A patient asks: Should I be taking calcium supplements? I have osteopenia, but I’ve heard supplements are linked to higher heart attack risk. Help!
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The doctor answers: I have been worried about calcium supplements for years. Increasingly, research is showing that your daily calcium supplement could set you up for future heart problems.
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To cite one example: New Zealand researchers analyzed the results of 11 studies with 12,000 aggregate participants — over 40 years of age, both genders — who took at least 500 mg supplemental calcium (half the daily recommended intake) for more than a year. The pooled data suggests daily pill takers were 30 percent more likely to suffer a heart attack compared to those taking a placebo.
If you eat a proper diet and get your calcium through food — milk, almonds, beans, greens — there will be little or no need for calcium supplements.
Vitamin D is essential for normal development of strong bones. Vitamin D deficiency causes rickets in children and osteopenia (a decrease in the amount of calcium and phosphorus in the bone), osteoporosis (when bones become fragile and are more likely to fracture), and osteomalacia (softening of the bones) in adults.
If your vitamin D is low, the calcium in your supplement will not go into your bones; it will either go into your urine or into your arteries.
Vitamin D deficiency can also contribute to high blood pressure, so I have been measuring it routinely in all my patients.
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I have been astounded to find that perhaps 80 percent of my patients over 60 years of age (including me) have low or very low levels of vitamin D. If your vitamin D is low, the calcium in the supplement you take will not go into your bones; it will either go into your urine, and potentially form a kidney stone, or into your arteries, which will become stiff and diseased.
Make sure your vitamin D level is good, and be careful before you accept a recommendation to go on a calcium supplement. For those who have a real problem with osteopenia or osteomalacia despite a healthy level of vitamin D, there are special bone-strengthening drugs such as Fosamax and Boniva that are taken once a week or once a month to build up your bones.
You may need to add a calcium supplement — but more than that, you may need a special bone-strengthening drug.
Fortunately, dietary calcium poses none of the heart risk raised by supplements. What’s more, previous research shows that when you get calcium from food sources, you actually end up with stronger bones than those who rely on pills only — even when pill takers have higher overall intakes.
In addition to dairy, such as yogurt, you can boost your calcium intake with almonds, sardines, collards, dandelion, kale, canned salmon and black-eyed peas.
While we typically associate calcium with bone health, diets rich in calcium from food may help protect against 10 different types of cancer, including prostate, breast, lung and colorectal.
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