2012-06-21

Calcium and Diabetes

For the past few years, I have noticed a growing sense that I somehow feel better when I consume an adequate amount of dairy products. While many people take vitamin C or zinc supplements when they feel as though they're coming down with a cold, my approach has been to increase my intake of calcium. I have had no scientific reason to believe that calcium helps me ward off colds and makes me feel better. Rather, it has just been a vague impression I've had. For the most part, I have seemed to anecdotally feel better if I consume a lot of milk and fish, and these things are typically regarded as healthy, so I assumed that even if I were wrong, I wouldn't be hurting myself much if I continued to eat a good amount of dietary calcium.

Because my routine has been significantly disrupted by my move, my dairy intake has been significantly lower than it typically is. Usually, I start my day with a couple of homemade cafe lattes, each having about 8oz of 1% milk. That's two servings of dairy, plus a serving of cheese or Greek-style yogurt at some point later in the day.

Predictably, in absence of all that good calcium, I have been feeling a little sluggish. On a bit of a lark, I decided to scan Google for a connection between calcium and type 1 diabetes.

As I said, I haven't had a scientific reason to favor dairy and dietary calcium... until now. Okay, pay attention, kids, because what follows is vitally important for all diabetics to know (type 1 and type 2 alike). My focus will as usual be on type 1 diabetics, but it stands to reason that the conclusions implied here will ring true for type 2 diabetics also.

Research On Calcium and Diabetes
My best find was this .pdf copy of an article from the Suez Canal University Medical Journal, entitled "Calcium Homeostasis in Children With Type 1 Diabetes Mellitus," by Zeiton, et al. Do yourselves a favor and read this article in its entirety. I do not consider it beyond the layman to understand. (I'm a layman, and I understood it.)

What we most notably learn from this research is:
The results of the present study clearly demonstrate that children with type I diabetes mellitus have significant abnormalities in calcium homeostasis compared to healthy control children.
In other words, I was right to think that I felt better when I ate more calcium; I was likely suffering from minor calcium deficiency. This is because diabetics, for unknown reasons, cannot metabolize calcium the same way normal people can. (The authors postulate that we diabetics suffer from an imbalance in parathyroid hormone and calcitonin.)

Zeiton, et al., also demonstrate that the less control you have over your blood sugar, the less likely you will absorb dietary calcium.

All of this results in osteopenia, or below-average bone density.

Another interesting article is "Calcium insufficiency accelerates type 1 diabetes in vitamin D receptor-deficient nonobese diabetic (NOD) mice," by Driver, et al., from the journal Endocrinology (gated copy, but the abstract is adequate for most of us). This study found that calcium deficiency actually accelerated the onset of type 1 diabetes in laboratory mice.

Finally, research by Amado, et al, and Singh, et al seem to suggest (to me, anyway, given my limited understanding of medical research) that diabetics have lower levels of ionized calcium, which may be a major contributor to the cardiovascular co-morbidities that occur among diabetics.

Don't Believe the "Paleo" Hype: Eat Your Dairy
What all this adds up to is that we diabetics really need to watch our calcium intake. We are at risk of low bone density (if we don't already have it - remember, there are no symptoms of low bone density until your bone cracks), and the reduced calcium ionization is causing our hearts to slowly malfunction. This is bad.

The key is to make sure you're getting adequate levels of calcium, and therefore vitamin D, which is required for calcium absorption. We might not be able to control how well our bodies absorb calcium, beyond keeping tight control of our blood sugar readings; but we can certainly control whether or not we consume adequate amounts of vital micronutrients.

Now, there are many good sources of dietary calcium out there, and spending a little time in the sun every day is probably the best way you can get adequate vitamin D intake. Fish bones (such as those found in canned or very bony cooked fish) are a very, very good source of calcium, but of course you can't eat too much fish without risking mercury poisoning. My vegetarian sister (who eats plenty of dairy) suggested to me once that sesame seeds are a good vegan source of calcium.

But for the "average" person with an "average" diet, I'd suggest there is no better reliable, daily source of dietary calcium than dairy products. My dietitian recommended I eat dairy. Medical research seems to indicate that if you are a member of the lucky majority who has no problem eating dairy products, it is healthy to do so. (If you're lactose intolerant, then I suppose that's another story.)

Most of the anti-dairy sentiment out there comes from "paleo-diet" practitioners who oppose dairy because dairy production required the advent of agriculture. Apparently, these people believe that agriculture dealt a terrible blow to human health, but I know a few substance farmers who would disagree.

If you're not diabetic, eat dairy and get enough calcium. But if you are diabetic, it is vitally important that you are getting adequate calcium and vitamin D on a daily basis.

File this fact under the list of things for which I developed an intuition before eventually being proven correct by medical science. That's my patting my own ego - you need not worry about that. Just make sure you're drinking milk.