text: Calcium Requirement in Children If your child falls into any of the above categories, you should go to the doctor and see the highly touted mineral levels in virtually every television commercial for a popular children’s health drink claiming to be stronger, stronger, and faster in body and mind. It makes up about 3.5% of the earth’s crust and contains 99% of bones and teeth, the fifth most abundant element in the human body and ubiquitous minerals.
  Calcium, the main component of the human skeleton, gives us shape, growth, and structure. The pattern of how metabolic calcium absorption, along with bone mineral density, is present from adolescence to adulthood to old age is imprinted from the age of a fetus.
  At birth, about 25-30 g of calcium is accreted by a neonate which gets transferred across the placenta, mostly during the 3rd trimester when rapid ossification of collagen matrix happens.2 Such is the importance of this macromineral, that while one’s inside the womb, maternal calcium supply is regulated with various adaptions to meet the peak fetal demands like hormonal changes, increasing efficiency of intestinal absorption of calcium, increased renal conservation, and mobilization of calcium from the maternal skeleton.
  Maintenance of a mother’s calcium levels at the time of pregnancy is essential for catering to the increased calcium requirement of a rapidly mineralizing skeleton of fetus/neonate. The calcium homeostasis in pregnancy and lactation aid insufficient supply of calcium to the fetus, wherein calcium is pumped from the maternal circulation via the placenta to the newborn aided by maternal hormonal changes that ensure a sufficing calcium supply. Maternal calcium deficiency in a pregnant woman or exclusively lactating women can hinder cardiovascular development in the fetus and pose a risk of high blood pressure, increased body fat percentage, elevated triglycerides, and insulin resistance in children as they grow.
  Smiles of yellowish brittle teeth, prone to carries; Are hovered with weakness; afflicting the childhood with worries. Tiny little tots that tend to fall always, Are subjected to severe fractures that way. When rib joints appear like rosary beads, and Deformities ensue with bowed legs or knock knees, Ignorant to the calamities the little ones still try to run and play, Fetch that ball or climb the park slide.. Over looking the overt signs or lacking hygiene and proper diet, Is crushing the bones and dreams of your child. Pay heed to these warning signs, As health of your child is too precious to discount!
  Calcium- An Amazing Multitasker!
  The human body indeed is knit together with calcium, and despite being the most abundant mineral in the material universe, it still poses a real challenge in reaping its benefit due to challenging processes of absorption, uptake, and assimilation! It doesn`t work always in isolation as an ion, but essentially in synergy with certain factors like vital minerals and vitamins, which are so important that the absence/irregular levels of even one, manifest variations in calcium metabolism.
  The structural formation of human bones and calcified cartilage requires various minerals like phosphorus, magnesium, silicon, strontium, boron along with bound calcium; phosphorus in substantial amounts maintains the skeleton`s majority of calcium-phosphate complexes and hydroxyapatite. Vitamin D plays an indispensable hormonal role to maintain normal blood calcium levels and intestinal absorption of renal calcium and phosphorus.
  A vital mineral, whose maintained levels are extremely essential for the sustenance of life, is yet not synthesized by our bodies. And thus the responsibility falls on the external sources, for human bodies to acquire their daily calcium needs from dietary sources like dairy products (milk, yogurt, cheese), sardines and salmon with bones, dry fruits (figs and apricots), nuts, chickpeas, vegetables like spinach, cabbage, legumes (red beans, white beans), and soy products (tofu).
  Calcium Absorption: A process not so simple!
  Calcium absorption, being a sensitive process requires energy for transporting calcium to various organs; often achieved upon its chelation with proteins or amino acids for its increased absorption. Depending on the body’s needs, 50-70% of calcium ingested may be absorbed in the body during infancy and childhood. Infants have high calcium needs to support their rapid growth of bones and teeth; as they get older and enter adolescence, calcium needs almost double to cater to rapid bodily changes marked by puberty.
  Vitamins A and C also support normal membrane transport of calcium and proteins, and dietary fats favor calcium absorption, but excess of both can reduce the absorption, and cause its elimination via intestines. Milk is touted to be the poster child for acquiring calcium, be it breast milk or cow/buffalo’s milk, it’s a perfect blend of lactose with a protein-fat combo, providing easily assimilated calcium which aids in its absorption.
  Various homogenized fortified products like milk with synthetic vitamin D or nonfat milk don’t make a perfect source of calcium as they don’t aid in calcium absorption, and some may rather hinder it. Lactose intolerant kids or kids allergic to cow milk can opt for other calcium-rich dietary sources or go for calcium-rich soy milk, almond milk, rice or oat milk, and soy yogurt.
  Gastric hydrochloric acid aids in calcium absorption carried out in the duodenum of the small intestine. Excessive stress levels in adolescent kids have a visible effect on stomach acid levels, digestion, and intestinal motility which can affect calcium absorption. Kids who play and indulge in physical activities like outdoor sports, or regular yoga, exercises, dancing, etc. have improved calcium absorption. Lack of physical activities with a sedentary lifestyle, to top it with a lazy attitude reduces calcium absorption in the young bodies of kids.
