1. What is Calcium Citrate Malate ?
Calcium Citrate Malate (CCM), also known as calcium citrate, is a neutral complex salt formed by malic acid, citric acid and calcium. The molecular formula and typical structure are shown in Figure 1.
1. Calcium Citate malate has the characteristics of high solubility, high absorption and utilization, safety and non-toxicity. Its water solubility is more than 100 times that of calcium carbonate and more than 10 times that of calcium citrate. Its aqueous solution is weakly acidic and its absorption and utilization rate is 37% higher than that of calcium carbonate.
2. Compared with calcium carbonate, calcium citrate malate as a calcium source does not consume gastric acid while supplementing calcium, and does not increase the risk of kidney stones.
3. Compared with other calcium nutritional enhancers, calcium citrate malate has the functions of supplementing calcium, enhancing bone density, regulating blood lipids, and enhancing oral health, reducing the risk of kidney stones, and not affecting the absorption of other trace elements.
4. Calcium citrate malate also has the physiological functions of malic acid such as anti-fatigue and heart protection. It can be used as a food additive and can also be directly made into calcium supplement health food, with broad development and application prospects.
The bioavailability of calcium refers to the proportion of calcium used by the body, which depends on many factors, including the number of "enhancing factors" and "hindering factors" and the acidity of the digestive environment. Studies have shown that malic acid and citric acid are the best absorbed substances for chelating minerals. Calcium is mainly absorbed in the duodenum, which is actively absorbed, and malic acid and citric acid are absorbed in the upper digestive tract. The biggest feature of calcium phosphate is that the human body has a high absorption rate of its calcium, and it also has high biological availability such as promoting bone formation and alleviating bone loss.
The high absorption of calcium hydroxyapatite has been confirmed by clinical experiments and animal experiments [2]. Miller et al. used single-label and double-label stable isotope technology to conduct clinical experiments on the calcium absorption rate of calcium carbonate and calcium hydroxyapatite. The calcium absorption rate of calcium hydroxyapatite reached (36.2±2.7)%, while the absorption rate of calcium carbonate was (26.4±2.2)%.
Wang Ling et al. [3] studied the effects of different calcium sources (calcium citrate malate group, solid calcium carbonate group, liquid calcium carbonate group, solid calcium carbonate plus vitamin D3 group and low calcium control group) on rat bone metabolism. Through the test results of six indicators including serum alkaline phosphatase, serum tartrate-resistant acid phosphatase, serum calcium, serum phosphorus, bone calcium and bone density, calcium citrate malate and solid calcium carbonate plus vitamin D3 had better effects on improving rat bone metabolism, indicating that organic acids and vitamin D3 can effectively promote calcium absorption.
Rzymski et al. [4] administered oral calcium pyruvate, calcium citrate malate, calcium carbonate, and placebo to 12 healthy postmenopausal women who had fasted before the intervention. They observed an increase in calcium levels within 180 minutes after ingestion, with calcium citrate malate providing the highest calcium levels (Figure 2).
Figure 2 Changes in serum calcium concentration after taking placebo or 1000 mg of different calcium sources
People mostly focus on supplementing a single dose of nutrients. When calcium and iron are taken at the same time, their interaction is often ignored. Hallerg et al.’s research suggests that oral calcium supplementation has a significant inhibitory effect on iron absorption, and there is a dose-response relationship. Other studies have shown that the effect of calcium on iron absorption is related to the time interval between the two intakes, and the inhibitory effect when ingested at the same time The strongest; oral calcium supplementation may affect the absorption of dietary iron, reduce circulating iron, and affect red blood cell production due to iron deficiency [5].
Wu Meiyin et al.[5] discussed the effects of three commonly used calcium agents, calcium citrate malate (CCM), calcium carbonate (CaCO3), and bone calcium (BC), combined with ferrous fumarate (FF) on calcium and iron absorption. and bioavailability of three calcium supplements.
Experimental results show that the CCM/FF combination can significantly increase the hemoglobin content (see Table 1) and serum iron content (see Table 2) in rats with iron deficiency anemia, indicating that CCM has a small inhibitory effect on iron absorption. In addition, the area under the calcitonin curve (AUC) of CCM is higher than that of CaCO3 and BC, which indirectly reflects that the absorption rate of CCM is higher than that of other calcium agents.
References:
[1]. Jing Yiwen, Zhang Qiao, Yang Xiuyun, et al. Determination of 25 elemental impurities in calcium citrate malate[J]. Journal of Pharmaceutical Analysis, 2023, 43(7): 1229-1237.
[2]. Wu Junlin, Wu Qingping, Zhang Jumei, Research progress on the physiological effects of calcium citrate malate. Food Science, 2010. 31(7): pp. 333-337.
[3]. Wang Ling, et al., Effects of different calcium sources on bone metabolism in rats. Food and Fermentation Technology, 2017. 53(3): pp. 29-32.
[4]. Rzymski, P., et al., The bioavailability of calcium in the form of pyruvate, carbonate, citrate–malate in healthy postmenopausal women. European Food Research and Technology, 2016. 242(1): p. 45-50.
[5]. Wu Meiyin, Chen Shaojie, Yan Xiao, Effects of different calcium supplements on calcium and iron absorption in rats with iron deficiency anemia. Food Industry Science and Technology, 2015. 36(17): pp. 371-374.
