Calcium And Heart Disease: My update on calcium supplement recommendations based on recent studies 05/30/12

The British Medical Journal:Heart recently (2012) published results from the EPIC study showing a correlation between high calcium intake and myocardial infarction, after following a large population European population for an 11-year period (all participants were free from heart disease at the beginning of the study). A meta-analysis published previously (BMJ 2010) also showed a small correlation between higher calcium intake and risk of myocardial infarction. When evaluating these studies we need to keep in mind that these findings are correlations, not the results of intervention trials. However, some concern about over recommending calcium supplementation is likely warranted at this time, based on these recent publications. Future studies will shed more light on this issue. In the meantime I have put together some facts to consider when recommending supplements.

Recommending Calcium Supplementation: Some Facts To Consider:

  1. Many people in the above noted studies took calcium supplements without magnesium. This may explain the increased risk in heart attack, based on the fact that calcium and magnesium are required to maintain the electrical potential of the myocardium. An imbalance may trigger fibrillation leading to heart disease. So, I believe it’s best to make sure any calcium supplement also contains magnesium to prevent an imbalance. Both the Adeeva Multiple Vitamin and Mineral and Adeeva Bone Support Formula contain calcium with a balanced amount of magnesium
  2. It’s possible that a sharp elevation in blood calcium may encourage calcification of arterial plaque, thickening and hardening the plaque – increasing risk for a coronary event. Thus, making sure that the patient does not supplement with more than 500 mg of calcium at any one time, and staging-in their calcium supplementation throughout the day helps to prevent a spike in blood calcium levels. This is especially true if supplements are taken with a meal, as they should be.
  3. Recommending the minimum calcium required to prevent osteoporosis now makes sense in light of recent concerns. Previously, many of us felt that ensuring that all adults ingest at least 1500 mg of calcium per day, from food and supplementation, was a good target, as this amount helps to prevent and reverse bone loss, according to various peer-reviewed studies (especially when combined with 1000-2000 IU of Vitamin D). However, I would now suggest you tailor your calcium recommendations to the patient’s unique circumstances using the following criteria:
  4. Patients at low risk for heart disease (low cholesterol, normal blood pressure etc) and osteoporosis (normal bone density test) should probably not supplement with more than 800 mg of calcium per day (example 4 caplets Adeeva Multiple Vitamin and Mineral and 1 caplet Bone Support Formula). They may not require the Bone Support Formula if their diet (abundant calcium-containing foods) and exercise behaviours are good.
  5. Patients at higher risk for heart disease (cholesterol or blood pressure problems, smoker, previous CVD episode or procedure such as by-pass surgery etc), and who have normal bone density, should probably not supplement with more than 500 mg per day of calcium. This would preclude them from taking Adeeva Bone Support Formula until we have more clarification on the link between calcium supplementation and heart disease. In this case I would keep them on 4 caplets of the Adeeva Multiple Vitamin and Mineral supplement as their only source of calcium supplementation.
  6. Patients with known osteopenia and/or osteoporosis – it is well documented that the nutrient dosages contained in 4 Adeeva Multiple Vitamin and Mineral caplets, along with 2 Adeeva Bone Support Formula caplets can reverse bone loss in these patients. We have documented cases on file and the peer-reviewed scientific research supports this approach.  Unless the patient is at very high risk for a heart attack, I would continue to use this supplementation protocol in this patient population. Preventing an osteoporotic fracture is crucial to their long-term survival and quality of life.

As the research unfolds I will keep the recommendations as current as possible on this important subject.

References:

http://www.nature.com/ejcn/journal/v58/n5/abs/1601869a.html

http://heart.bmj.com/content/98/12/920

http://www.bmj.com/content/341/bmj.c3691.full

http://www.nutraingredients.com/Research/BMJ-calcium-heart-study-not-valid-for-dietary-calcium-Marigot

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