  Absorption of calcium improves absorption of vitamin B12 as well, but excess can interfere with absorption of other competing minerals like zinc, magnesium, iron, etc. Dietary factors like phytates in whole grains or fiber-rich foods may hinder calcium absorption similar to foods high in oxalic acid (spinach, chocolate, etc.) interfere with calcium absorption which also forms insoluble salts in the gut.
  Calcium Requirement in Children
  0–6 months* | 200 mg | 200 mg |
  7–12 months* | 260 mg | 260 mg |
  1–3 years | 700 mg | 700 mg |
  4–8 years | 1,000 mg | 1,000 mg |
  9–13 years | 1,300 mg | 1,300 mg |
  14–18 years | 1,300 mg | 1,300 mg |
  19–50 years | 1,000 mg | 1,000 mg |
  * Adequate Intake (AI)
  Calcium Deficiency (Hypocalcemia)
  Younger kids, babies, and teens especially girls suffering from diseases like chronic kidney disease (CKD), impaired calcitriol production, etc., hormonal and electrolyte imbalances or whose diets are deficient in calcium and other nutrients like vitamin D, high in minerals like phosphorus (for eg: from sodas/soft drinks), are at a greater risk of developing weak bones and teeth; thus are prone to following medical conditions as they grow.
  A bone softening disease affecting children which cause severely bowed legs, stunted growth, muscle pain and weakness, weak and brittle nails result upon lack of dietary calcium, vitamin D, ample sunlight exposure, maternal nutritional deficiencies, and maternal diseases like osteomalacia.
  Normal calcium levels directly foster a healthy sleep cycle as it plays a vital role in the production of the sleep hormone, melatonin using tryptophan. Difficulties to sleep and insomnia observed in infants and young children are signs of less than normal levels of body calcium.
  Tingling, muscle tremors, confusion, poor memory, impaired sense of touch, numbness are observed in this condition wherein low blood calcium levels cause physical and neurological impairment.
  Insufficient levels of calcium and high phosphorus intake cause yellowish and brittle teeth, carry poor dentition, tooth loss, periodontal disease, and gingivitis among children.
  Occurs in pre-term infants affected with congenital hypoparathyroidism, causing hypotonia, abnormal heartbeat and breathing, tetany, etc.
  Excessive calcium levels in the human body are usually eliminated through urine and intestines at times, but a long-term overdose of calcium can result either due to sarcoidosis, hyperthyroidism, kidney function-associated disorders, vitamin D poisoning, diseases like CKD, or upon an excessive intake of calcitriol, etc. This leads to its accumulation: in kidneys, liver, gallbladder causing stone formation; in the arteries as plaques, in the vascular system of the head as calcified blood vessels of the brain and in joints as calcium deposits and malformed bones making the skeleton thin and weak.
  Calcium Levels: Low or High? Diagnose it beforehand!
  Based on the symptoms observed, a doctor analyses the patient’s medical and family history for any prior calcium-related conditions and prescribes the following tests for differential diagnosis and root cause analysis.
  A doctor taps on the facial areas to check for twitching (Chvostek’s sign) and uses a blood pressure cuff to detect any muscular spams (Positive Trousseau’s sign) in the patient suspected of hypocalcemia.
  Serum calcium, serum phosphorus, serum alkaline phosphatase levels are tested in blood samples taken to detect any changes in shape or structure of bones or joints, and limbs. Additional tests to measure levels of ionized calcium, phosphorous, magnesium, vitamin D, and parathyroid hormone to detect any underlying causes of abnormal calcium levels.
  An electrocardiogram is usually performed to check for prolonged QT interval, decreased myocardial contractility, and ventricular dysrhythmias in the hypo-calcemic patient. X-rays are taken to determine the presence of bone cysts, pathological fractures, demineralization, etc. Ultrasound, Computed Tomography (CT) Scan, Intravenous (IV) pyelogram are also done to determine calcifications, parathyroid glands adenoma, etc.
  Manage the dangers attached!
  Children as they grow, are in positive bone balance wherein the rate of formation of bone is higher than its resorption, ensuring healthy skeletal growth without compromising the skeleton for all of the body’s calcium needs. As the bones achieve peak bone mass, this bone balance becomes neutral when the formation is equal to the resorption of bones and is usually seen in healthy young adults. Any disorders observed with calcium levels are treated by supplementing the deficient nutrient/mineral along with prescribing medications to treat any underlying causative condition.
  Assessment of calcium intake following a well-rounded calcium-rich diet while leading an active lifestyle with regular exercises or mild/regular sports, ample sunlight exposure; establishing a positive attitude towards failures/disappointments right from a tender age will inculcate a sturdy foundation for overall health in years to come!
  Calcium-The teen bone builder,
  Leeches of your skeleton, when its levels go haywire!
  Protect your child before it strikes with perils.