BBC website 30/7/2010

http://www.bbc.co.uk/news/health-10805062

Calcium pills 'increase' risk of heart attack
By Emma Wilkinson Health reporter, BBC News
Calcium pills Calcium supplements are commonly taken by older people at risk of fracture

Calcium supplements taken by many older people could be increasing their risk of a heart attack, research shows.

The study, in the British Medical Journal, said people who took supplements were 30% more likely to have a heart attack.

Data from 11 trials also suggested the medicines were not very effective at preventing bone fractures.

Almost 3m people in the UK are thought to have osteoporosis and many take calcium pills to prevent fractures.

The study recommends doctors review their use of calcium supplements for managing osteoporosis.

The National Osteoporosis Society said most people should be able to get enough calcium through their diets, rather than reaching for the medicine cabinet.

The researchers said those who had a diet naturally high in calcium were at no increased danger.
'Limited benefit'

In all 12,000 people aged over 40 took part in the trials of calcium supplements of 500mg or more a day.

“It is a balance of risks - people should consider the risks involved and how they apply to their own circumstances and discuss the matter with their GP" Dr Alison Avenell Study author

The risk of heart attack was seen across men and women, was independent of age and the type of supplement given.

A small increased risk of death was seen in the study but was not statistically significant, the researchers said.

The reason for the increased risk of heart attack is not clear but it is thought the extra calcium circulating in the blood could lead to a hardening of the arteries.

Calcium in the diet is safe and the Food Standards Agency recommends adults have 700mg of calcium a day from milk, cheese and green, leafy vegetables.

Dr Alison Avenell, from the University of Aberdeen which did the research with colleagues in New Zealand and the US, said the evidence suggests calcium supplements only have a limited benefit in preventing fractures, especially when compared to other treatments available.

"It is a balance of risks - people should consider the risks involved and how they apply to their own circumstances and discuss the matter with their GP," she said.

She added the results did not necessarily apply to younger people with conditions for which they take calcium.

Judy O'Sullivan, senior cardiac nurse at the British Heart Foundation, said the results should be interpreted with caution because the trials did not set out to look at the risk of heart attack.

"However, the research should not be completely ignored," she said.

"Any new guidelines on the prevention of fractures in those most vulnerable to them should take this type of analysis into account."

Dr Claire Bowring, of the National Osteoporosis Society, said: "We've always recommended that people should aim to get the calcium they need from their diet to help build stronger bones.

"If you get all of the calcium that you need from your diet and adequate vitamin D from exposure to sunshine, then a supplement will not be necessary."

She said there were still questions to be answered about the treatment of osteoporosis but advised people taking calcium supplements to talk to their GP, especially if they have a heart condition.

Good to know. Thanks for posting!

Bone problems may have more to do with lack of fat to help adsorb calcium and low vitamin D levels than with "inadequate" calcium intake.

Here is another reasonable summary of the story.
Calcium linked to higher risk of heart attacks BMJ Group

Dr Davis Heartscanblog has been warning about too much supplemental calcium for some time. He specializes in reducing calcification by using scans to monitor the effect of his dietary and lifestyle modifications and uses EFFECTIVE strength D3 supplements so has first hand knowledge of the need (or lack of) calcium when 25(OH)D levels are above 40ng/ml.

this paper shows that
Dietary calcium and serum 25-hydroxyvitamin D status in relation to BMD among U.S. adults. Above vitamin D Levels of > 20 ng/ml Men don't need more than 626 mg/day supplemental calcium, and women with D don't need more than 566 mg/day.

If you raise your 25(OH)D to around or above 40ng it's possible you will absorb even more calcium from food/water and thus be able to reduce supplemental calcium even more.

Magnesium counterbalances the actions of calcium so it's important to ensure you are getting sufficient magnesium anyway and particularly if you use calcium supplements. See what Krispin says here It is more likely you are deficient in magnesium than calcium as food/water sources of calcium are more readily available but modern crop varieties have reduced magnesium content.

Vitamin K2 also helps to lock calcium into bones and checking the acidity of your urine

reducing the acidogenicity of the diet into the alkali-producing range with bicarbonate lowers calcium excretion and the bone resorption rate in healthy older men and women consuming rather typical acid-producing American diets.

Recipe for Magnesium Bicarbonate water

For UK readers the cheapo discount retailer Aldi do a carbonated spring water £1 for 4 x 2lt with a high magnesium bicarbonate level, for those without access to a soda stream.

remember
-Adults under age 50 need a total of 1,000 mg of calcium from all sources every day.

-Adults 50 and older need a total of 1,200 mg of calcium from all sources every day. and the
BEST source is diet = food and water

We should be getting MOST of our calcium from FOOD and WATER,

It's not that difficult to ring your local water provider or check their internet based information or read the label on your bottled water, then do the sums based on your total daily water consumption.

Same with food sources, it may take a bit of time to work out roughly how much yoghurt, cheese, milk fish greens etc. you average daily over the week but it's fairly straightforward.

Milk & yogurt 8 oz 300-450 mg
Cheese 3 oz 300-450 mg
Bones in canned sardines and salmon 3 oz 181-325 mg
Calcium fortified foods (i.e., orange juice, soy milk) 8 oz 200-300mg
Dark green, leafy vegetables 1 cup 100-200 mg

It's then just basic math to add those figures together and subtract from 1200mg/daily to work out how much calcium you need to supplement with.
If the difference between what you are getting from diet and need to supplement with is more than 500mg then it's a matter of seeing how you can improve you dietary intake so you are not needing to take 500mg or more daily.
Remember also that Calcium Carbonate is the supplement form MOST likely associated with problems and the least likely to cause problems is Calcium Citrate/Malate blends code ~~~~~~ $5 introductory discount Looks like they may be cheaper from Vitaminlife if you can't use the discount code (depending on shipping cost) remember no one should be taking the recommended serving size because you should ALL be getting the greatest amount of calcium from your food/water, and the supplement should only be to make up any shortfall.

I was watching Dr. Rosenthal on TV and he was talking about a study to determine if calcium supplements in older women caused plaque in the arteries. What they found was that the extra calcium in post menopausal women went directly to their bones and not to the arteries. They didn't say anything about men. Somehow, this seemed linked to the decrease in estrogen during menopause.

Without a link to the actual study he was referring to it's difficult to comment except to point out that the latest understanding comes from a META analysis, which combines the results from several papers.

Given it's not that difficult to ensure you provide sufficient calcium in your diet, and it's not that difficult or expensive to correct vitamin D insufficiency to raise 25(OH)D to above 40ng/ml 100nmol/l so you are able to maximise the uptake of that calcium, and it's pretty easy to reduce the acidic nature or your diet so you reduce calcium loss in your urine, it seems to me Calcium supplements are unnecessary and given their uncertain benefits, any level of increased heart attack risk is unwarranted.

New analysis slams calcium supplements over heart problems

Yeah, I stopped taking calcium awhile back based on what Dr. Davis was blogging about this. Or actually, I stopped feeling guilty I was so irregular about taking my calcium supplements...