5***) balance point between calcium and magnesium for many normal body processes. Phosphorus and calcium also work together in bones. Vitamins A, C, D, E, and K perform actions to assist calcium pathways. 

***The trend to increase calcium supplements over the last two decades has increased the calcium to magnesium ratio to a point over 3.0. Above 2.7 and below 1.5, detrimental actions begin for those in the USA. Other Countries may have other challenge levels related to magnesium beginning levels and the current ratio number. Since both bone building as well as cardiovascular disease are involved, it is necessary to consider each when adding or decreasing calcium or magnesium supplement amounts for balancing ratio. It is possible for CVD risk to go up as bones gain density. It is the other related nutrients that can play vital protective roles here, especially vitamin K2.

What's wrong with MILK?

The Center for Disease Control, Nutritionists, FDA, DofA, NIH, and even many Alternative Health Practitioners often get this one wrong. What is up with Milk? What about Organic Milk? article  <While some good points in this article, they miss some main issues, like antibiotics and rBGST that does change milk producing greater amount of IGF-1 and estrogen hormones. Finish reading below before accepting any misconception face values. The Doctor letter is especially revealing at the end.

Mainstream medicine says whole milk is bad. Too much saturated fat leading to Cardiovascular Disease. Low fat milk 1-2% is good. Great for bones. Good source of calcium and vitamin D to prevent fractures. According to the Dairy Industry, milk protects bones and decreases fracture risk. Maybe not according to Dr Ludwig. ref  Plus, how is it possible that the Nurses Health Study following 78,000 Nurses for over 12 years has now discovered more bone fractures from increased milk consumption? ref   UK study > ref   And a Swedish study  here  Another study looked at family history on hip fractures (genetics) and found risk independent of Bone Mineral Density. ref

These studies from different areas of the World showing the same thing, more milk does not prevent fractures, and may slightly increase fractures over time compared to those who consume less or are non-milk drinkers. article Only one study would not carry much weight, especially if only an association survey, but when multiple studies begin showing the same result, credibility grows, and genetics carried more influence than density.

Goofy reference about milk. Are these things it says true? They make it sound like milk is poison!

Here are some of the facts that need to be addressed about milk:          

• Raw versus Pasteurized ref
• Organic versus Regular Pasteurized
• The calcium to magnesium ratio at 9:1 versus...
• Pasteurization process on mineral precipitation.
• Homogenization on fat particle size and effects.
• XO uptake with smaller fat particles
• IGF-1 increase in milk with rBGST hormone use**
• D-galactose effects on body ref ref
• Percent of calcium in human milk compared to cow's milk
• Infant dynamics between breast fed and bottle fed
• Grass fed versus grain lot fed cows on milk composition
• Effect of estrogen hormones found in milk ref ref

From T. Colin Campbell Center for Nutritional Studies ref

1. In observational studies both across countries and within single populations, higher dairy intake has been linked to increased risk of prostate cancer (cited in [2]).
2. Observational cohort studies have shown higher dairy intake is linked to higher ovarian cancer risk. (Could be the hormones) ref
3. Cow’s milk protein may play a role in triggering type 1 diabetes through a process called molecular mimicry. ref ref
4. Across countries, populations that consume more dairy have higher rates of multiple sclerosis.
5. In interventional animal experiments and human studies, dairy protein has been shown to increase IGF-1 (Insulin-like Growth Factor-1) levels. Increased levels of IGF-1 has now been implicated in several cancers. 
6. In interventional animal experiments and human experiments, dairy protein has been shown to promote increased cholesterol levels (in the human studies and animal studies) and atherosclerosis (in the animal studies).
7. The primary milk protein (casein) promotes cancer initiated by a carcinogen in experimental animal studies.
8. D-galactose has been found to be pro-inflammatory and actually is given to create animal models of aging.
9. Higher milk intake is linked to acne.
10. Milk intake has been implicated in constipation and ear infections.
11. Milk is perhaps the most common self-reported food allergen in the world.
12. Much of the world’s population cannot adequately digest milk due to lactose intolerance.

One positive note is that many studies report higher dairy and calcium intake shows a reduction of colon cancers. Risks and benefits overall have to be evaluated according to related conditions and diet, lifestyle, and genetics.

**IGF-1 levels are not always cut and dried, higher more cancers. Here is a study that shows weight adds an extra factor for direction of IGF-1 actions in HER2+ women. IGF-1 is more of a cancer risk for overweight people. Regular weight people show higher IGF-1 levels offers greater protection against cancers. There is more to this story.

MILK ASSOCIATIONS

Old as well as new research questions the amount of milk that is safe in the diet. ref  Yes, this study only looked at data as associations between heart disease rates and dietary food consumption, with milk often at the top of the list. Since butter didn't show the same CVD risk, it may not be just the saturated fat content of milk that is problematic.

This next reference dives deeper into milk health myth and explains simply and rather boldly the body principles as to why milk in large amounts does not help the body prevent factures long term. This comes from Singapore in a website for a nursing home that includes health information for their tenants. 

Copied from the above referenced website information: "In fact, in countries where the people consume high amounts of fish and eggs (which are the only vitamin D containing foods), the hip fracture rates are high too; because when both the intake of calcium (due to consuming dairy products) and vitamin D is high, the vitamin D causes a high uptake ratio of the calcium - accelerating the aging of osteoblasts."

Osteoblasts are bone building cells. The concern is that like many other body cells, osteoblasts have a certain lifespan, meaning they divide only a set number of times before they die. Thus, what would cause them to accelerate aging? Evidently, having to process extra calcium loads daily into bones. The blood level of calcium has to be maintained at a certain level for body processes. When calcium blood level goes up, the body quickly springs into action to eliminate the extra by either speeding up elimination or packing the extra calcium into bone storage areas. This increases osteoblast cell work and ages them faster.

