Acute Effects Of Oral Calcium Carbonate With And Without The Addition Of Omeprazole And Fiber Enriched Milk On Serum Calcium Concentrations In Postmenopausal Women

  • Paula Aragão Prazeres Oliveira
  • Maria Mariana Barros Melo Silveira Universidade de Pernambuco
  • Leiliandry Araújo Melo
  • Isabela Cristina Cordeiro Farias
  • Maria Elba Bandeira Farias
  • Ana Carla Peres Montenegro
  • Francisco Alfredo Bandeira Farias


Introduction: In recent years, some studies have shown an increase in cardiovascular risk due to the use of calcium supplements in excess of the recommended doses. One hypothesis is that some calcium supplements lead to a more pronounced elevation of serum calcium concentrations.

Objectives: The aim of this study was to evaluate the serum calcium responses after ingestion of calcium carbonate, with and without the prior use of omeprazole, and after ingestion of soluble fiber enriched milk (SFM).

Method: Five postmenopausal women were evaluated in three phases. For each phase, the serum calcium responses were determined at 0h (baseline), 1h, 2h, 3h and 4h. After ingestion of 1200mg of calcium, both for the patients who received the calcium carbonate and for those who received SFM. The rise in serum calcium observed after ingestion of calcium carbonate with a calcium peak of 0.56 mg/dl (p=0.032), and it was higher when compared to SFM 0.26 mg/dl (p=0.284). There was no significant elevation of serum calcium after ingestion of SFM.

Results: The calcium responses were negative after the administration of omeprazole in comparison with the use of calcium carbonate and SFM, reaching 7.06mg/dl vs 9.04mg/dl vs 9.12mg/dl at 0h, 5.30mg/dl vs 9. 32mg/dl vs 9.00mg/dl at 1hr, 5.52mg/dl vs 9.48mg/dl vs 9.32mg/dl at 2hr, 5.18mg/dl vs 9.48mg/dl vs 9.34mg/dl at, respectively. In conclusion, our data show that the same amount of SFM induced a lower serum calcium response when compared to calcium carbonate.

Conclusion: The use of omeprazole significantly reduced the intestinal absorption of calcium carbonate.


1. Huertas EL, Teucher B, Boza JJ: Absorption of calcium from milks enriched with fructo-oligosaccharides, caseinophosphopeptides, tricalcium ph osphate, and milk solids. Am J Clin Nutr. 2006;83:310–6.

2. Karp HJ, Ketola ME, Lamberg-Allardt JC: Acute effects of calcium carbonate, calcium citrate and potassium citrate on markers of calcium and bone metabolism in young women. British J of Nutr. 2009;102:1341-1347.

3. Allen LH: Calcium bioavailability and absorption: a review. Am J Clin Nutr. 1982;35:783-808.

4. Miller DD: Calcium in the diet: food sources, recommended intakes, and nutritional bioavailability. Adv Food Nutr Res. 1989;33:103-56.

5. Green H, Boot C, Bunning R: Postprandial metabolic responses to milk enriched with milk calcium are different from responses to milk enriched with calcium carbonate. Asia Pacific J Clin Nutr. 2003;12:109-119.

6. Yang RS, Liu TK, Tsai KS: The acute metabolic effects of oral tricalcium phosphate and calcium carbonate. Calcif Tissue Int. 1994;55: 335–341.

7. Reginster JY, Denis D, Bartsch V: Acute biochemical variations induced by four different calcium salts in healthy male volunteers. Osteoporosis Int. 1993;3: 271–275.

8. Zikán V, Roubal P, Haas T: Acute effects of calcium carbonate and milk on the calcium-parathyroid axis and bone resorption in healthy women. In: Burckhardt P, Dawson-Hughes B, Heaney RP (eds) “Nutritional Aspects of Osteoporosis: Proceedings of the 4th International Symposium, Lausanne” May 2000, London: Academic Press. 2001;131–140.

9. Martini L, Wood RJ: Relative bioavailability of calcium-rich dietary sources in the elderly. Am J Clin Nutr. 2002;76:1345-50.

10. Bostick RM, Kushi LH, Wu Y: Relation of calcium, vitamin D and dairy food intake to ischemic heart disease mortality among postmenopausal women. Am J Epidemiol. 1999;30:1772-9.

