Calcium is the most abundant mineral in the human body and is an essential nutrient that helps build and maintain healthy bones, is needed for muscle contraction, blood vessel contraction and expansion, the secretion of hormones and enzymes, and sending messages through the nervous system. Most notably, calcium helps to reduce the risk of osteoporosis and is important to people of all genders and ages at every stage of ones lifecycle. The best dietary sources of calcium include milk, yoghurt and cheese, followed by oily fish with bones such as salmon and sardines. Vegetables such as broccoli, kale and spinach contain calcium, but it is poorly absorbed.

Osteoporosis is a systemic disease causing bones to become porous and more susceptible to fractures, especially of the spine, hip and wrist. 1 in 3 women and 1 in 5 men will get this disease (potentially 4-6 million South Africans).

Osteoporosis is often the “Silent Epidemic” because there are usually no symptoms until you fracture a bone.

It is a serious disease and the cause of much pain and suffering. The disease can develop from calcium deficiency, poor dietary habits, excessive smoking and drinking, inactivity and certain medications. Up to 20% of people die after a hip fracture and more than 50% of the rest will never live independently again. In the first 5 years after menopause, women may lose up to 30% of their bone mass.

Vitamin D helps your body absorb calcium by increasing the production of a bone protein (osteocalcin) which is essential to bind calcium and deposit it into the bone matrix. Calcium uptake into bone is thus dependent upon sufficient osteocalcin being produced by the bone-forming cells (osteoblasts), which is in turn stimulated by Vitamin D. Vitamin D is either derived from the diet or produced by our exposure to sunlight.

Vitamin D increases the production of bone protein “osteocalcin”; however vitamin K2 is essential to ACTIVATE the bone protein! Without sufficient vitamin K2, osteocalin remains inactive and thus ineffective, resulting in very little calcium being deposited. As a result, the calcium leaks into the bloodstream and can deposit into arteries, increasing both the risk for osteoporosis and arterial calcification.

Vitamin K1 is found in green vegetables, especially spinach, broccoli and kale, but is very poorly absorbed (5-15%) and the amount ingested is rapidly cleared by the liver and excreted. Consequently, vitamin K1 will not stay long enough in the circulation to reach peripheral arteries or bone cells in sufficient amounts for optimal action. K1 is the form used in the liver to activate clotting factors.

Vitamin K2 is produced by various types of bacteria. The K2 variants can thus be found in bacterial fermented food products, however there is very little Vitamin K2 in meat, fish or fresh fruits. The traditional Japanese food Natto, is the richest source of Vitamin K2 (especially in MK-7), which is extracted during the fermentation process.

Human cells are not able to synthesize vitamin K2 and present knowledge strongly indicates that western diets do not contain enough Vitamin K2.

K2 is the form used in the rest of the body to activate other vitamin K-dependent proteins, including osteocalcin, which is essential for bone health, and matrix-Gla protein (MGP), which prevents calcification of blood vessels and organs.

Calcium carbonate is nature's most concentrated form of calcium and is what MenaCal.7 contains. It's about 40% elemental calcium by weight, so with each tablet you get the recommended dose of 500g elemental calcium. Taken with your last meal of the day, the bioavailability of calcium carbonate is comparative to that of calcium citrate. With less concentrated forms of calcium such as citrate, you'd need to take more tablets to get the same amount of calcium.

Calcium is best absorbed when taken in amounts of 500mg or less. It is also important to read the product labels and follow the directions for use.

Calcium carbonate preparations are generally the cheapest and most widely used supplements. Calcium carbonate is also the most concentrated form of calcium, allowing for smaller quantities to be used. It is also best absorbed in the presence of stomach acid so it is important that calcium carbonate supplements be taken with meals.

Calcium citrate is better absorbed than calcium carbonate products, but it is more expensive and you need to take more of the supplement because the elemental calcium content is half that of calcium carbonate. Calcium citrate can however be taken throughout the day as it does not need the acid environment of the stomach to be absorbed.

Special considerations when taking calcium supplementation:

- If you are taking an iron supplement that is not chelated, you must take your calcium supplement either two hours before or after the iron supplement to ensure proper absorption of both. If you are taking a chelated iron supplement such as Chela-fer, you need not take them separately.

- Calcium may interfere with the body's ability to use certain antibiotics like tetracycline – so always have a two hour window period between taking them.

- If you are using a bisphosphonate drug like Fosamax or Actonel for osteoporosis in the morning, then take your calcium supplement in the evening.

- Excessive intake of protein, salt and caffeine may lead to an increased excretion of calcium in the urine

- Calcium absorption is decreased by fibre in the diet e.g. bran, cereals, whole grain breads etc so try taking your calcium when you are having a low-fibre meal or last thing at night.

- The phytate content of calcium-containing green vegetables like spinach is high, so little calcium gets absorbed.

- Vitamin D is necessary for calcium absorption and is consumed in the diet and produced in the skin by the UV rays in sunlight. Thus, persons who are not exposed to sunlight should be supplemented with vitamin D. The RDA for vitamin D is 400 IU per day in persons under 70 and 800 IU in persons over 70 years of age.

- Special care should be taken when considering supplements that contain oyster shells, dolomite or bone meal as these may contain high doses of lead which can in the long run be harmful to your health.

Calcium and magnesium Magnesium is important in calcium metabolism (low magnesium levels stimulate calcium excretion in the urine), however it is accepted that most healthy individuals do not need additional supplementation for vitamins and minerals like magnesium, boron, vitamin C, zinc, selenium etc. as many of these nutrients are present in sufficient quantities in the normal diet, especially with all the fortified foods of today.

