The role of calcium in the prevention and treatment of diseases of the musculoskeletal system is extremely important, if not paramount. In general, calcium is one of the most important macronutrients in our body, its role is not limited to building bone tissue, as many people think. Calcium is an element without which human life is impossible. It plays a crucial role in many metabolic processes, many enzymes work only in its presence, it is a catalyst for most biochemical reactions. Here is just a small list of functions that calcium performs in the body: Participates in the formation of bone, cartilage and other types of connective tissue; Carries intracellular information; Plays a primary role in the process of muscle contraction; Acts as a catalyst in chemical reactions; Regulates the process of blood coagulation; Included in the chemical composition of many proteins and other biologically important substances. Calcium must be supplied with food and, rather, in large quantities. It is especially important in early childhood, during pregnancy and after menopause in women. During the period of active growth of the skeleton, namely up to 24 years, it is simply necessary to consume a sufficient amount of calcium. According to Goulding A., calcium deficiency during the period of active skeletal growth in childhood leads to an increased risk of fractures in the future, even in young people. And, of course, it is very important to monitor its intake in various diseases of the ligamentous tissue and the musculoskeletal system as a whole. Also obvious is the positive effect of calcium for the prevention of diseases of the musculoskeletal system, as well as in combination therapy with other drugs. Calcium is a key component in the prevention and treatment of osteoporosis. Here are just a few examples of the positive effects of calcium intake. Data from meta-analyses of randomized clinical trials show high efficacy of calcium supplementation. Approximately 370,000 people participated in the study and 100% were found to have no bone loss compared to placebo subjects (National Institute for Health and Clinical Excellence/ 2008). Calcium is successfully used for the rapid growth of bone tissue in fractures. A large study carried out back in 1992 Chapuy M.S. et al. studied about 3,000 patients with hip fractures aged 69 years and over. A clinical study showed successful bone healing in 100% of subjects compared to placebo-treated participants. Now, not a single therapeutic therapeutic program for diseases of the musculoskeletal system, in particular osteoporosis, arthrosis, can do without the inclusion of calcium supplements (or increased calcium intake from food). This is due to several factors. Firstly, most of the medicines prescribed for the treatment of diseases (calcitonins, biophosphonates) have a pronounced hypocalcemic effect (wash out calcium from the body). Secondly, after stopping the course of drugs, there is a sharp increase in bone resorption. In general, 99% of calcium is found in bone tissue, and it is natural that in case of a malfunction of the musculoskeletal system, with any problems of the connective tissue, it is simply necessary to include additional calcium in your diet. Therefore, the intake of foods rich in calcium is necessary in the diet therapy of diseases of the bones and joints. A study conducted in 2003 in Scotland (SIGN national clinical guideline Management of osteoporosis) proved the ability of calcium to slow age-related bone loss and reduce the risk of fractures associated with osteoporosis. Calcium is simply necessary in the fight against age-related changes in bone tissue in post-menopausal women. Due to the insufficient production of certain hormones – estrogen, in women there is a softening of the bone tissue, as well as an active leaching of calcium. Just the same during menopause, the risk of developing arthritis, osteoporosis, hip fracture and other diseases increases. Therefore, experts recommend including a large amount of calcium-rich foods in the diet of women after 45 years of age. According to a meta-analysis (Toroptsova N.V. et al.), adequate calcium intake in the risk group of women over 45 years of age reduces the risk of bone fractures associated with osteoporosis by 100%. Calcium in the diet of a person with ODA diseases The problem of adequate calcium intake with food is very acute all over the world. According to statistics (NAS, Optimal Calcium Intake. Osteoporosis Clinical Updates, 2008) in the US and Europe, only about 20% get enough calcium from food. People at risk (women over 45 and men over 50) also do not get enough calcium. For example, a study conducted in 9 European countries showed that post-menopausal women consume 500-700 mg of calcium per day, which is not normal for this population group. Only about 6% of women consumed enough calcium to prevent osteoporosis (about 1300 mg) (Bruyere O, Malaise O, Calcium daily food intake in European postmenopausal women. 