Casein-encapsulated calcium eases GI concerns, study finds

The research was conducted by a team from the Palacios Institute of Women’s Health in Madrid. The casein coated test material, which was tested in two forms, came from Nexentia S.A.S., an ingredient manufacturer based in Sabaneta, Colombia, which also supported the research.

Ingredient of concern

Calcium is an ingredient of special concern in the US and elsewhere.  According to the Council for Responsible Nutrition’s 2017 Consumer Survey on Supplements, 26% of regular supplement users take calcium products.  

In addition, the organization noted:

• Calcium is essential at every life stage. A proper intake of calcium plus vitamin D helps build optimal bone mass during childhood and adolescence and helps maintain it during old age.
• Calcium is also implicated in other health protection mechanisms, including helping blood to clot, aiding in nerve signaling and in muscle contractions.
• Americans are falling short in calcium, which has been identified by national health authorities as a “nutrient of public health concern.”​

But calcium use has some concerns that can interfere with compliance.  A number of users report gastric issues at higher dosages.  And calcium has even been associated with an increase in colon polyps, which could be linked to increased intestinal irritation (Andrea Wong, PhD, CRN’s senior vice president of scientific & regulatory affairs said this result pertained to a very specific set of subjects​​ already prone to polyps and shouldn’t put the majority of consumers on their guard).

The Spanish study aimed to test the gastric tolerability of two different forms of a casein-encapsulated calcium carbonate dietary supplement against more conventional, non encapsulated calcium carbonate and calcium citrate forms.

Encapsulated calcium forms eased stomach upset

The two test materials were formulated in a 90% calcium to 10% casein form, and in a 95-5 ratio version.  The size of the two forms varied slightly, with the 95:5 system averaging 7.5 microns in width, and the 90:10 particles averaging 9 microns.

The study subjects were 177 postmenopausal women between 45 and 70 years old with low calcium intake. They were randomized to one of four groups receiving one of the two test materials or one of the two conventional supplements.  All were in the form of two chewable tablets that delivered 1,000 mg of calcium, with the exception of the calcium citrate arm, which received 945 mg spread across three tablets.

Participants filled out the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire to evaluate the

GI tolerability and the Treatment Satisfaction Questionnaire for Medication (TSQM) to analyze the satisfaction of the participants with the use of the calcium supplements.

The study found that the casein coating protected the calcium core long enough to get to the small intestine, reducing the build up of carbon dioxide that accounts for the GI issues reported by some calcium supplement users.  The beneficial effect was most pronounced for the 90:10 form of the product, which was the expected result.

Further research could elucidate compliance benefits

The researchers noted that noncompliance with calcium supplementation regimes is vexing problem when trying to help older populations.

“In chronic asymptomatic diseases as osteoporosis, overcoming non-adherence presents a challenge. According to recent studies concerning the treatment of osteoporosis, adherence to long-term calcium and vitamin D supplementation varies between 30 and 75%,”​ they wrote.

“The positive result of the microCaCO supplement in postmenopausal women could encourage a study using this type of delivery system in different risk groups with additional calcium requirements, such as individuals over 50 years to prevent fractures and bone loss or individuals with high risk of cancer in the digestive system,” they added.​

Source:​ Drugs in Context​​​
2020; 9: 2020-1-4. DOI: 10.7573/dic.2020-1-4
Clinical study of the tolerability of calcium carbonate–casein microcapsules as a dietary supplement in a group of postmenopausal women​
Authors: Palacios S, et al.