BMJ study provokes Danish calcium investigation

By Shane Starling

- Last updated on GMT

Related tags Calcium Vitamin d Osteoporosis

The controversial study published last month in the British Medical Journal (BMJ) that suggested calcium supplementation could increase heart attack risk has prompted an assessment of the mineral by Danish authorities.

The Danish Veterinary and Food Administration (DVFA) and the Danish Medicines Agency (DMA) said they would analyse the study findings along with calcium use in Denmark.

At the same time they played down the meta-analysis (15 studies surveyed) findings that calcium supplement use could increase heart attack risk by 30 per cent compared to placebo.

"Calcium supplements are primarily used for the prevention and treatment of osteoporosis - often in combination with vitamin D or other osteoporosis drugs,"​ said the DMA. "It is important to highlight that the analysis only involves calcium without the concomitant use of a vitamin D supplement."

Food (supplements) for thought

The DMA and theDVFA pointed out that while a 30 per cent increase in heart attack is signifcant, heart attack risk is already low. They said the meta-analysis contained enough of interest to warrant their recommendation that the Danish National Food Institute perform its own evaluation of the study.

The DMA will perform a separate aalysis to determine consequences, if any, for the use of osteoporosis medicines.

The agencies noted that most calcium supplements are sold as food supplements in Danish retail outlets, with only one calcium-containing medicine sold over-the-counter.

There are no immediate plans to change this,​”​the DMA said.

“The DMA advises persons who take a calcium supplement to discuss whether it is necessary to continue taking the supplement at the next convenient doctor's visit. Persons who have been prescribed or recommended a calcium supplement by a doctor should not stop their treatment without consulting their doctor.”

Study briefing

The BMJ​ meta-analysis found calcium supplements cause more cardiovascular events such as heart attacks and stroke than the number of fractures they prevent.

Calcium supplements are commonly taken by older people as a measure to reduce the effects of osteoporosis. The widely used supplements have been shown to marginally reduce the risk of fracture for osteoporosis sufferers and improve bone density, but very little research has been compiled on the risks of calcium supplementation.

The results observed in the study saw an increased risk in people using supplementation, but not those who obtained calcium from the food supply. The researchers explained that this could be related to higher blood calcium levels from supplementation compared to dietary calcium – higher blood calcium levels are believed to lead to hardening of the arteries, which can cause heart attacks.

But the supplements industry criticised the study for “cherry picking”​ the studies in the meta-analysis and downplaying the bone health benefits of calcium supplementation.

To read NutraIngredients coverage of the study click here.

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Medical bias against nutritional supplements

Posted by Leo Ray Ingle,

I've practiced medicine since my graduation from Indiana University Medical School in 1967. I've long marveled at the authoritarian nature of our medical establishment. I've also found that, with some exceptions, MD's (including researchers) are generally ignorant of and biased against nutritional supplements. Do they resent supplements being non-prescription and thus out-of-their-control?
I've had to write an extensive critique of the BMJ piece for family and friends. My review of the literature convinced me that a total daily intake of anything less than 2500 mg of elemental calcium, with magnesium and supplementary Vitamin D and Vitamin K will promote quality of life and extend life.

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Yes, calcium can kill

Posted by Bill Sardi,

The calcium supplement analysis published in the British Medical Journal does not represent "cherry picking" of studies. Yes, calcium can kill. In countries of the world where hip fractures are rare, women don't consume much calcium from their diet and don't take supplements. See my authoritative report here:

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