9 Calcium absorption Inversely correlated Total calcium intakeDietary fiberAlcohol consumptionPhysical activityNo significant association: age, dietary protein, dietary phosphorus, caffeine consumption, or smokingRandi L Wolf et alFactors associated with calcium absorption efficiency in pre- and perimenopausal womenAmerican Journal of Clinical Nutrition, Vol. 72, No. 2, , August 2000
14 Percent of calcium absorption (mean+S.E.) Solubility (g/dl of water)Percent calcium absorption (mean+SE)Calcium acetate43.632+4Calcium lactate7.9Calcium gluconate3.8527+3Calcium citrate9.6x10-230+3Calcium carbonate5.6x10-339+3milk31+3ANOVA showed no statistical significantMudassir SS, et al. N Engl J Med 1987;317:532-6.
15 Ca is a threshold nutrient, there is no benefit in taking dose larger than dose recommended
16 Calcium carbonate: empty stomach calcium from carbonate and citrate is well absorbed in patients with normal stomachacidity and hyperacidity, while supplementation with fumarate and gluconate will be moreeffective in patients with hypoacidityCalcium carbonate: empty stomachBarbara DolinskaA Model for Calcium Permeation into Small IntestineBiol Trace Elem Res (2011) 142:456–464
19 The calcidiol level for clinical vitamin D inadequacy is < 35 ng/ml The prevalence of vitamin D inadequacy in Thai urbanized elderly women was 65.35%The elderly with vitamin D inadequacy has higher risk of femoral neck osteoporosis than the normal vitamin D (Odds ratio 2.87; p<0.03)Suppasin SoontrapaVitamin D inadequacy and the risk of osteoporosis in elderly womenSrinagarind Med J 2002; 17(3):p
20 รับแสงแดด นาทีที่บริเวณใบหน้าและแขนได้ vitamin D ประมาณ 200 IU