In the News: Confusion About Calcium Supplements
The motto of this cautionary tale: More is not necessarily better.
In a meta-analysis published in the British Medical Journal (BMJ) last week, researchers said the risk of heart attack increased modestly in the women who took calcium supplements in large research studies. Around 40 percent of American women are currently taking calcium supplements. Even a modest risk could be a big problem for anyone.
Background: Calcium today
Calcium is well known for its role in building and preserving strong bones. A calcium deficiency is thought to contribute to osteoporosis; optimum calcium intake has been associated with denser bones. Indeed, the FDA backs the relationship between "calcium and a reduced risk of osteoporosis,” and before bestowing their coveted backing, they require a significant body of scientific literature to support a health claim.
In the US, osteoporosis is seen as a major public health threat. Of people age 50 and older, 55 percent have low bone mass or osteoporosis. Calcium intake in the United States is well-documented by NHANES (National Health and Nutrition Examination Survey) data to be suboptimal. Presently, only 40 percent of women, ages 20 to 40 years, meet the calcium intake recommendation, and in women age 50 and older, only 27% of achieve that goal.
For doctors, it is de rigor to discuss calcium intake with women of all ages. (Note: men need calcium too.) Doctors often tell women to take calcium supplements and many women can recall receiving that advice. But qualified nutritionists always say that it is better to get nutrients from food. In fact, the FDA suggests this model claim for food and supplement producers: "Adequate calcium throughout life, as part of a well-balanced diet, along with physical activity, may reduce the risk of osteoporosis." They did not mention calcium supplements.
A closer look at intake
In the BMJ study, research subjects ate between 406 to 1,240 milligrams of calcium a day. Calcium requirements are set between 1,000 – 1,300 milligrams a day, depending on gender and age. Dietary calcium is found in many foods, not only in dairy products. Salmon, black beans, almonds, broccoli, and others are naturally high in calcium, and in recent years, many foods have been fortified with extra calcium to increase sales. Calcium-fortified foods include juices, cereals, bars, waffles, soy milk, and rice milk, to name a few. Indeed, Whole Grain Total cereal contains 1,000 mg in three-quarters of a cup.
But calcium has a Tolerable Upper Intake Level (UL) of 2,500 milligrams a day set by the Institute of Medicine. If the UL is consistently exceeded, blood levels of calcium may rise and that could impair kidney function and reduce the absorption of other minerals. BMJ researchers speculated that supplemental calcium increased the rate of heart attacks by increasing vascular calcification. The researchers did not say that heart attack victims had too much calcium, but given their reported dietary intakes, the question should be asked. Overall, the Institute of Medicine makes it clear: calcium intake should not exceed the UL, regardless of source.
Who's your daddy?
Everyone needs to establish a baseline calcium intake before adding supplements - and Calorie Count makes it easy to do just that. To find your baseline, keep food logs without changing your intake for three or more days (two weekdays and one weekend day is good), and then compare the amount you typically eat to the amount you personally need. Click the Analysis tab under the My Account section to find your "Calorie Count Recommended Values" for calcium and other nutrients. Supplement with only the amount you need to reach your personal RDA. It’s that easy to be safe with Calorie Count.
Are you mega-dosing on calcium?