2006). Of course, with already identified problems with the musculoskeletal system, when signs of degradation of the connective tissue (osteoporosis, arthrosis, rickets, scoliosis) have already been detected, experts prescribe additional administration of calcium with food and preparations based on it. But, as the studies cited above show, it is enough to include adequate amounts of calcium in the diet to prevent these diseases and fractures. This is important not only for people at risk, but in general for all population groups. When adjusting the diet and making up a diet for the prevention of ODA diseases, as well as using diet therapy for various connective tissue diseases, you need to know which foods contain enough calcium, how and with what to use them. The absorption of calcium is associated with its absorption in the large and small intestines. Its absorption is facilitated by a hormone-like substance – cholecalciferol (vitamin D3). This vitamin is usually synthesized in the skin under the influence of ultraviolet radiation. However, in winter, the sun is not enough, and foods containing vitamin D3 must also be added to the diet. It should be borne in mind that only 50% of the calcium consumed is absorbed by the body and integrated into the bone tissue. The norm of calcium intake for a middle-aged person is about 1000 mg For pregnant women and women after 18 years of age – these 1000 – 1200 mg For middle-aged men – 1000 mg For the prevention of bone tissue diseases, as well as during the post-menopause period – 1500 mg For men after 50 years – 1200 – 1500 mg For various degenerative diseases of the musculoskeletal system – 2000 mg It is important to know that there are a number of factors that interfere with the absorption of calcium or contribute to its leaching. So, coffee, tea, sugar, an excess of protein – worsen the absorption of calcium. Salt also affects absorption – excessive sodium intake in food increases the excretion of calcium in the urine (Lesnyak O.M.). Calcium absorption requires the presence of a small amount of fatty acids in food. On the other hand, the presence of a large amount of fat in the diet reduces the availability of calcium, since calcium forms insoluble compounds with certain fats. Factors affecting the absorption of calcium The state of the gastrointestinal tract Taking other medications In what form calcium is used (in what foods) The concentration of vitamin D in the body Fat content of food So what foods should be included in diet therapy to prevent calcium deficiency? First of all, these are dairy products. Milk, yogurt, kefir – contain a fairly high amount of calcium. But the champions are cottage cheese, soft and hard cheese. Cottage cheese and cheese are isolated milk proteins. And, as you know, milk calcium is in a bound state with milk proteins (albumin, casein-calcium complexes), which is why protein dairy products contain the largest amount of calcium. In addition, milk calcium is quite bioavailable, this is also due to the fact that milk protein is easily included in the metabolic process and calcium is perfectly absorbed in the intestines. There are practically no calcium antagonists in milk. What can you say about greenery. A well-known fact – greens (parsley, dill, sorrel, spinach) contain a lot of calcium. But the fact is that there are many antagonists of this ion in greens – phytins and oxalic acid bind calcium and prevent its absorption in the intestines. However, greens contain vitamin D, so it should not be neglected. Beans and many vegetables (broccoli, turnips) also contain a lot of calcium, but not all of it is absorbed due to the inhibitors present in them. Soy products (soy milk, soy foam, tofu) are a good source of calcium and, despite the inhibitors they contain, they still contain enough calcium. Nuts are an excellent source of calcium. Hazelnut, almond, walnut – contain a high percentage of calcium, as well as many other useful macronutrients needed by the body. A good source of calcium is fish, especially sea fish. In addition, fish contains vitamin D, which is necessary for the incorporation of calcium into metabolism. Surprisingly, an excellent and complete source of calcium are sesame and poppy. There is more calcium in 100 g of sesame than in cottage cheese, there are no inhibitors that interfere with the absorption of the ion in the seeds. Therefore, it is worth recommending to include ground sesame seeds and poppy seeds (in the form of sesame flour, for example) in the diet during diet therapy for diseases of the musculoskeletal system. In addition to the high content of calcium, these seeds contain essential fatty acids, amino acids, trace elements.