Calcium Concerns: Not if You Are Thoughtful About Your Supplementation

posted by on October 14th, 2016

Calcium Concerns: Not if You Are Thoughtful About Your Supplementation

There are many essential vitamins and minerals considered critical for intake, calcium is one of them.  While it is still best practice to get your micro-nutrients through diet, we know that many people today still do not eat a balanced diet, or worse don’t have access to healthy and well balanced food choices.

Having less than optimal consumption results in what is known as micronutrient depletion or a sub-clinical deficiency.   Due to this fact, if your diet doesn’t provide adequate levels of calcium, it is crucial to take, either through thoughtful supplementation or other fortification, vitamins and minerals for optimal functioning.

In turning to supplementation, some also turn to the literature, media and their health professionals for the best advice.  Over the course of the last 8 years the scientific community has weighed in on the benefits of calcium supplementation.  They are decidedly split.  For every study that says increased calcium supplementation from sources other than diet are a waste or harmful there is one, or more, that can make a sound argument for supplementation.

Earlier this month a study came out and hit the medical community with this question again.  “Should we or shouldn’t we recommend calcium?”

First, let’s ask why is calcium so widely recognized by health professionals for healthy aging and metabolism?  Calcium plays a primary role in bone mineral density, cardiovascular health and endocrine balance.  Nevertheless, Johns Hopkins researchers led by Dr. Erin Michos have reported that calcium supplements can contribute to heart disease.

The study was remarkable for the reason it looked at a large group of individuals and controlled their data, or findings, for risk factors for heart disease before reporting on their findings.  This was remarkable because to date in the literature asking this question.  Most studies are osteoporosis studies having bone mineral density concerns or risk as inclusion criteria and as a result, do not control for age or cardiovascular health that may compromise cardiovascular findings.   Therefore, many past studies can only be considered hypothesis and should not be used as a rule.

As the adage goes: Correlation is not causation.

Dr. Michos made an important distinction when she reported the findings.  She made it clear this gives the give researches an important question to ask about how the body utilizes calcium.

“We think the body metabolizes supplements and dietary calcium differently,” said Dr. Erin Michos, associate director of preventive cardiology and associate professor of medicine at the Ciccarone Center for the Prevention of Heart Disease at the Johns Hopkins University School of Medicine.”

She and her team reported those that consume in the upper 20% of calcium intake by a combination of dietary sources and supplement sources have a 27% lower risk of heart disease.  Yet, when she and her team separated out those that consumed excess amounts of calcium through supplementation alone, they found a higher risk of atherosclerosis and abnormal calcium scores.  A calcium score is a value given after the coronary arteries have been evaluated with the help of an MRI to assess cardiovascular risk.

Dr. Michos is thoughtful in discussing the role supplementation may play in contribution to heart disease rather than reporting it causes heart disease.  While her and her team’s findings are important to the medical community, they do declare the non-judicious use of calcium in excessive amounts in the absence of healthy diet contribute to heart disease. The findings were just as clear the combination of calcium and a diet rich in color are protective in heart disease.

Dr. Duffy McKay, Senior Vice President of the Council for Responsible Nutrition reminds practitioners that there is a large body of evidence that still supports the safety of calcium supplementation based on the conclusion of several large studies in recent years.

The discussion in the medical community around this new study maintain it is critical to focus on the benefits of diet and combinations of nutrients that allow calcium to perform better in the body, regardless of its source.  Both Dr. Michos and Dr. McKay agree the best approach to better bone and cardiovascular health is by consuming a diet that is rich in many healthy nutrients and these nutrients should be consumed in addition to health lifestyle and weight management.

Studies have shown that combining vitamin K, vitamin D, magnesium, vitamin C and calcium works more effectively to improve bone mineral density, than calcium alone. Vitamin D facilitates the absorption of calcium and vitamin K may help focus calcium to the right tissue.  Vitamin C lends to collagen production and flexibility of bone tissue, while calcium and magnesium are continuously maintained in your blood in order to promote normal blood clotting, skeletal and muscle contraction and endocrine balance.

Mineral & vitamin intake, in combination with weight bearing physical activity, support a healthy balance of bone offering a recipe for a healthy heart as well as healthy aging.

  • John J.B. Anderson, Bridget Kruszka, Joseph A.C. Delaney, Ka He, Gregory L. Burke, Alvaro Alonso, Diane E. Bild, Matthew Budoff, Erin D. Michos. Calcium Intake From Diet and Supplements and the Risk of Coronary Artery Calcification and its Progression Among Older Adults: 10‐Year Follow‐up of the Multi‐Ethnic Study of Atherosclerosis (MESA). Journal of the American Heart Association, 2016; 5 (10): e003815 DOI: 10.1161/JAHA.116.003815