SHOULD WE CHALK UP CALCIUM?

The San Francisco Chronicle and the New York Times recently reported research that taking calcium supplements might increase the risk of heart attack.  The most recent study in Germany and Switzerland  recorded calcium supplements used by 23,980 women without prior heart disease over an average time of 11 years.  Taking supplements of calcium alone, i.e. a calcium supplement but no other supplement, was associated with twice the rate of heart attacks.  However, there was only a slight and not significant increase in cardiovascular related death in women taking calcium supplements, and the risk was based on observation of the small subgroup of 256 women who took calcium supplements alone, less than 2 percent of the entire study group.

A limitation of this paper is that the authors gave no explanation for why their results are the opposite of results from the Iowa Women’s Health Study published in 2011.   The Iowa study followed 38,772 women from 1986 to 2008 and found that daily use of a calcium supplement was associated with a statistically significant 9 percent decrease in the chance of death from all causes. 

With conflicting results, what should a prudent person do in 2012? 

First, find out what you need.  The Institute of Medicine still recommends 1000 to 1200 milligrams of calcium each day.  You need it for proper function of muscles, your heart for instance, and you need it for bone health.  Remember that osteoporosis (weakening of your bones by chronic loss of calcium) contributes to hip fractures, and it is still true that 10 percent of persons, over 65 years of age, who have a hip fracture, die of a various complications within 6 months.

Second, figure out how much calcium you get already.  Most of us get some calcium in our regular diet.  You can estimate your calcium intake from the US Department of Agriculture website.  This website shows that the largest amount of calcium is in dairy products and foods prepared with dairy products.  Some vegetables have moderate amounts.  Look at what you eat in a typical day and add it up. It is likely that you get a lot of your needs met already, but unless you take milk by the glass, cheese by the ounce, or yogurt by the cup, every day, you are likely to fall short.

Third, makeup the difference between what you get and what you need.  No one knows for certain the best way to make up the difference between what you get and what you need.  For now, I suggest taking the lead from the reasons people speculate the calcium supplements might cause harm.  A calcium pill, taken with water, on an empty stomach, can cause a calcium spike in your blood.  Calcium in food does not cause a spike, so the logical thing is to mimic the calcium in food – take the supplement you need with food.

To put this all together, unless you eat dairy regularly, you may not to take in enough calcium.  If you need a calcium supplement, the best guess in 2012 is to take only what you need, and take it with food. 

Obviously, this is an important topic.  There is conflicting information, but there is also certain to be more information over the next few years. 

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