Regulation of intracellular calcium plays a key role in hypertension
and obesity. Dysregulation of calcium homeostasis appears to
be a fundamental factor linking these conditions. Regulation
of intracellular calcium in key disease-related target tissues
by calcitrophic hormones provides the opportunity to modulate
disease risk with dietary calcium.
Overall, sub-optimal calcium
intakes contribute to the etiology of salt-sensitivity and hypertension.
High salt diets exert a calciuretic effect, serving to exacerbate
the physiological consequences of sub-optimal calcium diets.
Among these are increases in 1,25-dihydroxyvitamin D, which
increases vascular smooth muscle intracellular calcium, thereby
increasing peripheral vascular resistance and blood pressure.
Dietary calcium reduces blood pressure in large part via suppression
of 1,25-dihydroxyvitamin D, thereby normalizing intracellular
calcium.
The practical relevance of this approach has been confirmed
in the DASH (Dietary Approaches to Stop Hypertension) trial,
which demonstrated that increasing low-fat dairy product and
fruit and vegetable consumption exerted profound blood pressure-lowering
effects. The magnitude of this effect among hypertensives was
comparable to that typically found in pharmacological trials
of mild hypertension. 1,25-dihydroxyvitamin D also stimulates
calcium influx in human adipocytes, resulting in stimulation
of lipogenesis, inhibition of lipolysis and expansion of triglyceride
stores.
Accordingly, suppression of 1,25-dihydroxyvitamin D
by dietary calcium has been identified as a target, which may
contribute to the prevention and management of obesity. Indeed,
laboratory, clinical and population data all indicate a significant
anti-obesity effect of dietary calcium, although large-scale
prospective clinical trials have not yet been conducted to definitively
demonstrate the scope of this effect. Thus, available evidence
indicates that increasing dietary calcium intakes may result
in reductions in fat mass as well as in blood pressure.
By. Zemel, M. B., Calcium Modulation of Hypertension and Obesity: Mechanisms and Implications
Journal of the American College of Nutrition, Vol. 20, No. 90005, 428S-435S (2001)