1. What is Calcium Citrate Malate ?
Calcium Citrate Malate (CCM), also known as calcium citrate, is a neutral complex salt formed by malic acid, citric acid and calcium. The molecular formula and typical structure are shown in Figure 1.
1. Calcium Citate malate has the characteristics of high solubility, high absorption and utilization, safety and non-toxicity. Its water solubility is more than 100 times that of calcium carbonate and more than 10 times that of calcium citrate. Its aqueous solution is weakly acidic and its absorption and utilization rate is 37% higher than that of calcium carbonate.
2. Compared with calcium carbonate, calcium citrate malate as a calcium source does not consume gastric acid while supplementing calcium, and does not increase the risk of kidney stones.
3. Compared with other calcium nutritional enhancers, calcium citrate malate has the functions of supplementing calcium, enhancing bone density, regulating blood lipids, and enhancing oral health, reducing the risk of kidney stones, and not affecting the absorption of other trace elements.
4. Calcium citrate malate also has the physiological functions of malic acid such as anti-fatigue and heart protection. It can be used as a food additive and can also be directly made into calcium supplement health food, with broad development and application prospects.
The bioavailability of calcium refers to the proportion of calcium used by the body, which depends on many factors, including the number of "enhancing factors" and "hindering factors" and the acidity of the digestive environment. Studies have shown that malic acid and citric acid are the best absorbed substances for chelating minerals. Calcium is mainly absorbed in the duodenum, which is actively absorbed, and malic acid and citric acid are absorbed in the upper digestive tract. The biggest feature of calcium phosphate is that the human body has a high absorption rate of its calcium, and it also has high biological availability such as promoting bone formation and alleviating bone loss.
The high absorption of calcium hydroxyapatite has been confirmed by clinical experiments and animal experiments [2]. Miller et al. used single-label and double-label stable isotope technology to conduct clinical experiments on the calcium absorption rate of calcium carbonate and calcium hydroxyapatite. The calcium absorption rate of calcium hydroxyapatite reached (36.2±2.7)%, while the absorption rate of calcium carbonate was (26.4±2.2)%.
Wang Ling et al. [3] studied the effects of different calcium sources (calcium citrate malate group, solid calcium carbonate group, liquid calcium carbonate group, solid calcium carbonate plus vitamin D3 group and low calcium control group) on rat bone metabolism. Through the test results of six indicators including serum alkaline phosphatase, serum tartrate-resistant acid phosphatase, serum calcium, serum phosphorus, bone calcium and bone density, calcium citrate malate and solid calcium carbonate plus vitamin D3 had better effects on improving rat bone metabolism, indicating that organic acids and vitamin D3 can effectively promote calcium absorption.
Rzymski et al. [4] administered oral calcium pyruvate, calcium citrate malate, calcium carbonate, and placebo to 12 healthy postmenopausal women who had fasted before the intervention. They observed an increase in calcium levels within 180 minutes after ingestion, with calcium citrate malate providing the highest calcium levels (Figure 2).
Figure 2 Changes in serum calcium concentration after taking placebo or 1000 mg of different calcium sources
People mostly focus on supplementing a single dose of nutrients. When calcium and iron are taken at the same time, their interaction is often ignored. Hallerg et al.’s research suggests that oral calcium supplementation has a significant inhibitory effect on iron absorption, and there is a dose-response relationship. Other studies have shown that the effect of calcium on iron absorption is related to the time interval between the two intakes, and the inhibitory effect when ingested at the same time The strongest; oral calcium supplementation may affect the absorption of dietary iron, reduce circulating iron, and affect red blood cell production due to iron deficiency [5].
Wu Meiyin et al.[5] discussed the effects of three commonly used calcium agents, calcium citrate malate (CCM), calcium carbonate (CaCO3), and bone calcium (BC), combined with ferrous fumarate (FF) on calcium and iron absorption. and bioavailability of three calcium supplements.
Experimental results show that the CCM/FF combination can significantly increase the hemoglobin content (see Table 1) and serum iron content (see Table 2) in rats with iron deficiency anemia, indicating that CCM has a small inhibitory effect on iron absorption. In addition, the area under the calcitonin curve (AUC) of CCM is higher than that of CaCO3 and BC, which indirectly reflects that the absorption rate of CCM is higher than that of other calcium agents.
References:
[1]. Jing Yiwen, Zhang Qiao, Yang Xiuyun, et al. Determination of 25 elemental impurities in calcium citrate malate[J]. Journal of Pharmaceutical Analysis, 2023, 43(7): 1229-1237.
[2]. Wu Junlin, Wu Qingping, Zhang Jumei, Research progress on the physiological effects of calcium citrate malate. Food Science, 2010. 31(7): pp. 333-337.
[3]. Wang Ling, et al., Effects of different calcium sources on bone metabolism in rats. Food and Fermentation Technology, 2017. 53(3): pp. 29-32.
[4]. Rzymski, P., et al., The bioavailability of calcium in the form of pyruvate, carbonate, citrate–malate in healthy postmenopausal women. European Food Research and Technology, 2016. 242(1): p. 45-50.
[5]. Wu Meiyin, Chen Shaojie, Yan Xiao, Effects of different calcium supplements on calcium and iron absorption in rats with iron deficiency anemia. Food Industry Science and Technology, 2015. 36(17): pp. 371-374.
