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Guidelines for Canadian Drinking Water Quality: Guideline … – Canada.ca

There is no evidence of adverse health effects specifically attributable to calcium in drinking water. Insufficient data are available to set a specific value for an aesthetic objective for calcium in drinking water. A guideline for calcium has therefore not been specified.
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Calcium is the fifth most abundant natural element. It enters the freshwater system through the weathering of rocks, especially limestone, and from the soil through seepage, leaching and runoff.Footnote 1 The average concentration of calcium in soil is about 1.37 104 mg/kg.Footnote 2 The leaching of calcium from soil has been found to increase significantly with the acidity of rainwater.Footnote 3
The concentration of calcium in water depends on the residence time of the water in calcium-rich geological formations.
Table 1 footnotes
Based on an estimated intake of 1.5 L/day of drinking water by Canadians.Footnote 23
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Typical recommended nutrient intake (RNI) for adult males.Footnote 20Footnote 24
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Calcium is primarily absorbed in the proximal portion of the small intestine by a vitamin D-enhanced active transport process. The amount of calcium absorbed from the diet depends on the concentrations of a number of dietary components, as well as on non-dietary factors, such as pH of the intestine. Absorption ranges widely, from 12 to 67 percent, and is the chief means of controlling body calcium concentrations.
The total body burden of calcium in an adult male is about 1010 g, of which >99 percent is associated with the skeleton and only 0.1 percent with the extracellular fluids. The extracellular concentrations are regulated by parathyroid hormone and calcitonin, which, respectively, increase and decrease the calcium concentrations. A calcium buffer is provided by the bones, where 0.5 to 1.0 percent of the total bone mass, consisting of calcium phosphate compounds, is rapidly available.
Calcium blocks the absorption of heavy metals, and it has been found, for example, that a low-calcium diet increases the susceptibility of rats to lead poisoning.
As a contributor to hardness, calcium can have detrimental effects on drinking water quality. These effects are mainly aesthetic and are discussed in the “Hardness” review in the Supplementary Documentation.
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Scythes, C.A., Gibson, R.S. and Draper, H.H. Dietary calcium and phosphate intakes of a sample of Canadian premenopausal women consuming self-selected diets. Nutrition, 2: 385 (1982).
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O’Connor, D., Gibson, R.S. and Martinez, O.B. Dietary calcium and phosphorus intakes of a sample of Canadian post-menopausal women consuming self-selected diets. J. Can. Diet. Assoc., 46: 45 (1985).
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Monsen, E.R. and Cook, J.D. Food iron absorption in human subjects — IV. The effect of calcium and phosphate salts on the absorption of non-heme iron. Am. J. Clin. Nutr., 29: 1142 (1976).
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Kim, Y. and Linkswiler, H. Effect of level of calcium and phosphorus intake on calcium, phosphorus and magnesium metabolism in young adult males. Fed. Proc., 115: 167 (1979).
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Hines, R.G., Jacobson, J.L., Beitz, D.C. and Littledike, E.T. Dietary calcium and vitamin D: risk factors in the development of atherosclerosis in young goats. J. Nutr., 115: 167 (1985).
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Spencer, H. Calcium and magnesium interactions in man. Clin. Chem., 25: 1043 (1980).
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Lakshmanan, F.L., Rao, R.B., King, W.W. and Kelsay, J.L. Magnesium intakes, balances and blood levels in adults consuming self-selected diets. Am. J. Clin. Nutr., 40: 1380 (1984).
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Adham, N.F. and Long, M.K. Effects of calcium and copper on zinc absorption in the rat. Nutr. Metab., 24: 281 (1980).
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Snedeker, S.M., Smith, S.A. and Greger, J.L. Effects of dietary calcium and phosphorus levels on the utilization of iron, copper and zinc by adult males. J. Nutr., 112: 136 (1982).
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Spencer, H., Vandinscott, I. and Samachson, J. Zinc-65 metabolism during low and high calcium intake in man. J. Nutr., 86: 168 (1965).
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Pecoud, A., Donzel, P. and Schelling, J.L. The effects of foodstuffs on the absorption of zinc sulfate. Clin. Pharmacol. Ther., 17: 489 (1975).
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Merty, W. Chromium. In: Absorption and malabsorption of mineral nutrients. N.W. Solomons and I.H. Rosenberg (eds.). Alan R. Liss, New York, NY (1984).
