Nutrition Recommendations and Interventions for Diabetes

Smart Snacks in Schools

Adobe Acrobat Reader Learn & Support
More research is needed to make recommendations for or against fish oil supplementation as far as prostate cancer is concerned. Decreased intracellular calcium concentrations in turn increase fat breakdown and discourage fat accumulation in these cells [ ]. Stephanie's Freezer Spaghetti Sauce. People with this condition are unable to consume any products containing cow's milk proteins and are therefore at higher risk of obtaining insufficient calcium. Stella is a competitive athlete in field hockey, rowing, and ice hockey. The greater the peak bone mass, the longer one can delay serious bone loss with increasing age. Does not appear to augment nor alleviate the immunosuppression that occurs during exercise in otherwise healthy persons.

Customers who viewed this item also viewed

National School Lunch Program

In a follow-up study to the Calcium Polyp Prevention Study, supplementation with calcium carbonate led to reductions in the risk of adenoma a nonmalignant tumor in the colon, a precursor to cancer [ 63 , 64 ], even as long as 5 years after the subjects stopped taking the supplement [ 65 ]. But other observational studies have found the associations to be inconclusive [ 62 , 67 , 68 ].

In the Women's Health Initiative, a clinical trial involving 36, postmenopausal women, daily supplementation with 1, mg of calcium and International Units IU of vitamin D 3 for 7 years produced no significant differences in the risk of invasive colorectal cancer compared to placebo [ 69 ]. The authors of a Cochrane systematic review concluded that calcium supplementation might moderately help prevent colorectal adenomas, but there is not enough evidence to recommend routine use of calcium supplements to prevent colorectal cancer [ 70 ].

Given the long latency period for colon cancer development, long-term studies are needed to fully understand whether calcium intakes affect colorectal cancer risk. Several epidemiological studies have found an association between high intakes of calcium, dairy foods or both and an increased risk of developing prostate cancer [ ].

However, others have found only a weak relationship, no relationship, or a negative association between calcium intake and prostate cancer risk [ ].

The authors of a meta-analysis of prospective studies concluded that high intakes of dairy products and calcium might slightly increase prostate cancer risk [ 82 ]. Interpretation of the available evidence is complicated by the difficulty in separating the effects of dairy products from that of calcium. Calcium has been proposed to help reduce cardiovascular disease CVD risk by decreasing intestinal absorption of lipids, increasing lipid excretion, lowering cholesterol levels in the blood, and promoting calcium influx into cells [ 1 ].

However, data from prospective studies of calcium's effects on CVD risk are inconsistent, and whether dietary calcium has different effects on the cardiovascular system than supplemental calcium is not clear.

Other prospective studies have shown no significant associations between calcium intake and cardiac events or cardiovascular mortality [ 83 ]. Data for stroke are mixed, with some studies linking higher calcium intakes to lower risk of stroke, and others finding no associations or trends in the opposite direction [ 83 , 85 ]. Several studies have raised concerns that calcium from supplements might increase the risk of CVD, including myocardial infarction and coronary heart disease [ ].

While there is no established biological mechanism to support an association between calcium and CVD, some scientists hypothesize that excessively high calcium intakes from supplements might override normal homeostatic controls of serum calcium levels and produce a temporary hypercalcemia [ 85 , 91 , 92 ].

Hypercalcemia is associated with increased blood coagulation, vascular calcification, and arterial stiffness, all of which raise CVD risk [ 90 , 91 , 93 , 94 ]. Many scientists question the strength of the available evidence linking supplemental calcium intake with CVD risk, noting that no clinical trials were designed primarily to evaluate this potential relationship, so researchers have only considered CVD outcomes in secondary analyses of trial data [ 93 , 95 , 96 ].

Based on a systematic review and meta-analysis of 4 randomized trials and 27 observational studies [ 97 ], the American Society for Preventive Cardiology and the National Osteoporosis Foundation concluded that there is "moderate-quality evidence" that calcium with or without vitamin D from supplements or foods "has no relationship beneficial or harmful with the risk for cardiovascular and cerebrovascular disease, mortality, or all-cause mortality in generally healthy adults" [ 92 ].

They added that based on the evidence to date, "calcium intake from food and supplements that does not exceed the [UL] should be considered safe from a cardiovascular standpoint. Several clinical trials have demonstrated a relationship between increased calcium intakes and both lower blood pressure and risk of hypertension [ ], although the reductions are inconsistent. In the Women's Health Study, calcium intake was inversely associated with risk of hypertension in middle-aged and older women [ ].

However, other studies have found no association between calcium intake and incidence of hypertension [ 83 ]. The authors of a systematic review of the effects of calcium supplements for hypertension found any link to be weak at best, largely due to the poor quality of most studies and differences in methodologies [ ].

Calcium's effects on blood pressure might depend upon the population being studied. In hypertensive subjects, calcium supplementation appears to lower systolic blood pressure by 2—4 mmHg, whereas in normotensive subjects, calcium appears to have no significant effect on systolic or diastolic blood pressure [ 83 ]. Other observational and experimental studies suggest that individuals who eat a vegetarian diet high in minerals such as calcium, magnesium, and potassium and fiber and low in fat tend to have lower blood pressure [ 48 , ].

The diet containing dairy products resulted in the greatest decrease in blood pressure [ ], although the contribution of calcium to this effect was not evaluated. Studies suggest that calcium supplementation during pregnancy reduces the risk of preeclampsia, but the benefits may apply only to populations with inadequate calcium intakes [ , ].

For women with higher dietary calcium intakes, however, the reduction in preeclampsia risk was not statistically significant. Several professional organizations recommend calcium supplements during pregnancy for women with low calcium intakes to reduce the risk of preeclampsia.

Similarly, the World Health Organization WHO recommends 1,—2, mg calcium for pregnant women with low dietary calcium intakes, particularly those at higher risk of gestational hypertension [ ]. The WHO also recommends separating calcium and prenatal iron supplements by several hours to minimize the inhibitory effects of calcium on iron absorption. But some researchers argue that this interaction has minimal clinical significance and suggest that providers not counsel patients to separate the supplements to simplify the supplement regimen and facilitate adherence [ ].

Kidney stones in the urinary tract are most commonly composed of calcium oxalate. Some, but not all, studies suggest a positive association between supplemental calcium intake and the risk of kidney stones, and these findings were used as the basis for setting the calcium UL in adults [ 1 ].

The Nurses' Health Study also showed a positive association between supplemental calcium intake and kidney stone formation [ ]. High intakes of dietary calcium, on the other hand, do not appear to cause kidney stones and may actually protect against developing them [ 1 , ].

For most individuals, other risk factors for kidney stones, such as high intakes of oxalates from food and low intakes of fluid, probably play a bigger role than calcium intake [ ]. Several studies have linked higher calcium intakes to lower body weight or less weight gain over time [ ]. Two explanations have been proposed. First, high calcium intakes might reduce calcium concentrations in fat cells by decreasing the production of parathyroid hormone and the active form of vitamin D.

Decreased intracellular calcium concentrations in turn increase fat breakdown and discourage fat accumulation in these cells [ ]. Secondly, calcium from food or supplements might bind to small amounts of dietary fat in the digestive tract and prevent its absorption [ , , ]. Dairy products, in particular, might contain additional components that have even greater effects on body weight than their calcium content alone would suggest [ , ].

Despite these findings, the results from clinical trials have been largely negative. Three reviews of published studies on calcium from supplements or dairy products on weight management came to similar conclusions [ 83 , , ].

A meta-analysis of 13 randomized controlled trials published in concluded that neither calcium supplementation nor increased dairy product consumption had a statistically significant effect on weight reduction [ ].

More recently, a evidence report from the Agency for Healthcare Research and Quality concluded that, overall, clinical trial results do not support an effect of calcium supplementation on weight loss [ 83 ]. Also, a meta-analysis of 29 randomized controlled trials found no benefit of an increased consumption of dairy products on body weight and fat loss in long-term studies [ ].

Overall, the results from clinical trials do not support a link between higher calcium intakes and lower body weight or weight loss. For additional information on calcium and weight management, see our health professional fact sheet on Weight Loss. Excessively high levels of calcium in the blood known as hypercalcemia can cause renal insufficiency, vascular and soft tissue calcification, hypercalciuria high levels of calcium in the urine and kidney stones [ 1 ].

Although very high calcium intakes have the potential to cause hypercalcemia [ 85 ], it is most commonly associated with primary hyperparathyroidism or malignancy [ 1 ]. High calcium intake can cause constipation. It might also interfere with the absorption of iron and zinc, though this effect is not well established [ 1 ].

High intake of calcium from supplements, but not foods, has been associated with increased risk of kidney stones [ 1 , , ]. Some evidence links higher calcium intake with increased risk of prostate cancer, but this effect is not well understood, in part because it is challenging to separate the potential effect of dairy products from that of calcium [ 1 ]. Some studies also link high calcium intake, particularly from supplements, with increased risk of cardiovascular disease [ , 90 , 91 ].

