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2 . 2021

On the question of the application of calcium preparations for the purpose of optimizing the diets of the population, including and for different diseases

Abstract

In recent years, there has been a particular interest in the use of calcium in order to optimize the diet of the population. It is known that calcium, indirectly affecting nervous excitability, muscle contractility, hormone secretion and blood clotting, plays an important role in the human body. However, there is an opinion about the risks of calcium supplement intake, and concerns about possible adverse consequences are becoming more pronounced. In this regard, the aim of this study was to review the scientific literature on calcium supplement intake from the standpoint of the effectiveness of fortification of food rations and the occurrence of concomitant risks.

Results. The results of the analysis of numerous literature data allow us to conclude that due to the threat of calcium overdose and an increased risk of cardiovascular complications as a result of transient hypercalcemia, calcium intake from dietary sources is a priority, and calcium supplements should be prescribed only to patients with a serious risk of osteoporotic fractures and those individuals who, due to social reasons, cannot meet their daily nutritional needs. With equal effects, calcium consumption precisely from foods containing a sufficient amount of this micronutrient, in comparison with calcium supplements, provides the organism with other nutrients (proteins, amino acids, etc), without causing risks of side effects. It can be assumed that the results of risk-benefit assessments of calcium supplements in connection with the descriptions of risks to the cardiovascular, gastrointestinal, and urinary-excretory systems cannot be considered final. In view of the above, cautious use of calcium supplements is recommended, especially considering their possible interaction with various medications, including antihypertensive drugs, calcium channel blockers, synthetic thyroid hormones, bisphosphonates and antibiotics, etc.

Conclusion. Given the growing concern of the medical community about the role of calcium intake and the conflicting results of individual studies, it is clear that large-scale prospective cohort studies are needed to clarify the balance of benefits and risks of calcium supplementation in different populations, especially in the elderly.

Keywords:calcium, calcium supplements, calcium intake, enrichment of diet, efficiency, risks, complications

Funding. The study was not sponsored.

Conflict of interests. The authors declare no conflicts of interest.

For citation: Gureev S.A., Mingazova E.N. On the question of the application of calcium preparations for the purpose of optimizing the diets of the population, including and for different diseases. Voprosy pitaniia [Problems of Nutrition]. 2021; 90 (2): 6-14. DOI: https://doi.org/10.33029/0042-8833-2021-90-2-6-14 (in Russian)

References

1. Morelli M., Santulli G., Gambardella G. Calcium supplements: good for the bone, bad for the heart? A systematic updated appraisal. Editorial. Atherosclerosis. 2020; 296: 68–73. DOI: https://doi.org/10.1016/j.atherosclerosis.2020.01.008

2. Reid I.R., Bolland M.J., Avenell A., Grey A. Cardiovascular effects of calcium supplementation. Osteoporos Int. 2011; 22 (6): 1649–58. DOI: https://doi.org/10.1007/s00198-011-1599-9

3. Slinin Y., Blackwell T., Ishani A., Cummings S.R., Ensrud K.E. MORE Investigators. Serum calcium, phosphorus and cardiovascular events in post-menopausal women. Int J Cardiol. 2011; 149 (3): 335–40. DOI: https://doi.org/10.1016/j.ijcard.2010.02.013

4. Grandi N.C., Brenner H., Hahmann H., Wüsten B., März W., Rothenbacher D., et al. Calcium, phosphate and the risk of cardiovascular events and all-cause mortality in a population with stable coronary heart disease. Heart. 2012; 98 (12): 926–33. DOI: https://doi.org/10.1136/heartjnl-2011-300806

5. Van Hemelrijck M., Michaelsson K., Linseisen J., Rohrmann S. Calcium intake and serum concentration in relation to risk of cardiovascular death in NHANES III. PLoS One. 2013; 8 (4): e61037. DOI: https://doi.org/10.1371/journal.pone.0061037

6. Li K., Kaaks R., Linseisen J., Rohrmann S. Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition study (EPIC-Heidelberg). Heart. 2012; 98 (12): 920–5. DOI: https://doi.org/10.1136/heartjnl-2011-301345

