FiberCon

a chemical element, atomic number 20, atomic weight 40.08. (See Appendix 6.) Calcium is the most abundant mineral in the body. In combination with phosphorus it forms calcium phosphate, the dense, hard material of the bones and teeth. It is an important cation in intracellular and extracellular fluid and is essential to the normal clotting of blood, the maintenance of a normal heartbeat, and the initiation of neuromuscular and metabolic activities.

Within the body fluids calcium exists in three forms. Protein-bound calcium accounts for about 47 per cent of the calcium in plasma; most of it in this form is bound to albumin. Another 47 per cent of plasma calcium is ionized. About 6 per cent is complexed with phosphate, citrate, and other anions.

Ionized calcium is physiologically active. One of its most important physiological functions is control of the permeability of cell membranes. Parathyroid hormone, which causes transfer of exchangeable calcium from bone into the blood stream, maintains calcium homeostasis by preventing either calcium deficit or excess.

Hypercalcemia: This is when the level of serum calcium rises above normal; neuromuscular activity begins to diminish. Symptoms include lethargy, muscle weakness (which, as the level of calcium increases, can progress to depressed reflexes and hypotonic muscles), constipation, mental confusion, and coma. The heartbeat also slows, which potentiates the effects of digitalis.

Hypocalcemia: This is a serum level of calcium that is below normal; it is manifested by increased neuromuscular irritability. When there is a deficit of ionized calcium, the nerve cells become more permeable, allowing leakage of sodium and potassium from the cells. This produces excitation of the nerve fibers and triggers uncontrollable activity of the skeletal muscles. Hence, as the calcium level continues to drop, the patient begins to experience muscle twitching and cramping, grimacing, and carpopedal spasm, which can quickly progress to tetany, laryngospasm, convulsions, cardiac arrhythmias, and eventually to respiratory and cardiac arrest. Relatively early signs of hypocalcemia are a positive trousseau's sign and a positive chvostek's sign.

Dietary sources of calcium include dairy products (such as milk and cheese), soybeans, fortified orange juice, dark green leafy vegetables (such as mustard greens and broccoli), sardines, clams, and oysters. The recommended dietary allowance of calcium for children aged 4 to 8 is 800 mg, and that for women aged 50 to 70 is 1200 mg. (See tables in the Appendices for recommended dietary allowances across the life span.) It is difficult to meet these requirements without including milk or milk products in the daily diet. The most familiar calcium deficiency disease is rickets, in which the bones and teeth soften. However, it is believed that a large number of people suffer from subclinical calcium deficiency because of poor eating habits. Since calcium is essential to the formation and maintenance of strong bones, an adequate intake is important in the prevention of osteoporosis.

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