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‘Risks outweigh benefits’ for calcium supplements: Meta-analysis

12 commentsBy Nathan Gray , 30-Jul-2010
Last updated the 14-Jan-2011 at 10:25 GMT

Regularly taking calcium supplements for osteoporosis may cause more heart attacks than the number of fractures they prevent, according to new research.

The study, published in the British Medical Journal, suggests that calcium supplements – which are commonly taken by older people to reduce the effects of osteoporosis – may increase the risk of cardiovascular events , such as heart attacks and stroke, by up to 30 percent.

Professor Ian Reid, senior author of the study, told NutraIngredients.com that he believes the findings indicate a need to review the use of calcium supplements in the general population; saying that the industry needed to “sit back and not just look at the benefits, but the clearly demonstrated risks”.

“When you do the arithmetic, then it just doesn’t add up. The risks outweigh the benefits,” said Prof. Reid, from the University of Auckland, Australia.

Calcium

The widely used supplements have been shown to marginally reduce the risk of fracture for osteoporosis sufferers, and improve bone density. However, the authors noted that very little research has been compiled on the risks associated with calcium supplementation.

The results observed in the new study – a meta-analysis of fifteen randomized trials on calcium supplements conducted in the last twenty years – saw an increased risk of cardiovascular events in people using calcium supplementation but not people with high dietary intakes of calcium.

Prof. Reid explained that this may be related to supplements causing higher blood calcium levels compared to dietary calcium – high blood calcium levels are believed to lead to hardening of the arteries, which can cause heart attacks.

Heart risk

The study investigated the links between calcium supplementation and cardiovascular events by analyzing data from over 12,000 people involved in 15 trials.

They found that calcium supplements increase the risk of heart attack by about 30 percent.

“The likely adverse effect of calcium supplements on cardiovascular events, taken together with the possible adverse effect on incidence of hip fracture and its modest overall efficacy in reducing fracture (about 10 percent reduction in total fractures) suggest that a reassessment of the role of calcium supplements in the prevention and treatment of osteoporosis is warranted,” said the researchers.

They added that, although the increase in heart attack risk is modest, the widespread use of calcium supplements means that “even a small increase in incidence of cardiovascular disease could translate into a large burden of disease in the population.”

Wider impact

Reid told NutraIngredients.com that he also believes the study has broader implications for all nutritional supplements:

“We have tended to focus on just the benefits of supplements without really looking at their safety. In the future I think we need to look at both the efficacy and the safety of supplements,” said Reid.

“People assume that these supplements are natural. A high calcium meal is natural, but taking highly concentrated calcium tablets is not, and does not have the same effects,” he warned.

Industry response

The Health Supplement Information Service responded to the research findings saying: “While the results of this meta-analysis are interesting and should encourage more research, the authors did not include the totality of the evidence on calcium supplementation and there were limitations to the analysis. For these reasons, it is not appropriate at this stage to change public health advice on the use of calcium supplements to maintain bone health."

Further industry responses to this study can be found here .

Source: British Medical Journal
doi:10.1136/bmj.c3691
“Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis”
Authors: M.J. Bolland, A. Avenell, J.A. Baron, A. Grey, G.S. MacLennan, G.D. Gamble, I.R. Reid

12 comments (Comments are now closed)

another limited and skewed study

like the others said, magnesium is crucial for calcium absorption, as is sunshine and vitamin D, C and weight-bearing exercise. if the elderly are not getting any of the other vitally important ingredients for calcium absorption then calcium will end up getting toxic.
I am tired of these ridiculous studies that don't give the whole picture. We cannot scare people off calcium... what me must do is educate them of the total story for proper absorption.

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Posted by Birgitta Lauren
05 August 2010 | 06h45

calcium supplements

This sounds scary, but when one gets to the original communication, it says that it only considers calcium without vitamin D. As most supplements contain vitamin D, the results of this metaanalysis do not seem to be so dangerous

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Posted by Anna
04 August 2010 | 12h03

Calcium without adequate Magnesium intake can manifest as cardiovascular disease.

Calcium without adequate magnesium intake can manifest as cardiovascular disease
We are not surprised by the meta-analysis results of Ca supplement studies showing a possible rise in cardiovascular disease. Calcium is, indeed, low in intakes from foods, and is, indeed, important in bone health; however, over 50% of adults in USA do not get adequate nutritional Magnesium from foods, and fewer take Mg supplement than do Ca supplements. The long term results of low magnesium being associated with cardiovascular diseases, especially in the face of high Ca intakes, is well reviewed in the book, "The Magnesium Factor", by M.S. Seelig, 2003, Avery- Penguin as well as more recent peer-reviewed articles. Calcium supplements need to be balanced with adequate magnesium intakes, often low in populations consuming a processed food diet. An overall balance of all essential micro-nutrients is emphasized by the recent BMJ results. A. Rosanoff, Ph.D., Director of Research, Center for Magnesium Educ & Research, Pahoa, HI

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Posted by A. Rosanoff, Ph.D.
03 August 2010 | 19h07

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