7. Meng Q., Huang L., Tao K., Liu Y., Jing J., Wang W., et al. Integrated genetics and micronutrient data to inform the causal association between serum calcium levels and ischemic stroke. Front Cell Dev Biol. 2020; 8. DOI: https://doi.org/10.3389/fcell.2020.634957

8. Xiao Q., Murphy R.A., Houston D.K., Harris T.B., Chow W.H., Park Y. Dietary and supplemental calcium intake and cardiovascular disease mortality. JAMA Intern Med. 2013; 173 (8): 639–46. DOI: https://doi.org/10.1001/jamainternmed.2013.3283

9. Otton J.M., Lonborg J.T., Boshell D., et al. A method for coronary artery calcium scoring using contrast-enhanced computed tomography. J Cardiovasc Comput Tomogr. 2012; 6: 37–46. DOI: https://doi.org/10.1016/j.jcct.2011.11.004

10. Bolland M.J., Barber P.A., Doughty R.N., Mason B., Horne A., Ames R., et al. Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial. BMJ. 2008; 336 (7638): 262–6. DOI: https://doi.org/10.1136/bmj.39440.525752.BE

11. Bolland M.J., Grey A., Avenell A., Gamble G.D., Reid I.R. Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women´s Health Initiative limited access dataset and meta-analysis. BMJ. 2011; 342: d2040. DOI: https://doi.org/10.1136/bmj.d2040

12. Lewis J.R., Zhu K., Prince R.L. Adverse events from calcium supplementation: Relationship to errors in myocardial infarction self-reporting in randomized controlled trials of calcium supplementation. J Bone Miner Res. 2012; 27: 719–22. DOI: https://doi.org/10.1002/jbmr.1484

13. Lewis J.R., Radavelli-Bagatini S., Rejnmark L., Chen J.S., Simpson J.M., Lappe J.M., et al. The effects of calcium supplementation on verified coronary heart disease hospitalization and death in postmenopausal women: a collaborative meta-analysis of randomized controlled trials. J Bone Miner Res. 2015; 30 (1): 165–75. DOI: https://doi.org/10.1002/jbmr.2311

14. Reid I.R., Bolland M.J., Grey A. Does calcium supplementation increase cardiovascular risk? Clin Endocrinol. 2010; 73: 689–95. DOI: https://doi.org/10.1111/j.1365-2265.2010.03792.x

15. Wang M., Yan S., Peng Y., Shi Y., Tsauo J.Y., Chen M. Serum calcium levels correlates with coronary artery disease outcomes. Open Med (Wars). 2020; 15 (1): 1128–36. DOI: https://doi.org/10.1515/med-2020-0154

16. Hulbert M., Turner M.E., Hopman W.M. Changes in vascular calcification and bone mineral density in calcium supplement users from the Canadian multi-center osteoporosis study (CaMOS). Atherosclerosis. 2020; 296: 83–90. DOI: https://doi.org/10.1016/j.atherosclerosis.2019.12.003

17. Reid I.R., Ames R., Mason B., Bolland M.J., Bacon C.J., Reid H.E., et al. Effects of calcium supplementation on lipids, blood pressure and body composition in healthy older men: a randomized controlled trial. Am J Clin Nutr. 2010; 91 (1): 131–9.

18. Chai W., Cooney R.V., Franke A.A., Bostick R.M. Effects of calcium and vitamin D supplementation on blood pressure and serum lipids and carotenoids: a randomized, double-blind, placebo-controlled clinical trial. Ann Epidemiol. 2013; 23 (9): 564–70. DOI: https://doi.org/10.1016/j.annepidem.2013.07.003

19. RX List. Calcium. 2019. URL: https://www.rxlist.com/calcium/supplements.htm (date of access November 19, 2020)

20. Cormick G., Ciapponi A., Caerata M.L., Belizán J.M. Calcium supplementation for prevention of primary hypertension. Cochrane Database Syst Rev. 2015; 6: CD010037. DOI: https://doi.org/10.1002/14651858.CD010037.pub2

21. Hofmeyr G.J., Lawrie T.A., Atallah Á.N., Duley L., Torloni M.R. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev. 2014; 6: CD001059. DOI: https://doi.org/10.1002/14651858.CD001059.pub5

