[FALSE] Is calcium deficiency rare in Hong Kong because of an abundance of resources?

Screenshot of the Facebook post.

The Claim and Our Verdict

• The claim: A Facebook post published Oct. 19, 2021 claims that calcium deficiency is rare in Hong Kong, because Hong Kong has abundant resources.
• Fact-checking:
  • The report of the Hong Kong Total Diet Study, the first of its kind in Hong Kong, was published in 2014 by the Center for Food Safety. The report shows that more than 97% of the adults in Hong Kong were below the World Health Organization’s (WHO’s) recommended nutrient intake (RNI) for calcium. Therefore, the public is advised to increase the dietary intake of calcium to lower the risk of osteoporosis.
  • The Hong Kong Dietitians Association (HKDA) replied to our inquiry that Hong Kong people’s dietary intake of calcium is generally inadequate and few people’s calcium intake exceeded the upper limit. “When blood calcium level is low, the system automatically releases calcium in the bones to rebalance the blood calcium level. In the short term, inadequate calcium dietary intake will not cause symptoms. However, over time, it will lead to blood calcium ‘overdraft’ associated with skeletal dysplasia in children and adolescents and osteoporosis in adults,” says HKDA. Therefore, even if Hong Kong has abundant food resources, an imbalanced diet and long-term calcium inadequacy may still cause calcium deficiency.
• Our ruling: Therefore, we rate the claim as FALSE.

News Brief

A Facebook post published Oct. 19, 2021 claims that calcium deficiency is rare in Hong Kong because Hong Kong has abundant resources. The post translates in part as, “Calcium intake will absolutely prevent osteoporosis if there is a lack of dietary calcium. However, Hong Kong is so rich in foods and resources that most people will not lack calcium at all. Excessive calcium intake will only increase the risk of kidney stones.”

As of the issuance of this report, the post had been shared 60 times, and had received 30 comments and 521 likes or reactions.

Fact-checking

A keyword search found the report of the first Hong Kong Total Diet Study published in December 2014 by the Hong Kong Center for Food Safety (CFS). The report aims to estimate dietary exposures of the Hong Kong population and various population sub-groups to a range of substances, including contaminants and nutrients, and thus assess any associated health risks.

According to the report, WHO’s recommended nutrient intake (RNI) of calcium for adults is: 1,000 mg each day for males aged between 19 and 65 years, and 1,300 mg each day for males aged above 65 years; 1,000 mg each day for females aged between 19 years and menopause; and 1,300 mg each day for females post-menopause. The study shows that the dietary calcium intake of more than 97% of adults in Hong Kong was below the WHO’s RNI. Thus, the public is advised to increase the dietary intake of calcium to lower the risk of osteoporosis.

Kelly Ching, external affairs officer, Hong Kong Dietitians Association (HKDA) replied to our inquiry concerning the claim: “The report of Hong Kong Total Diet Study published in 2014 by CFS shows that Hong Kong people’s dietary intake of calcium is generally inadequate, while few Hong Kong people’s intake of calcium exceeded the upper limit. The dietary calcium intake of more than 90% of Hong Kong people was below the WHO’s RNI for adults. Less than 1% of the population exceeded the WHO’s upper limit of dietary calcium intake for adults. Long-term high calcium intake may cause kidney stones and interfere with the absorption of other minerals.”

Ching adds, “Nearly all (99%) the total calcium in human body is stored in the bones. The remaining is distributed in blood and extracellular fluid. When the blood calcium level is low, the body will automatically release calcium from the bones to rebalance the level of calcium in the blood. In the short term, inadequate dietary calcium intake will not cause symptoms. However, over time, it will lead to blood calcium ‘overdraft’ associated with skeletal dysplasia in children and adolescents and osteoporosis in adults.” Therefore, even if Hong Kong has abundant food resources, an imbalanced diet and long-term calcium inadequacy may still cause calcium deficiency.

HKDA offers some tips for healthy calcium intake:

• Dietary intake of calcium is the best source to meet the daily calcium requirement. There are a lot of calcium-rich foods and drinks to consume, for example, hi-calcium low-fat milk, dark green vegetables, firm tofu, canned sardines (with bones), sesame, soy milk, and cereal.
• Children, adolescents, the elderly, menopausal and post-menopausal women, people with lactose intolerance or allergic to milk protein should properly increase their dietary intake of calcium.
• Choose foods or drinks with “high calcium” on the nutrition labels.
• Avoid excessive intake of salt and caffeine, which will accelerate calcium excretion through the urine.
• Sunlight helps the body to make vitamin D which helps in the absorption of calcium.
• Too much calcium, however, can damage your health. An adult’s daily intake of calcium (from food and supplements) should not exceed 2,000 mg, and the RNI is 800 mg to 1,000 mg each day. Consult a health professional before taking calcium supplements.