Absorbability and cost effectiveness in calcium supplementation

R. P. Heaney, M. S. Dowell, J. Bierman, C. A. Hale, A. Bendich

Research output: Contribution to journalArticle

113 Citations (Scopus)

Abstract

Background: Cost-effectiveness of calcium supplementation depends not only on the cost of the product but on the efficiency of its absorption. Published cost-benefit analyses assume equal bioavailability for all calcium sources. Some published studies have suggested that there are differences in both the bioavailability and cost of the major calcium supplements. Design: Randomized four period, three-way cross-over comparing single doses of off-the-shelf commercial calcium supplements containing either calcium carbonate or calcium citrate compared with a no-load blank and with encapsulated calcium carbonate devoid of other ingredients; subjects rendered fully vitamin D-replete with 10 μg/day 25(OH)D by mouth, starting one week prior to the first test. Subjects: 24 postmenopausal women Methods: Pharmacokinetic analysis of the increment in serum total and ionized calcium and the decrement in serum iPTH induced by an oral calcium load, based upon multiple blood samples over a 24-hour period; measurement of the rise in urine calcium excretion. Data analyzed by repeated measures ANOVA. Cost calculations based on average retail prices of marketed products used in this study from April through October, 2000. Results: All three calcium sources (marketed calcium carbonate, encapsulated calcium carbonate and marketed calcium citrate) produced identical 24-hour time courses for the increment in total serum calcium. Thus, these were equally absorbed and had equivalent bioavailability. Urine calcium rose slightly more with the citrate than with the carbonate preparations, but the difference was not significant. Serum iPTH showed the expected depression accompanying the rise in serum calcium, and there were no significant differences between products. Conclusion: Given the equivalent bioavailability of the two marketed products, the cost benefit analysis favors the less expensive carbonate product.

Original languageEnglish
Pages (from-to)239-246
Number of pages8
JournalJournal of the American College of Nutrition
Volume20
Issue number3
StatePublished - 2001

Fingerprint

cost effectiveness
Cost-Benefit Analysis
Calcium
calcium
Calcium Carbonate
blood serum
Biological Availability
calcium carbonate
Calcium Citrate
bioavailability
Serum
citrates
Carbonates
Costs and Cost Analysis
carbonates
Urine
mouth
urine
cost benefit analysis
Vitamin D

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Food Science

Cite this

Heaney, R. P., Dowell, M. S., Bierman, J., Hale, C. A., & Bendich, A. (2001). Absorbability and cost effectiveness in calcium supplementation. Journal of the American College of Nutrition, 20(3), 239-246.

Absorbability and cost effectiveness in calcium supplementation. / Heaney, R. P.; Dowell, M. S.; Bierman, J.; Hale, C. A.; Bendich, A.

In: Journal of the American College of Nutrition, Vol. 20, No. 3, 2001, p. 239-246.

Research output: Contribution to journalArticle

Heaney, RP, Dowell, MS, Bierman, J, Hale, CA & Bendich, A 2001, 'Absorbability and cost effectiveness in calcium supplementation', Journal of the American College of Nutrition, vol. 20, no. 3, pp. 239-246.
Heaney RP, Dowell MS, Bierman J, Hale CA, Bendich A. Absorbability and cost effectiveness in calcium supplementation. Journal of the American College of Nutrition. 2001;20(3):239-246.
Heaney, R. P. ; Dowell, M. S. ; Bierman, J. ; Hale, C. A. ; Bendich, A. / Absorbability and cost effectiveness in calcium supplementation. In: Journal of the American College of Nutrition. 2001 ; Vol. 20, No. 3. pp. 239-246.
@article{31fd913237d44b0cb071e85f60d7d3dd,
title = "Absorbability and cost effectiveness in calcium supplementation",
abstract = "Background: Cost-effectiveness of calcium supplementation depends not only on the cost of the product but on the efficiency of its absorption. Published cost-benefit analyses assume equal bioavailability for all calcium sources. Some published studies have suggested that there are differences in both the bioavailability and cost of the major calcium supplements. Design: Randomized four period, three-way cross-over comparing single doses of off-the-shelf commercial calcium supplements containing either calcium carbonate or calcium citrate compared with a no-load blank and with encapsulated calcium carbonate devoid of other ingredients; subjects rendered fully vitamin D-replete with 10 μg/day 25(OH)D by mouth, starting one week prior to the first test. Subjects: 24 postmenopausal women Methods: Pharmacokinetic analysis of the increment in serum total and ionized calcium and the decrement in serum iPTH induced by an oral calcium load, based upon multiple blood samples over a 24-hour period; measurement of the rise in urine calcium excretion. Data analyzed by repeated measures ANOVA. Cost calculations based on average retail prices of marketed products used in this study from April through October, 2000. Results: All three calcium sources (marketed calcium carbonate, encapsulated calcium carbonate and marketed calcium citrate) produced identical 24-hour time courses for the increment in total serum calcium. Thus, these were equally absorbed and had equivalent bioavailability. Urine calcium rose slightly more with the citrate than with the carbonate preparations, but the difference was not significant. Serum iPTH showed the expected depression accompanying the rise in serum calcium, and there were no significant differences between products. Conclusion: Given the equivalent bioavailability of the two marketed products, the cost benefit analysis favors the less expensive carbonate product.",
author = "Heaney, {R. P.} and Dowell, {M. S.} and J. Bierman and Hale, {C. A.} and A. Bendich",
year = "2001",
language = "English",
volume = "20",
pages = "239--246",
journal = "Journal of the American College of Nutrition",
issn = "0731-5724",
publisher = "American College Of Nutrition",
number = "3",