11. Autier P, Gandini S: Vitamin D supplementation and total mortality: a meta-analysis of randomized controlled trials. Arch Intern Med. 2007;167:1730-7.

12. Bolland MJ, Avenell A, Baron JA: Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. Br Med J. 2010;341:c3691.

13. Ivanovich P, Fellows H, Rich C: The absorption of calcium carbonate. Ann Intern Med. 1967;66:917-23.

14. Wood RJ, Serfaty-Lacrosniere C: Gastric acidity, atrophic gastritis, and calcium absorption. Nutr Rev. 1992;50:33-40.

15. Tetsuhide I, Jensen RT: Association of Long-term Proton Pump Inhibitor Therapy with Bone Fractures and effects on Absorption of Calcium, Vitamin B12, Iron, and Magnesium. Curr Gastroenterol Rep. 2010;12: 448–457.

16. Spencer H, Norris C, Derler J: Effect of oat bran muffins on calcium absorption and calcium, phosphorus, magnesium and zinc balance in men. J Nutr. 1991;121:1976–1983.

17. Balasubramanian R, Johnson EJ, Marlett JA: Effect of wheat bran on bowel function and fecal calcium in older adults. J Am Coll Nutr. 1987;6:199–208.

18. Behall KM, Scholfield DJ, McIvor ME: Effect of guargum on mineral balances in NIDDM adults. Diabetes Care. 1989;12:357–364.

19. Coudray C, Bellanger J, Castiglia-Delavaud C: Effect of soluble or partly soluble dietary fibres supplementation on absorption and balance of calcium, magnesium, iron and zinc in healthy young men. Eur J Clin Nutr. 1997;51:375–380.

20. Shah M, Chandalia M, Adams-Huet B: Effect of a High-Fiber Diet Compared With a Moderate-Fiber Diet on Calcium and Other Mineral Balances in Subjects With Type 2 Diabetes. Diabetes Care. 2009;32:990-995.

21. Bo-Linn GW, Davis GR, Buddrus DJ: An evaluation of the importance of gastric acid secretion in the absorption of dietary calcium. J Clin Invest. 1984;73:640-7.

22. Graziani G, Como G, Badalamenti S: Effect of gastric acid secretion on intestinal phosphate and calcium absorption in normal subjects. Nephrol Dial Transplant. 1995;10:1376–1380.

23. Gerson LB: The Final Word on Proton Pump Inhibitors and Oesteoporosis? Gastroenterology. 2013; 144: 650-652.

24. Yang YX, Lewis JD, Epstein S: Long-term Proton Pump Inhibitor Therapy and Risk of Hip Fracture. JAMA. 2006;296:2947-2953.

25. Yu Ew, Blackwell T, Ensrud Ke: Acid-suppressive medications and risk of bone loss and fracture in older adults. Calcif Tissue Int. 2008;83:251–259.

26. Gray SL, LaCroix AZ, Larson L: Proton pump inhibitor use, hip fracture, and change in bone mineral density in postmenopausal women. Arch Intern Med. 2010;170:765–771.

27. Targownik LE, Lix Lm, Leung S: Proton-pump inhibitor use is not associated with osteoporosis or accelerated bone mineral density loss. Gastroenterology. 2010;138:896–904.

28. Ye X, Liu H, Wu C: Proton pump inhibitors therapy and risk of hip fracture: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2011;23:794–800.

29. Chun-Sick E, Sang M, Seung-Kwon M: Use of Acid-Suppressive Drugs and Risk of Fracture: A Meta-analysis of Observational Studies. Ann Fam Med. 2011;9:257-267.

30. Bristow SM, Gamble G, Stewart A: Acute effects of calcium citrate with or without a meal, calcium-fortified juice and a dairy product meal on serum calcium and phosphate: a randomised cross-over trial. Br J Nutri. 2015;113: 1585–1594.
How to Cite
OLIVEIRA, Paula Aragão Prazeres et al. Acute Effects Of Oral Calcium Carbonate With And Without The Addition Of Omeprazole And Fiber Enriched Milk On Serum Calcium Concentrations In Postmenopausal Women. International Archives of Medicine, [S.l.], v. 10, may 2017. ISSN 1755-7682. Available at: <>. Date accessed: 13 dec. 2018. doi: