Tricalcium citrate (TCC) and health
Background:Calcium plays a key role in body physiology and bone health. Inadequate intake is common in certain groups of the population Methods:Systematic evaluation of relevant literature using medical (Medline) and nutrition databases and inclusion of physiological studies, randomized controlled trials, cohort studies, meta-analyses and dietary guidelines Results:Despite the essentiality of calcium for bone growth and maintenance, clinical studies and meta-analyses on positive effects of calcium supplementation on skeletal health and osteoporosis have shown contradictory results. Dietary recommendations for calcium have therefore been developed primarily in order to meet physiological needs. For individuals who are not able or willing to cover their recommended calcium requirements (1000-1200 mg / d for adolescents and adults in industrialized countries) from dietary sources, numerous calcium supplements such as CaCO3 ortricalciumdicitrate*4 H2O (TCC) are available. Of these, TCC is characterized by its good compliance, sufficient calcium content, a better absorbability than CaCO3 and a gastric acid-independent intestinal absorption. Despite the generally poor association between acute effects of high calcium absorption on serum calcium concentration and long term effects on BMD, bone structure and fracture incidence, a higher intake of calcium citrate (TCC) has led to increased bone mineral density and reduced bone loss in a number of randomized controlled studies in elderly women. Moreover, whereas in some clinical trials and meta-analyzes, (supplemental) calcium caused an increased risk for cardiovascular diseases and stroke as well as for kidney stones, a larger number of studies did not show this or even the opposite, in particular with calcium citrate. Conclusion:Supplemental TCC is a good opportunity to allow subjects at risk of inadequate calcium supply a calcium intake according to common recommendations. Small positive effects of TCC on bone health have been shown in numerous studies, but the study results are not fully consistent. There is no evidence for an increased cardiovascular disease or renal stone risk.
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