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

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, New Zealand.

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