Recent research published in Sweden on the dangers of calcium supplementation has sent the health industry in a spin. Inquiries have been coming in regularly from my clients, asking if they should stop taking all calcium supplements. Reports of increased danger of heart disease is disconcerting for someone who has supplemented for years with calcium because of bone density issues.
It is always possible to get too much of a good thing in any supplement. Most nutrients have a range of intake that is both safe and effective, below which result in morbidity and above which may result in potential negative effects. Calcium is one of the nutrients that is often misused, likely due to a misunderstanding of how much to take.
Can I skip calcium supplements and get all I need from my diet?
It is possible, but it takes quite a bit of work. Everyone should be taking the time to access calcium intake through both dietary and supplemental sources. The RDA for calcium in adults over 50 is 1,200 mg.
"Write down what you eat for a week, figure out how much calcium is in what you've eaten during that time," says J. Edward Puzas, MD, a professor of orthopedics and director of orthopedic research at the University of Rochester Medical Center in New York. "Then divide by seven. I'll bet you'll be well under 1,000 milligrams."
Based on typical dietary averages, women obtain about 744 mg per/day and men 975 mg per day in their diet. In reality, the 1,200 mg should make up overall intake (diet and supplements), and not be added solely from supplements. Keep in mind that there's really not that much difference between getting calcium in a supplement and calcium in food. Instead of worrying about getting all 1,200 mg from supplements, focus more on assessing diet and supplementing with appropriate levels.
I have been supplementing with calcium for years. Should I be worried?
The Swedish study showed that women with the highest (and lowest) calcium intakes were at increased risk of heart disease mortality. The greatest risk was in those whose dietary intakes were above 1,400 mg (meaning they ate a lot of dairy products) AND who took supplements on top of this high dietary intake. Those with intakes below 600 mg were also at increased risk. In other words, very low and very high amounts of calcium are associated with higher mortality.
“Super high dose calcium supplements appear harmful: usual recommendations for calcium intake are confirmed.” Dr. William Goodson III
Maintaining a healthy moderate level of calcium through both diet and supplementation is vital for bone health. Osteoporosis affects 55% of Americans aged 50 and above. With one in two women and up to one in four men likely to break a bone due to osteoporosis in their lifetime, getting the recommended amount of calcium every day remains a top priority for women and men of all ages. In fact, two million bone breaks occur every year in the U.S. due to osteoporosis, often resulting in immobility, pain, placement in a nursing home, isolation and other health problems.
More information:
Council for Responsible Nutrition: Supplements Remain Safe and Beneficial for Bone and Cardiovascular Health
Dr. William Goodson III: Calcium Supplements: Let's Get the Facts Right
USDA National Nutrient Database for Calcium: A chart for determining dietary calcium
Conclusion
The amount of calcium needed from a supplement depends on age and dietary intake of calcium. Consumers should talk with their doctors or other healthcare practitioners to determine what is right for them. Calcium supplements should be taken in balance with other bone health supplements such as Mg, vit D, vit K, silicon and boron. The omission of any of these key nutrients will reduce the effectiveness in the prevention of osteoporosis. Some calcium supplements can be purchased in 200 mg dosages to titrate total calcium intake to appropriate levels.
Be Well!
Robin Thomas
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