There is no cure for osteoporosis, so prevention is as important as treatment! Preventive measures aim to ensure maximum accumulation and reduced loss of bone tissue during each life stage. Childhood is the time to build skeletal reserve; midlife aims to preserve bone mass and assure bone health in future years. In later life, those who may already have developed osteopenia or osteoporosis can take measures to prevent further bone loss and painful fractures.

Although certain risk factors for developing osteoporosis, such as gender, race or age cannot be changed, you can still however do much to prevent further bone loss.

Lifestyle Changes
There are 4 main areas in which you can help maintain healthy bones:
• Balanced diet rich in calcium
• Calcium supplement containing Vitamin K2 for effective calcium utilization
• Regular weight-bearing exercise
• Stop smoking
• Avoid excessive alcohol intake
• Avoid bone toxic drugs

MenaCal.7 is a unique combination therapy of calcium, vitamin D3 and natural Vitamin K2 (as MenaQ7) for effective calcium utilization. These 3 ingredients work synergistically to put calcium in its place – into bones where it is needed and out of arteries where it causes calcification and damage. Without Vitamin K2 our bodies cannot use calcium effectively, as Vitamin K2 activates crucial proteins in bones and blood vessels that are responsible for building bone and preventing arteries from calcifying. Scientific research shows that inadequate levels of Vitamin K2 may contribute significantly to the development of Arteriosclerosis (hardening of the arteries due to calcium) and Osteoporosis (bone decalcification). Critical to both processes, Vitamin K2 is the essential vitamin for effective utilization, by producing opposite effects in bone and blood vessels. Your bones and heart will thank you!

MenaCal.7 is a supplement for every stage of your lifecycle. Children form 50% of their bone mineral density (BMD) in the first 10 years of their lives and most healthy children are Vitamin K2 deficient. A recent intervention study published in the British Journal of Nutrition showed that improved vitamin K intake in children over a period of two years resulted in stronger, denser bones and that Vitamin K status is associated with childhood bone mineral content. MenaCal7 tablets are scored in half, making it easier to swallow. One has till the age of 30 to reach your peak bone mass, after which it declines steadily for men but is accelerated during menopause for women.

Women lose 20-30% of their bone mass in the first 5 years after menopause, so it is critical for peri-menopausal women to be taking MenaCal.7.

Elderly people have an even lower vitamin K status than healthy adults, so it is of the utmost importance for them to be taking this complete calcium supplement.

In South Africa, the hip fracture incidence of men approximates that of women, so this is not just a supplement for women, but also for that of men. Especially due to the fact that men generally have a higher protein intake (while causes calcium to be excreted) and also tend to drink and smoke more, which causes calcium to leach out of bones.

• Vitamin K2 is not known among health professionals and in the general public
• No upper safety limits have been established by international health authorities
• Vitamin K2 is easily associated with effects on the coagulation system

The main safety concerns may originate from less scientific knowledge of this new form of vitamin K compared to the well known vitamin K1, which is synonymous with coagulation. Introducing a new variant of vitamin K is challenging ... However, according to recent scientific documentation vitamin K – and especially vitamin K2 – is linked to how the body utilizes and stores calcium through a set of activated proteins.

The safety issue has been and will be monitored scrutinously in all MenaQ7 trials, but a substantial body of evidence demonstrates that the product is safe for use in the general population. Scientific studies have demonstrated significant health benefits of MK-7 versions of K2 to both bone and cardiovascular health. This means that one has to have a much broader perspective than just coagulation.

45 ug is unlikely to interfere with anticoagulant treatment with Coumadin/Warfarin and does not provoke any additional risk of clot formation inside blood vessels.

This is recognised by GRAS (Generally regarded as safe) association in the US as supplement safe to use. The European Food Safety Authority (EFSA) has published a positive scientific opinion on vitamin K2, MK-7 from natto as a dietary supplement and food ingredient.

The Japanese historical consumption as well as several clinical studies conducted using very high doses of natural MK‐7 show no adverse effects. The safety conclusions referred from the Japanese Health Authorities above show that MenaCal.7’s recommended dose of 45 ug/day equals less than 1ug/kg bodyweight/day for adults and 1/13 of the safety level found in the toxicity studies.

MenaQ7™ in dosages up to 360 μg/day in healthy adults did not induce activation of the clotting system; neither has it resulted in an increase of the thrombosis risk as measured by the most sensitive method presently available. No adverse side effects were reported by any of the participants. MenaQ7™ in a dose of 45 μg/day in children with an average weight of 30 kilograms did not induce activation of the clotting system; neither did it result in an increase of the thrombosis risk as measured by the most sensitive method presently available.

Vitamin K is not stored in the body, and is therefore nontoxic in high amounts. As shown in the paper “MenaQ7 and the coagulation system” the coagulation factors have glutamic acid residues which will be carboxylated – and which need to be carboxylated‐ before they are activated and ready to take part in the coagulation cascade. An important point is however that the numbers of glutamic acids which can be modified (carboxylated) are limited to the 10 glutamic acids. No more groups can be modified once all are carboxylated, despite large excesses of vitamin K. Thus excess vitamin K intake will therefore not make any harm in the clotting process but rather be excreted from the body.

Patients on anticoagulant therapy should consult their physician before taking vitamin K2 Supplements.