Getting too much calcium from foods is rare; excess intakes are more likely to be caused by the use of calcium supplements. Calcium supplements have the potential to interact with several types of medications. This section provides a few examples.

Individuals taking these medications on a regular basis should discuss their calcium intake with their healthcare providers. Calcium can decrease absorption of the following drugs when taken together: Thiazide-type diuretics can interact with calcium carbonate and vitamin D supplements, increasing the risks of hypercalcemia and hypercalciuria [ ].

Both aluminum- and magnesium-containing antacids increase urinary calcium excretion. Mineral oil and stimulant laxatives decrease calcium absorption.

Glucocorticoids, such as prednisone, can cause calcium depletion and eventually osteoporosis when they are used for months [ ]. The federal government's Dietary Guidelines for Americans notes that "Nutritional needs should be met primarily from foods.

Foods in nutrient-dense forms contain essential vitamins and minerals and also dietary fiber and other naturally occurring substances that may have positive health effects. In some cases, fortified foods and dietary supplements may be useful in providing one or more nutrients that otherwise may be consumed in less-than-recommended amounts.

For more information about building a healthy diet, refer to the Dietary Guidelines for Americans and the U. Department of Agriculture's MyPlate. This fact sheet by the Office of Dietary Supplements ODS provides information that should not take the place of medical advice. We encourage you to talk to your healthcare providers doctor, registered dietitian, pharmacist, etc. Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice.

March 2, History of changes to this fact sheet. Strengthening Knowledge and Understanding of Dietary Supplements. Calcium Fact Sheet for Health Professionals. National Academy Press, Department of Agriculture, Agricultural Research Service. Nutrient Data Laboratory Home Page, http: Calcium supplementation in clinical practice: Calcium absorption from apple and orange juice fortified with calcium citrate malate CCM.

J Am Coll Nutr ; Estimation of total usual calcium and vitamin D intakes in the United States. Dietary intake of selected minerals for the United States population: Advance Data from Vital and Health Statistics, number National Center for Health Statistics, Clarification of DRIs for calcium and vitamin D across age groups. J Am Diet Assoc.

Calcium absorption in women: J Bone Miner Res ;4: Isotopic exchange of ingested calcium between labeled sources: Calcif Tissue Int ; Human calcium absorption from whole-wheat products.

Choices for achieving adequate dietary calcium with a vegetarian diet. Am J Clin Nutr ; Bone mass, nutrition, and other lifestyle factors. The impact of dietary protein on calcium absorption and kinetic measures of bone turnover in women. J Clin Endocrinol Metab. Coffee-associated osteoporosis offset by daily milk consumption.

Caffeine, urinary calcium, calcium metabolism, and bone. Effects of alcohol on calcium homeostasis and bone. Anderson J, Garner S, eds. Calcium and Phosphorus in Health and Disease. Dietary phosphorus, calcium metabolism and bone. Carbonated beverages and urinary calcium excretion. Meta-analysis of the quantity of calcium excretion associated with the net acid excretion of the modern diet under the acid-ash diet hypothesis.

Am J Clin Nutr. Modern Nutrition in Health and Disease. Calcium, estrogen, and progestin in the treatment of osteoporosis. Rheum Dis Clin North Am ; Effect of estrogen on calcium absorption and serum vitamin D metabolites in postmenopausal osteoporosis.

J Clin Endocrinol Metab ; Estrogen therapy for osteoporosis prevention in postmenopausal women. A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women.

N Engl J Med ; Long-term effect of calcium supplementation on bone loss in perimenopausal women. J Bone Min Res ;9: Osteoporosis Handout on Health. American College of Obstetricians and Gynecologists. Hormone Therapy , April North American Menopause Society. The hormone therapy position statement of: The North American Menopause Society. Metabolic endocrinology appears to be only slightly more complicated than a nuclear reactor and brain surgery combined. No single hormone controls body composition, appetite, and hunger — and your individual hormonal profile may be relatively unique.

They were probably hungrier while losing that weight. A few things that likely are contributing to weight regain are that this was a diet. Reduce calories for 8 weeks, lose the weight, then hope things work out for you. Obviously since it worked for some people, this method has some merit. The macronutrient breakdown of this diet could also be relevant. We might see different hormonal effects with, say, a low-carb, high-fat, high-protein diet.