22. Belizan J.M., Villar J., Bergel E., del Pino A., Di Fulvio S., Galliano S.V., et al. Long term effect of calcium supplementation during pregnancy on the blood pressure of offspring: follow up of a randomized controlled trial. BMJ. 2011; 315: 281–5. DOI: https://doi.org/10.1136/bmj.315.7103.281

23. Buck B.H., Liebeskind D.S., Saver J.L., Bang O.Y., Starkman S., Ali L.K., et al. Association of higher serum calcium levels with smaller infarct volumes in acute ischemic stroke. Arch Neurol. 2007; 64: 1287–91. DOI: https://doi.org/10.1001/archneur.64.9.1287

24. Villa-Etchegoyen C., Lombarte M., Matamoros N., Belizán J.M., Cormick G. Mechanisms involved in the relationship between low calcium intake and high blood pressure. Nutrients. 2019; 11 (5). DOI: https://doi.org/10.3390/nu11051112

25. Koton S., Tashlykov V., Schwammenthal Y., Molshatzki N., Merzeliak O., Tsabari R., et al. Cerebral artery calcification in patients with acute cerebrovascular diseases: determinants and long-term clinical outcome. Eur J Neurol. 2012; 19: 739–45. DOI: https://doi.org/10.1111/j.1468-1331.2011.03620.x

26. Dibaba D.T., Xun P., Fly A.D., Bidulescu A., Tsinovoi C.L., Judd S.E., et al. Calcium Intake and serum calcium level in relation to the risk of ischemic stroke: findings from the REGARDS study. J Stroke. 2019; 21 (3): 312–23. DOI: https://doi.org/10.5853/jos.2019.00542

27. Bolland M.J., Avenell A., Baron J.A., et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ. 2010; 341: c3691. DOI: https://doi.org/10.1136/bmj.c3691

28. Rejnmark L., Avenell A., Masud T., et al. Vitamin D with calcium reduces mortality: patient level pooled analysis of 70,528 patients from eight major vitamin D trials. J Clin Endocrinol Metab. 2012; 97: 2670–81. DOI: https://doi.org/10.1210/jc.2011-3328

29. Wang X., Chen H., Ouyang Y., et al. Dietary calcium intake and mortality risk from cardiovascular disease and all causes: a meta-analysis of prospective cohort studies. BMC Med. 2014; 12 (158). DOI: https://doi.org/10.1186/s12916-014-0158-6

30. Asemi Z., Saneei P., Sabihi S.S., et al. Total, dietary, and supplemental calcium intake and mortality from all-causes, cardiovascular disease, and cancer: a metaanalysis of observational studies. Nutr Metab Cardiovasc Dis. 2015; 25: 623–34. DOI: https://doi.org/10.1016/j.numecd.2015.03.008

31. Chung M., Tang A.M., Fu Z., et al. Calcium intake and cardiovascular disease risk: an updated systematic review and meta-analysis. Ann Intern Med. 2016; 165: 856–66. DOI: https://doi.org/10.7326/M16-1165

32. Yang C., Shi X., Xia H., et al. The evidence and controversy between dietary calcium intake and calcium supplementation and the risk of cardiovascular disease: a systematic review and meta-analysis of cohort studies and randomized controlled trials. J Am Coll Nutr. 2020; 39 (4): 352–70. DOI: https://doi.org/10.1080/07315724.2019.1649219

33. Verbrugge F.H., Gielen E., Milisen K., Boonen S. Who should receive calcium and vitamin supplementation? Age Ageing. 2012; 41 (5): 576–80. DOI: https://doi.org/10.1093/ageing/afs094

34. Larsson S.C., Orsini N., Wolk A. Dietary calcium intake and risk of stroke: a dose-response meta-analysis. Am J Clin Nutr. 2013; 97 (5): 951–7. DOI: https://doi.org/10.3945/ajcn.112.052449

35. Levitan E.B., Shikany J.M., Ahmed A., Snetselaar L.G., Martin L.W., Curb J.D., et al. Calcium, magnesium and potassium intake and mortality in women with heart failure: the Women’s Health Initiative. Br J Nutr. 2013; 110 (1): 179–85. DOI: https://doi.org/10.1017/S0007114512004667

