Abstract
This review was performed to summarize and integrate the evidence relating calcium intake to health status in African Americans, with special attention to bone and fat. Despite lower average calcium intakes, African Americans typically have skeletons more massive than those of whites. This is the result of a relative resistance of the bony resorptive apparatus to parathyroid hormone, which forces better urinary conservation of calcium and, at some life stages, more efficient intestinal calcium absorption as well. This adaptation, however, has other costs and appears to contribute to a greater risk in African Americans for several chronic diseases, including cardiovascular disease and stroke, obesity, and the insulin resistance syndrome. Higher calcium intakes not only support the skeleton in African Americans, just as they do in whites, but reduce the disease burden for other chronic diseases as well.