}

TY - JOUR

T1 - Absorbability and cost effectiveness in calcium supplementation

AU - Heaney, R. P.

AU - Dowell, M. S.

AU - Bierman, J.

AU - Hale, C. A.

AU - Bendich, A.

PY - 2001

Y1 - 2001

N2 - Background: Cost-effectiveness of calcium supplementation depends not only on the cost of the product but on the efficiency of its absorption. Published cost-benefit analyses assume equal bioavailability for all calcium sources. Some published studies have suggested that there are differences in both the bioavailability and cost of the major calcium supplements. Design: Randomized four period, three-way cross-over comparing single doses of off-the-shelf commercial calcium supplements containing either calcium carbonate or calcium citrate compared with a no-load blank and with encapsulated calcium carbonate devoid of other ingredients; subjects rendered fully vitamin D-replete with 10 μg/day 25(OH)D by mouth, starting one week prior to the first test. Subjects: 24 postmenopausal women Methods: Pharmacokinetic analysis of the increment in serum total and ionized calcium and the decrement in serum iPTH induced by an oral calcium load, based upon multiple blood samples over a 24-hour period; measurement of the rise in urine calcium excretion. Data analyzed by repeated measures ANOVA. Cost calculations based on average retail prices of marketed products used in this study from April through October, 2000. Results: All three calcium sources (marketed calcium carbonate, encapsulated calcium carbonate and marketed calcium citrate) produced identical 24-hour time courses for the increment in total serum calcium. Thus, these were equally absorbed and had equivalent bioavailability. Urine calcium rose slightly more with the citrate than with the carbonate preparations, but the difference was not significant. Serum iPTH showed the expected depression accompanying the rise in serum calcium, and there were no significant differences between products. Conclusion: Given the equivalent bioavailability of the two marketed products, the cost benefit analysis favors the less expensive carbonate product.

AB - Background: Cost-effectiveness of calcium supplementation depends not only on the cost of the product but on the efficiency of its absorption. Published cost-benefit analyses assume equal bioavailability for all calcium sources. Some published studies have suggested that there are differences in both the bioavailability and cost of the major calcium supplements. Design: Randomized four period, three-way cross-over comparing single doses of off-the-shelf commercial calcium supplements containing either calcium carbonate or calcium citrate compared with a no-load blank and with encapsulated calcium carbonate devoid of other ingredients; subjects rendered fully vitamin D-replete with 10 μg/day 25(OH)D by mouth, starting one week prior to the first test. Subjects: 24 postmenopausal women Methods: Pharmacokinetic analysis of the increment in serum total and ionized calcium and the decrement in serum iPTH induced by an oral calcium load, based upon multiple blood samples over a 24-hour period; measurement of the rise in urine calcium excretion. Data analyzed by repeated measures ANOVA. Cost calculations based on average retail prices of marketed products used in this study from April through October, 2000. Results: All three calcium sources (marketed calcium carbonate, encapsulated calcium carbonate and marketed calcium citrate) produced identical 24-hour time courses for the increment in total serum calcium. Thus, these were equally absorbed and had equivalent bioavailability. Urine calcium rose slightly more with the citrate than with the carbonate preparations, but the difference was not significant. Serum iPTH showed the expected depression accompanying the rise in serum calcium, and there were no significant differences between products. Conclusion: Given the equivalent bioavailability of the two marketed products, the cost benefit analysis favors the less expensive carbonate product.

UR - http://www.scopus.com/inward/record.url?scp=0034954644&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034954644&partnerID=8YFLogxK

M3 - Article

C2 - 11444420

AN - SCOPUS:0034954644

VL - 20

SP - 239

EP - 246

JO - Journal of the American College of Nutrition

JF - Journal of the American College of Nutrition

SN - 0731-5724

IS - 3

ER -