WRAP UP

Here is a rather long but thorough letter from a California Medical Doctor to his patients on the merits and science of milk. It should end all debate, but it will not. You have to decide for yourself if you are willing to accept associated risks.

Copy from this letter FYI: Milk is not just milk. The milk of every species of mammal is unique and specifically tailored to the requirements of that animal.
For example, cows’ milk is very much richer in protein than human milk. Three to four times as much. It has five to seven times the mineral content. However, it is markedly deficient in essential fatty acids when compared to human mothers’ milk. Mothers’ milk has six to ten times as much of the essential fatty acids, especially linoleic acid. (Incidentally, skimmed cow’s milk has no linoleic acid). It simply is not designed for humans....

...Clearly, our specialization is for advanced neurological development and delicate neuromuscular control. We do not have much need of massive skeletal growth or huge muscle groups as does a calf. Think of the difference between the demands make on the human hand and the demands on a cow’s hoof. Human new-borns specifically need critical material for their brains, spinal cord and nerves." 

Plus, low fat milk is often used that further reduces essential fatty acids. On this point, a little history hardens the concrete. When low fat milk was first introduced, Pediatricians across the US started seeing record numbers of children with dry skin conditions. These were finally linked to the reduced fat in milk since whole milk fat was one of the primary sources for essential fatty acids needed for healthy skin in the diet of children. 

Good Bones

What are GOOD BONES?

Good Bones now often brings to mind the HGTV show about renovating older homes with good structure, not a reference to low fracture risk bones. Perhaps part of the current dilemma regarding what builds strong bones is due to equating fracture protection only from higher bone density readings. In Europe, bone structure is also factored in and this gives a better diagnosis of future bone fracture risk rather than just density. Good bones have to exhibit the ability to absorb stress and give or flex a little without breaking. Very high density can actually make certain bones too rigid and lead to a higher fracture risk. The proper marriage of bone structure and bone density together is the true measure of bone health, or Good Bones.

UPDATE: To benefit immediately from new research, limit calcium supplementation to no more than 600mg unless you know your dietary intake amount. The safest total amount with diet and supplement sources added together is between 600 mg to 1000 mg per day. Over 1400 mg total per day potentially increases CVD risk. ref  With so many foods fortified with extra calcium, like orange juice and cereals, 600mg may actually be a little high for some.** To be fair, here is another study around the same time that arrived at what appears to be an opposite heading, that higher calcium is protective. BUT, look at the dosages for the higher and the truth is revealed (lower <458 mg/d for men, <417 mg/d for women versus the highest quartile of dietary calcium intake (>762 mg/d for men, >688 mg/d for women). ref   Here is another study showing longer term benefits against osteoporosis but not for 3 year fracture prevention. ref  (Note that the long term benefits were assumed and not a verified fact using just the measurement of increased bone density at 3 years.)

From the Harvard Medical School newsletter:

Here is a key bone basic from the US Surgeon General's report ref : "The bony skeleton is a remarkable organ that serves both a structural function, providing mobility, support, and protection for the body, and a reservoir function, as the storehouse for essential minerals."

• Copied next is conclusion from the next reference: "Serum potassium content shows a significant positive correlation with BMD, suggesting potassium may be involved in the development of osteoporosis in postmenopausal women." ref Remember that blood level (serum) of calcium is very controlled. Potassium protects calcium in bones. ref

From Harvard Medical website the following is copied due to it's importance:

In particular, these studies suggest that high calcium intake doesn’t actually appear to lower a person’s risk for osteoporosis. For example, in the large Harvard studies of male health professionals and female nurses, individuals who drank one glass of milk (or less) per week were at no greater risk of breaking a hip or forearm than were those who drank two or more glasses per week. (2, 3) When researchers combined the data from the Harvard studies with other large prospective studies, they still found no association between calcium intake and fracture risk. (4) Also, the combined results of randomized trials that compared calcium supplements with a placebo showed that calcium supplements did not protect against fractures of the hip or other bones. Moreover, there was some suggestion that calcium supplements taken without vitamin D might even increase the risk of hip fractures. A 2014 study also showed that higher milk consumption during teenage years was not associated with a lower risk of hip fracture in older adults. (increased in some men) ref

Abstract

There is a consensus that adequate calcium intake during bone development, and possibly in adulthood and senescence, helps to prevent bone resorption and osteoporosis. The uptake of dietary calcium should be sufficient to maintain both normal serum calcium concentrations and parathyroid hormone levels in the low normal range throughout the day, otherwise, increased bone resorption occurs. Calcium intake varies with race and with environmental and dietary conditions. Estimating the appropriate amount of calcium to be added to dietary sources for an optimal supplementation regimen is therefore difficult. Few intervention studies have evaluated the dose-effect relationship for calcium supplementation conclusively. The mechanisms regulating fractional calcium absorption as a function of intake suggest that very high daily doses are probably useless. They may be unsafe in the long term because of the risks of hypercalciuria and kidney stones, and of an imbalance in the ratio of calcium to magnesium. Concomitant supplementation with limited amounts of magnesium may reduce this risk and improve mineralization. Dietary intake is 500-600 mg/day in most studies, making 400 mg/day an appropriate supplementary dose for most premenopausal women (RDA 1000 mg/day). After the menopause and during lactation (RDA 1200-1500 mg/day), 800 mg/day is probably appropriate, particularly if low doses of vitamin D are taken concomitantly.             PMID:10417956