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Spenser, H., Assmussen, C.R., Holtzman, R.B. and Kramer, L. Metabolic balance of cadmium, copper, manganese and zinc in man. Am. J. Clin. Nutr., 32: 1867 (1979).
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Méranger, J.C., Subramanian, K.S. and Chalifoux, C. Metals and other elements. Survey for cadmium, cobalt, chromium, copper, nickel, lead, zinc, calcium and magnesium in Canadian drinking water supplies. J. Assoc. Off. Anal. Chem., 64: 44 (1981).
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Recker, R.R. and Heaney, R.P. The effects of milk supplements on calcium metabolism, bone metabolism and calcium balance. Am. J. Clin. Nutr., 41: 254 (1985).
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Magess, R.B., Harper, A.R. and De Luca, H. Calcium intake and bone. Am. J. Nutr., 41: 568 (1985).
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Belizan, J.M. and Villar, J. The relationship between calcium intake and edemaproteinuria and hypertension-gestosis: a hypothesis. Am. J. Clin. Nutr., 33: 2203 (1980).
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Belizan, J.M., Villar, J., Zalagar, A., Rojas, L., Chan, D. and Bryce, G.F. Preliminary evidence of the effects of calcium supplementation on blood pressure in normal pregnant women. Am. J. Obstet. Gynecol., 146: 175 (1983).
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Garland, C., Barrett-Connor, E., Rossof, A.H., Shekelle, R.B., Criqui, M.H. and Paul, O. Dietary vitamin D and calcium and risk of colorectal cancer: a 19-year old prospective study in men. Lancet, i(8424): 307 (1985).
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Lipkin, M. and Newmark, H. Effect of added dietary calcium on colonic epithelial-cell proliferation in subjects at high risk for familial colonic cancer. New Engl. J. Med., 313: 1381 (1985).
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Silberner, J. Colorectal cancer: calcium a key? Sci. News, 128: 362 (1985).
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McCarron, I.A., Morris, C.D., Henry, J.J. and Stanton, J.L. Blood pressure and nutrient intake in the United States. Nutr. Today, 8: 14 (1984).
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McCarron, D.A., Morris, C.D. and Cole, C. Dietary calcium in human hypertension. Science, 217: 267 (1982).
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Belizan, J.M., Villar, J., Pinda, O., Gonzales, A.E., Sainz, E., Garrera, G. and Sibrian, R. Blood pressure reduction in young adults with calcium supplementation: a randomized clinical trial. J. Am. Med. Assoc., 249: 1161 (1983).
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McCarron, D.A. and Morris, C.D. Blood pressure response to oral calcium in persons with mild to moderate hypertension. A randomized, double-blind, placebo-controlled, crossover trial. Ann. Intern. Med., 103: 825 (1985).
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Johnson, N.E., Smith, E.L. and Freudenheim, J.L. Effects on blood pressure of calcium supplementation of women. Am. J. Clin. Nutr., 42: 12 (1985).
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Ayachi, S. Increased dietary calcium lowers blood pressure in the spontaneous hypertensive rat. Metabolism, 28: 1234 (1979).
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Belizan, J.M., Villar, J., Self, S., Pineda, O., Gonzales, G. and Lainz, E. The mediating role of the parathyroid gland in the effect of low calcium intake on blood pressure in the rat. Arch. Nat. Nutr., 24: 666 (1984).
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Yacowitz, H., Fleishman, A.I., Amoden, R.T. and Bierenbaum, M.L. Effects of dietary calcium upon lipid metabolism in rats fed saturated or unsaturated fat. J. Nutr., 92: 389 (1967).
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Raloff, J. Oxidized lipids: a key to heart disease? Sci. News, 127: 278 (1985).
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Pocock, S.J., Shaper, A.G., Cook, D.G., Packham, R.F., Lacey, R.F., Powell, P. and Russel, P.F. British regional heart study: geographic variation in cardiovascular mortality and the role of water quality. Br. Med. J., 280: 1243 (1980).
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Zieghami, E.A., Morris, M.D., Calle, E.E., McSweeny, P.S. and Schuknecht, B.A. Drinking water inorganics and cardiovascular disease: a case control study among Wisconsin farmers. U.S. Environmental Protection Agency Proceedings, Amherst, MA. PB85-216513, May (1985).
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