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Recent increases in recommended calcium intakes recognize the important role of calcium in skeletal health, but many Americans, especially women, consume far less than recommended amounts. A potential drawback to encouraging increased calcium intake is suggested by the extensive literature showing an adverse effect of high calcium intake on dietary iron absorption, at least in short, highly controlled, experimental studies. However, the applicability of short-term studies involving test meals to long-term iron absorption and iron status is limited given the variety of foods and food combinations in self-selected diets and the ability of individuals to adapt to reduced iron intake. In general, studies of whole diets and studies conducted over several weeks tend to show no effect of increased calcium intake on iron absorption. In addition, experimental studies of calcium and iron status measures such as serum ferritin show no long-term effect of calcium supplementation on iron status. Prevention and treatment of iron deficiency should emphasize adequate consumption of iron-rich foods and, when indicated, the use of iron supplements. Recommended calcium intakes are important for skeletal health and do not appear to increase the risk for iron deficiency in healthy people.

(C) 2002 Blackwell Science Ltd.