36. Paik J.M., Curhan G.C., Sun Q., Rexrode K.M., Manson J.E., Rimm E.B., et al. Calcium supplement intake and risk of cardiovascular disease in women. Osteoporos Int. 2014; 25 (8): 2047–56. DOI: https://doi.org/10.1007/s00198-014-2732-3

37. Khan B., Nowson C.A., Daly R.M., English D.R., Hodge A.M., Giles G.G., et al. Higher dietary calcium intakes are associated with reduced risks of fractures, cardiovascular events, and mortality: a prospective cohort study of older men and women. J Bone Miner Res. 2015; 30 (10): 1758–66. DOI: https://doi.org/10.1002/jbmr.2515

38. West S.L., Swan V.J.D., Jamal S.A. Effects of calcium on cardiovascular events in patients with kidney disease and in a healthy population. Clin J Am Soc Nephrol. 2010; 5: S41–47. DOI: https://doi.org/10.2215/CJN.05860809

39. Pfeifer M., Begerow B., Minne H.W., Suppan K., Fahrleitner-Pammer A., Dobnig H. Effects of a long-term vitamin D and calcium supplementation on falls and parameters of muscle function in community-dwelling older individuals. Osteoporos Int. 2009; 20 (2): 315–22. DOI: https://doi.org/10.1007/s00198-008-0662-7

40. Bihl G., Meyers A. Recurrent renal stones disease-advances in pathogenesis and clinical management. Lancet. 2001; 358 (9282): 651–6. DOI: https://doi.org/10.1016/S0140-6736(01)05782-8

41. Curhan G.C., Willett W.C., Spiezer F.E., Stampfer M.J. Twenty-four hour urine chemistries and the risk of kidney stones among women and men. Kidney Int. 2001; 59 (6): 2290–8. DOI: https://doi.org/10.1046/j.1523-1755.2001.00746.x

42. Heilberg I.P., Goldfarb D.S. Optimal nutrition for kidney stone disease. Adv Chronic Kidney Dis. 2013; 20 (2): 165–74. DOI: https://doi.org/10.1053/j.ackd.2012.12.001

43. Sorensen M.D. Calcium intake and urinary stone disease. Trans Androl Urol. 2014; 3: 235–40. DOI: https://doi.org/10.3978/j.issn.2223-4683.2014.06.05

44. Winzenberg T., Shaw K., Fryer J., Jones G. Effects of calcium supplementation on bone density in healthy children: meta-analysis of randomised controlled trials. BMJ. 2006; 333 (7572): 775. DOI: https://doi.org/10.1136/bmj.38950.561400.55

45. Shea B., Wells G., Cranney A., et al. Meta-analyses of therapies for postmenopausal osteoporosis. VII. Meta-analysis of calcium supplementation for the prevention of postmenopausal osteoporosis. Endocr Rev. 2002; 23 (4): 552–9. DOI: https://doi.org/10.1210/er.2001-7002

46. Grant A.M., Avenell A., Campbell M.K., McDonald A.M., MacLennan G.S., McPherson G.C., et al. Oral vitamin D3 and calcium for secondary prevention of low-trauma fractures in elderly people (Randomised Evaluation of Calcium Or vitamin D, RECORD): a randomised placebo-controlled trial. Lancet. 2005; 365 (9471): 1621–8. DOI: https://doi.org/10.1016/S0140-6736(05)63013-9

47. Matkovic V., Goel P.K., Badenhop-Stevens N.E., et al. Calcium supplementation and bone mineral density in females from childhood to young adulthood: a randomized controlled trial. Am J Clin Nutr. 2005; 81: 175–88. DOI: https://doi.org/10.1093/ajcn/81.1.175

48. Winzenberg T., Shaw K., Fryer J., Jones G. Effects of calcium supplementation on bone density in healthy children: meta-analysis of randomised controlled trials. BMJ. 2006; 333: 775.

