Calcium No More!

If you're a woman of a certain age (like me) you've probably been brainwashed when it comes to calcium intake, and most likely (like me) have a bottle of supplements in your kitchen cabinet.  You may even have taken a calcium-based antacid in hopes of killing two birds with one stone, and if you're really obsessive-compulsive, and as Rick would opine, like me, you have probably adopted a program of weight-bearing exercise, all in the hopes of avoiding osteoporosis, hip fracture, and that downward death trajectory.  Now, as we discuss on PodMed this week, and as published in the British Medical Journal or BMJ, it's time to reconsider calcium supplementation in light of an increased risk of cardiovascular disease and death in women, just as we've seen emerging in men these last few years.

The study crunched data from a huge (90, 303) cohort of Swedish women born between 1914 and 1948 and invited to participate in a study of routine mammography.  In addition to mammography a questionnaire was administered to those who agreed, with a food assessment and other dietary and lifestyle practices such as supplement use. Over 60,000 women enrolled and baseline data was obtained; about 40,000 of them remained in the study for follow up about 10 years later.

Calcium intake was calculated for study participants and included both estimates of dietary calcium as well as supplement use, including calcium as part of a multivitamin.  The long and short of the analysis was that the highest cardiovascular risk as well as all cause mortality was seen in the women with the highest calcium intake, in the group taking greater than 1400 mg/day of calcium.  A dose response was seen regarding calcium intake and cardiovascular and all-cause mortality.  The risk for all cause mortality among the group with the highest calcium intake was over 2.5 times that of women who did not use calcium supplements.

Well.  Yet again something that flies in the face of established opinion and renders us all wondering just how much damage we may have done to ourselves with regard to tossing down those supplements. Rick points out in the podcast that this is merely an association at this point, with no smoking gun on the scene.  Yet it seems prudent to stop taking calcium supplements if you're still doing so, perhaps to get a DEXA scan of your bones to find out where you are with regard to calcium stores in your skeletal system, and if you're really worried, maybe a coronary calcium scan to assess your heart health.  While the definitive study on this matter won't likely ever be done, since randomizing large numbers of women to take calcium supplements or not over decades of life and then examining causes of death would be prohibitively expensive and maybe even unethical, it sure does seem once again that moderation, prudent diet, exercise, and avoidance of now, even supplements may prove the best strategy for a long and healthy life.

Other topics this week include two in JAMA:  folic acid and autism, and risk of recurrent Helicobacter pylori infection in Latin America, and in JAMA Internal Medicine a look at consumer pricing of hip replacement surgery.  Until next week, y'all live well.

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<b>Calcium</b> No More! — PodBlog | Option One Nutrition
February 18, 2013 at 8:38 pm

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Comments

LaDonya Christopher February 6, 2015 at 12:23 pm

I need advice on calcification of knee bones due to high levels of PTH from dialysis. Caused my knee joints to have fused to bone. Can this be fixed or reversed?

Reply

Elizabeth Tracey February 20, 2015 at 10:37 am

This would have to be determined by your physician. All the best, and sorry not to be able to be more helpful.

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Mike April 24, 2013 at 3:05 am

Wow that was odd. I just wrote an extremely long comment but after I clicked submit my comment didn't show up. Grrrr... well I'm not writing all that over again.
Anyways, just wanted to say wonderful blog!

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Emily March 8, 2013 at 7:47 am

I know my mom is going to be thrilled to hear this news. Regarding the fact similar evidence has been found in men, you have to wonder if there is really something here. High amounts of calcium can certainly promote calcification of atherosclerotic lesions, and higher levels of calcification may increase one's risk of cardiovascular disease including stroke.

Although there is strong evidence for calcium's beneficial use in promoting bone density, treating heart burn, hyperphosphatemia, hypocalcemic tetany and osteoporosis, patients and clinicians a like should certainly consider the possible risks and side effects. Even though something is "natural" doesn't mean it is always safe, especially in large doses.

If you do take calcium, I think it is always beneficial to check with your health care team, especially pharmacists, to see if calcium interacts with any of your medications. Many elements, such as calcium, bind with medications and cause them to become ineffective. Although there are infinite possible confounders, this may be another reason why calcium was tied to higher mortality.

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Elizabeth Tracey March 8, 2013 at 9:04 am

Emily, thanks for your reply! One thing to remember is higher serum calcium is not related to atherosclerosis; Rick and I talk about this in last week's PodMed (3/1), but I'm so happy to know your mother will be relieved to take one less supplement!

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