Study: Calcium from Diet, Not Supplements May Be Best Advice for Preventing Osteoporosis in Older Adults

October 31, 2013

By Fran Kritz

Preferred advice for calcium intake for older adults in order to prevent osteoporosis may be to get the nutrient from their diet, rather than supplements, according to a new study review.

According to Dr. Douglas Bauer, MD, professor of medicine at the UC San Francisco School of Medicine, calcium supplements are known to have several side effects, the most common being indigestion and minor constipation, and kidney stones are a rare complication. However, several recent studies have also suggested that calcium supplements can also lead to an increased risk of heart attacks:

• A 2010 British Medical Journal study, which looked at nearly a dozen randomized trials, concluded that calcium supplements “are associated with an increased risk of myocardial infarction [heart attacks]” and went on to say, “As calcium supplements are widely used, these modest increases in risk of cardiovascular disease might translate into a large burden of disease in the population.”
• A 2013 JAMA Internal Medicine non-randomized study examined 11,778 cardiovascular-related deaths and found an increased risk with calcium supplement use. The authors concluded, “High intake of supplemental calcium is associated with an excess risk of CVD (cardiovascular disease) death in men but not in women.”

But Dr. Bauer adds that a definitive recommendation is confounding because several other studies have shown no relationship between the use of calcium supplements and cardiovascular events. In a Women’s Health Initiative trial participants showed “no significant relationship between supplementation and cardiovascular events” in three trials of calcium supplements alone, according to a review of the studies cited by Dr. Bauer in his recent article.

“Osteoporosis may result from inadequate calcium intake and it’s quite common for certain segments of our population, such as the elderly, to consume less than the recommend amount,” says Dr. Bauer. “But a high calcium diet should be the preferred method to receive adequate amounts of the nutrient.”

In the recent study, Dr. Bauer presented the case of a woman, age 62, who received some, but not enough, calcium from her diet, and recommended that she take a supplement dose only high enough to make up for her the amount she was missing from her diet “[and] she should be advised about a potential increased risk of cardiovascular events, although the evidence of the latter is currently inconsistent and inconclusive,” wrote Dr. Bauer in the article.

The Institute of Medicine’s recommended dosage for post-menopausal women over the age of 50 and men over 70 is 1,200 mg per day.

The UC San Francisco study was published in the New England Journal of Medicine.

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