49. Jackson R.D., LaCroix A.Z., Gass M., Wallace R.B., Robbins J., Lewis C.E., et al.; Women’s Health Initiative Investigators. Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med. 2006; 354 (7): 669–83. DOI: https://doi.org/10.1136/bmj.38950.561400.55

50. Winzenberg T.M., Shaw K.A., Fryer J., Jones G. Calcium supplementation for improving bone mineral density in children. Cochrane Database Syst Rev. 2006; 2: CD005119. DOI: https://doi.org/10.1002/14651858.CD005119.pub2

51. Bischoff-Ferrari H.A., Dawson-Hughes B., Baron J.A., Burckhardt P., Li R., Spiegelman D., et al. Calcium intake and hip fracture risk in men and women: a meta-analysis of prospective cohort studies and randomized controlled trials. Am J Clin Nutr. 2007; 86 (6): 1780–90. DOI: https://doi.org/10.1093/ajcn/86.5.1780

52. Jarjou L.M.A., Laskey M.A., SawoY., Goldberg G.R., Cole T.J., Prentice A. Effect of calcium supplementation in pregnancy on maternal bone outcomes in women with a low calcium intake. Am J Clin Nutr. 2010; 92: 450–7. DOI: https://doi.org/10.3945/ajcn.2010.29217

53. Jarjou L.M.A., Sawo Y., Goldberg G.R., Laskey A.M., Cole T.J., et al. Unexpected long-term effects of calcium supplementation in pregnancy on maternal bone outcomes in women with a low calcium intake: a follow-up study. Am J Clin Nutr. 2013; 98: 723–30. DOI: https://doi.org/10.3945/ajcn.113.061630

54. Tai V., Leung W., Grey A., et al. Calcium intake and bone mineral density: systematic review and meta-analysis. BMJ. 2015; 351: h4183. DOI: https://doi.org/10.1136/bmj.h4183

55. Zhao J.G., Zeng X.T., Wang J., et al., Association between calcium or vitamin D supplementation and fracture incidence in community-dwelling older adults: a systematic review and meta-analysis. JAMA. 2017; 318: 2466–82. DOI: https://doi.org/10.1001/jama.2017.19344

56. Yao P., Bennett D., Mafham M., et al. Vitamin D and calcium for the prevention of fracture: a systematic review and meta-analysis. JAMA Netw Open. 2019; 2: e1917789. DOI: https://doi.org/10.1001/jamanetworkopen.2019.17789

57. Weaver C.M., Gordon C.M., Janz K.F., Kalkwarf H.J., Lappe J.M., Lewis. R., et al. The National Osteoporosis Foundation’s position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations. Osteoporos Int. 2016; 27: 1281–386. DOI: https://doi.org/10.1007/s00198-015-3440-3

58. Verbrugge F.H., Gielen E., Milisen K., Boonen S. Who should receive calcium and vitamin supplementation? Age Ageing. 2012; 41 (5): 576–80. DOI: https://doi.org/10.1093/ageing/afs094

59. Persy V., D’Haese P. Vascular calcification and bone disease: the calcification paradox. Trends Mol Med. 2009; 15: 405–16.

60. Chiodini I., Bolland M.J. Calcium supplementation in osteoporosis: useful or harmful? Eur J Endocrinol. 2018; 178: D13–25. DOI: https://doi.org/10.1016/j.molmed.2009.07.001

61. Dong J.Y., Qin L.Q. Dietary calcium intake and risk of type 2 diabetes: possible confounding by magnesium. Eur J Clin Nutr. 2012; 66 (3): 408–10. DOI: 10.1038/ejcn.2012.5

62. Raffield L.M., Agarwal S., Cox A.J., Hsu F.C., Carr J.J., Freedman B.I., et al. Cross-sectional analysis of calcium intake for associations with vascular calcification and mortality in individuals with type 2 diabetes from the Diabetes Heart Study. Am J Clin Nutr. 2014; 100 (4): 1029–35. DOI: https://doi.org/10.3945/ajcn.114.090365

63. Tanaka S., Uenishi K., Yamazaki Y., Kuroda T., Shiraki M. Low calcium intake is associated with high plasma homocysteine levels in postmenopausal women. J Bone Miner Metab. 2014; 32 (3): 317–23. DOI: https://doi.org/10.1007/s00774-013-0499-9

64. Wang L., Manson J.E., Buring J.E., Lee I.M., Sesso H.D. Dietary intake of dairy products, calcium, and vitamin D and the risk of hypertension in middle-aged and older women. Hypertension. 2008; 51 (4): 1073–9. DOI: https://doi.org/10.1161/HYPERTENSIONAHA.107.107821