Strictly looking at improving ghrelin and leptin levels, some studies have shown that taking fish oil and getting regular sleep help. Many interacting hormones shape our appetite and hunger. Several factors affect these hormones and our response to them.

There are many things that you can do that will lead to lasting body composition change. The health and fitness world can sometimes be a confusing place. Click here to view the information sources referenced in this article.

Leptin, ghrelin, and weight loss. Here's what the research has to say. Why does this happen? Well, there are many reasons. Ghrelin is secreted primarily in the lining of the stomach. Hormone levels in weight maintainers WM and weight regainers WR , by sex. The role of leptin and ghrelin in the regulation of food intake and body weight in humans: The control of food intake: Fructose-induced leptin resistance exacerbates weight gain in response to subsequent high-fat feeding.

Region-specific leptin resistance within the hypothalamus of diet-induced obese mice. Symons, Mikhail Ermolenko and Craig A. Ghrelin secretion in humans is sexually dimorphic, suppressed by somatostatin, and not affected by the ambient growth hormone levels.

Beneficial effects of long-chain n-3 fatty acids included in an energy-restricted diet on insulin resistance in overweight and obese European young adults. Epub May Leptin and hunger levels in young healthy adults after one night of sleep loss. PLoS Med 1 3: As I continued to photograph, the dish slowly disappeared.

I mean, do you blame me? But all this fall hoopla had me wanting something different. So although this dish is a great alternative to eggs, it still actually contains eggs. The addition of pumpkin, apples, cinnamon, and pecans all boost the nutrient value with healthy fats and protein.

Great to make us feel fuller longer. This dish is a perfect addition to your fall breakfast routine. I love this time of year when I make pumpkin and apple dishes to remind me of the coziness of fall.

I enjoy the month break from pumpkin so that I appreciate it even more these few short months out of the year. Want to see just how easy this recipe is? Subscribe to get free weekly meal plans delivered straight to your inbox! And be sure to stay in touch on Facebook , Twitter , Pinterest and Instagram for all of the latest updates.

I love anything and everything pumpkin so this is perfect. Is there any substitution that you know of for the coconut milk? So glad you want to try! Do you have any nut milks by chance? The full fat stuff is the best, but another milk would also work. This is my first Whole30 and this looks amazing!

We are getting a little tired of our sweet potato, kale, egg hash every morning. So would it could as your vegetable because of the pumpkin , a fruit because of the apple and a fat because of the nuts and coconut milk? Just trying to think about what else we would need to eat with this.

Thanks for any suggestions! So yes, vegetable, fruit and fat, but also a bit of protein. It also depends on your breakfast appetite. Sometimes a slice of this can fill me up until noon, other times I want this first thing in the morning, and then I will eat again a few hours later. My husband is not a fan of eggs, so he will do this and a hemp protein shake. He says it fills him up until lunch. Hi Abby, without eggs it would be tough because of the custard consistency. You could try flax eggs to help it bind.

Yes, you can find it in the spice section of most grocery stores in the US. If out of country, you could make a blend of your own: There are plenty of pumpkin spice recipes out there! What is the calories, fats, carbs and protein percentage in each serving of the pumpkin apple breakfast bake? If you divide into 9 servings: If divided into 6 servings: Just made this and it is delicious. Do you by chance have any nutritional information for this recipe I.

I am trying to track what I eat along with my exercise program. You could try another nut milk almond, cashew, Flax, etc. I have only used the real thick coconut milk, but I still think it will work!

When you say full fat coconut milk…is that like a can of coconut milk from the Asian section? Or is is like Silk coconut milk? Maybe, but it probably needed to cook longer because of the silk. It could also be a difference in ovens, I would give it an extra minutes. Although a custard like texture is also yummy in this!

The recipe calls for 1 cup, so a small can would give you enough for 1 cup! I would love to have this! I think that would be a great idea to put in mini muffins! Cooking time will be shorter, check after around 20 mins. This is so very good — thanks for sharing! A couple edits to the recipe you might want to make for ease of use: This is not criticism at all, I just thought since the recipe is so popular you might want to make it fool-proof!

This is not Whole30 compliant. The ingredients may be, but baked goods are not allowed. By labeling it Whole30 you are setting people up to fail in doing a real Whole30 round. There is no gray area. It clearly states in the books and website, no baked goods. You need to do more research on what makes a meal Whole30 compliant.

Hi Jennifer, I appreciate your feedback. So I will take your advice and caution my readers who are doing Whole30 against eating this to satisfy a sweet tooth or as a dessert.

Annual Update for Current School Nutrition Program Sponsors