Proposed role of calcium and dairy food components in weight management and metabolic health.

Dietary calcium and dairy foods have demonstrated an antiobesity effect in animal studies, observational and population studies, and randomized clinical trials. Moreover, there is a strong theoretical framework to explain the effects of dietary calcium on energy metabolism. The supporting mechanisms include dietary calcium-correcting suboptimal calcium intakes, thereby preventing the endocrine response (parathyroid hormone [PTH] and calcitriol), which favors adipocyte energy storage and inhibits adipocyte loss via apoptosis. Dietary calcium appears to further promote energy loss via formation of calcium soaps in the gastrointestinal tract and thereby modestly reduces net energy absorption. Dietary calcium appears to be responsible for approximately 50% of the antiobesity bioactivity of dairy foods. The additional dairy bioactivity has not been fully identified, but is primarily localized in whey protein. The major components are the angiotensin-converting enzyme (ACE) inhibitor activity of whey proteins and the high concentration of leucine in whey. This high leucine content appears to be primarily responsible for the repartitioning of dietary energy from adipose tissue to skeletal muscle during weight loss, resulting in greater preservation of skeletal muscle and accelerated loss of adipose tissue during negative energy balance. Finally, high-calcium diets suppress obesity-induced oxidative and inflammatory stress independently from its role in modulating adiposity; these effects are similarly augmented by other dairy food components. However, the number of randomized clinical trials conducted is still modest, and a small number have not confirmed significant effects in weight management. Thus, the protective effects of dairy foods against obesity and its comorbidities are promising, but warrant further large-scale studies.