65. Shahar D.R., Schwarzfuchs D., Fraser D., Vardi H., Thiery J., Fiedler G.M., et al. Dairy calcium intake, serum vitamin D, and successful weight loss. Am J Clin Nutr. 2010; 92 (5): 1017–22. DOI: https://doi.org/10.3945/ajcn.2010.29355

66. Anderson J.J., Kruszka B., Delaney J.A., He K., Burke G.L., Alonso A., et al. Calcium intake from diet and supplements and the risk of coronary artery calcification and its progression among older adults: 10-year follow-up of the Multi-Ethnic Study of Atherosclerosis (MESA). J Am Heart Assoc. 2016; 5: e003815. DOI: https://doi.org/10.1161/JAHA.116.003815

67. Escribano J., Balaguer A., Roqué i Figuls M., Feliu A., Ferre N. Dietary interventions for preventing complications in idiopathic hypercalciuria. Cochrane Database Syst Rev. 2014; 2: CD006022. DOI: https://doi.org/10.1002/14651858.CD006022

68. Sanders K.M., Nowson C.A., Kotowicz M.A., Briffa K., Devine A., Reid I.R. Calcium and bone health: position statement for the Australian and New Zealand Bone and Mineral Society, Osteoporosis Australia and the Endocrine Society of Australia. Med J Aust. 2009; 190 (6): 316–20. DOI: https://doi.org/10.5694/j.1326-5377.2009.tb02421.x

69. Devine A., Dick I.M., Islam A.F., Dhaliwal S.S., Prince R.L. Protein consumption is an important predictor of lower limb bone mass in elderly women. Am J Clin Nutr. 2005; 81 (6): 1423–8. DOI: https://doi.org/10.1093/ajcn/81.6.1423

70. Binkley N., Krueger D., Buehring B. What’s in a name revisited: should osteoporosis and sarcopenia be considered components of «dysmobility syndrome»? Osteoporos Int. 2013; 24 (12): 2955–9. DOI: https://doi.org/10.1007/s00198-013-2427-1

71. Heaney R.P. Calcium supplementation and incident kidney stone risk: a systematic review. J Am Coll Nutr. 2008; 27: 519–27. DOI: https://doi.org/10.1080/07315724.2008.10719734

72. Prentice R.L., Pettinger M.B., Jackson R.D., Wactawski-Wende J., Lacroix A.Z., Anderson G.L., et al. Health risks and benefits from calcium and vitamin D supplementation: Women’s Health Initiative clinical trial and cohort study. Osteoporos Int. 2013; 24 (2): 567–80. DOI: https://doi.org/10.1007/s00198-012-2224-2

73. Tang B.M.P., Eslick G.D., Nowson C., Smith C., Bensoussan A. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet. 2007; 370 (9588): 657–66. DOI: https://doi.org/10.1016/S0140-6736(07)61342-7

74. Prince R.L., Devine A., Dhaliwal S.S., Dick I.M. Effects of calcium supplementation on clinical fracture and bone structure: results of a 5-year, double-blind, placebo-controlled trial in elderly women. Arch Intern Med. 2006; 166 (8): 869–75. DOI: https://doi.org/10.1001/archinte.166.8.869

75. Palacios C., Cormick G., Hofmeyr G.J., Garcia-Casal M.N., et al. Calcium-fortified foods in public health programs: considerations for implementation. Ann N Y Acad Sci. 2021; 1485 (1): 3–21. DOI: https://doi.org/10.1111/nyas.14495

76. Cormick G., Betrán A. P., Metz F., et al. Regulatory and policy-related aspects of calcium fortification of foods. Implications for implementing national strategies of calcium fortification. Nutrients. 2020; 12 (4). DOI: https://doi.org/10.3390/nu12041022

77. Palacios C., Hofmeyr G.J., Cormick G., Garcia-Casal M.N., Peña-Rosas J.P., Betrán A.P. Current calcium fortification experiences: a review. Ann N Y Acad Sci. 2021; 1484 (1): 55–73. DOI: https://doi.org/10.1111/nyas.14481

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CHIEF EDITOR
CHIEF EDITOR
Viktor A. Tutelyan
Full Member of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor, Scientific Director of the Federal Research Centre of Nutrition, Biotechnology and Food Safety (Moscow, Russia)

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