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Calcium supplements: risks versus rewards

April 25, 2011

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If you take a calcium supplement, you might be wondering what to make of a new finding from the British Medical Journal suggesting that calcium supplements increase a woman’s risk of heart attack and stroke by about 20 percent. Should you keep taking your supplement, and how do the benefits compare against the risks?

That’s a tricky question, and one that you might assume researchers have figured out by now — given that Americans with thinning bones have been advised to take the bone-protecting supplement for decades. Turns out, though, that calcium might be yet another nutrient that’s been oversold as a supplement — at least according to some experts.

“I think all people taking calcium supplements should reassess whether these are doing them any good,’’ says study coauthor Dr. Ian Reid, a professor of medicine and epidemiology at the University of Auckland in New Zealand via e-mail. “Our paper shows that for every three fractures that are prevented by calcium, six heart attacks or strokes are caused. Thus, the balance of risks and benefits is negative.’’

That finding, though, only applies to healthy postmenopausal women who were randomly assigned to take calcium along with vitamin D; more than half the women participating in the clinical trial — the landmark Women’s Health Initiative — were already taking calcium supplements on their own to, say, combat thinning bones. Oddly, those who were randomly assigned to take even more calcium had no increased heart or stroke risks compared to those who were assigned to take a placebo.

In fact, the supplement takers who were given more calcium had about a 16 percent lower risk of dying compared to their counterparts who took placebos.

Confused yet? So are experts who aren’t sure what to make of the findings, including whether some women benefit from calcium supplements more than others. Also, men weren’t included in the study, which means they could have a different risk-benefit profile.

“It is not possible to provide reassurance that calcium supplements given with vitamin D do not cause adverse cardiovascular events or to link them with certainty to increased cardiovascular risk,’’ write the European authors of an editorial that accompanied the study. “Clearly further studies are needed.’’

Until then, experts say we need to exercise some common sense when it comes to calcium. “I think it’s generally a good idea to get as much calcium as you can from food rather than supplements,’’ says Dr. Frank Hu, a calcium researcher and professor of nutrition at Harvard School of Public Health.

Women age 51 and over and men age 71 and over need 1,200 milligrams a day of calcium. Younger adults need 1,000 mg a day. Eight ounces of yogurt, an 8-ounce glass of milk, and a 1.5-ounce serving of cheddar cheese provide 1,000 mg of calcium. Adding a cup of fortified orange juice can get you up to 1,200 mg.

Experts generally agree that there’s no benefit to exceeding the government’s daily recommended allowance and that we should aim to get no more than 800 mg of daily calcium from a supplement. Research indicates that calcium overdose has become more common in recent years, leading to an increased risk of high blood pressure and even kidney failure.

If you do have thinning bones, talk to your doctor about the pros and cons of calcium supplements. They only have a modest effect on fracture prevention, says Hu, and need to be taken along with vitamin D. DEBORAH KOTZ

FredQuimby wrote: Maybe it’s just me but it seems every time we are told to take this pill or that supplement, a couple of years later there is a scientific study or lawsuit that proves they are bad for us. I’ll take my supplements the way they were intended. In natural foods.

rockin3 wrote: I totally agree Fred! Right now, it’s vitamin D. Will that end up being bad for us in a few years? Probably. I’m starting to rethink my multivitamin. . .

Green-Mountain-Views wrote: Cool! Now my doc has to stop frowning at me when I tell her I try to get my calcium from food! As for vitamin D, perhaps it’s best to have the blood test run to see if you have enough. I don’t, so I take a supplement. But I don’t take a megadose.

Growing interest in going green

I never considered myself all that environmentally conscious, though I’d like to do what I can to protect our planet — provided it’s not too difficult or costly. That’s why I’m enjoying a new website called Practically Green developed by Newton native Susan Hunt Stevens (a former general manager at Boston.com).

Tips on the website include:

■ Embracing recycling. Sure, I already recycle glass bottles, cans, and newspapers since my town provides handy containers and threatens to issue citations to those who don’t. But I’m thinking of trying recycled toilet paper and napkins. I’d be willing to pay a little extra if the quality is decent.

■ Reducing water consumption. I might consider a dual flusher if I replace my toilets, but for now I’ll follow some simpler tips like turning off the water when I brush my teeth and only running the laundry and dishwasher when they’re full. Stevens says she’s no longer watering her lawn.

■ Green cleaning. While the website is chock-full of environmentally friendly products, some are in the form of sponsored ads. Look carefully for reviews from actual folks who use the products to see which might be worthy to purchase. D.K.

TinaEisenhart wrote: I had queasiness while cleaning our home and made the switch almost four years ago to [greener] products. This small change made a huge impact on my whole family.

Lowering sugar intake can reduce triglycerides

If you’ve ever had your cholesterol levels tested, you might have been confused by the “triglycerides’’ reading. Like cholesterol, these, too, are fats that circulate in your blood and increase as you gain weight or consume high amounts of saturated fat.

But triglycerides often rise with the amount of sugar you eat. And in new guidelines published last week in the journal Circulation, the American Heart Association wants folks to understand how to lower their risk of heart disease and diabetes by lowering levels of too-high triglycerides.

While levels of “bad’’ LDL cholesterol can be tough to lower without a medication like a statin, triglycerides respond pretty well to some simple lifestyle changes. Switching away from saturated fats in red meat and dairy products to unsaturated fats like olive oil or fish can be a good first step, write the guideline authors. So, too, is engaging in exercise and losing weight. Lowering sugar intake is also key.

78sman3 wrote: This is an improvement over earlier guidelines, but many members of the American Heart Association still seem overly concerned with protecting the revenue stream of the junk food industry.

bluesguy9999 wrote: I was having a big problem with triglycerides 25 years ago. I went on a low-carb diet way back then [and] have been on it ever since. I get my blood checked every year and I have not had a bad reading since that time.

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