Q. Almost all women over 50 are told to take calcium supplements to prevent bone loss. Hip fractures, spine fractures and other bone problems can cause a lot of pain and misery, not to mention early death. But now I am reading that calcium pills themselves may lead to heart disease, stroke and premature death. This is very confusing.
A. Earlier research has shown that men who take calcium supplements (1500 mg) are more likely to suffer a heart attack or stroke (JAMA Internal Medicine, online Feb. 4, 2013). A new study has shown that this danger haunts women, too (BMJ, online Feb. 13, 2013).
The study included more than 60,000 Swedish women followed up for almost 20 years. The researchers found that those who ate a high-calcium diet (at least 1,400 mg/day) and also took calcium tablets (500 mg each) were more than twice as likely to die during the study as those whose diets contained between 600 and 999 mg of calcium daily. Overall, it appears that relying on dietary sources of calcium is safer and more likely to provide additional nutrients needed for bone strength, such as magnesium, vitamin K and vitamin D.
That is also the conclusion just issued from the US Preventive Services Task Force. This expert panel has reviewed the evidence and decided that low or moderate doses of vitamin D and calcium have not been shown to prevent bone loss or fractures. Instead, they recommend maintaining a healthy weight, getting calcium and vitamin D from the diet, and using exercise to bolster balance and strength against falls.
We discuss the confusion surrounding calcium supplements, offer a list of calcium-rich foods and advise on nondrug approaches in our Guide to Osteoporosis. The possible downside of calcium supplementation was discussed in our radio show Bone Vitality several years ago by Walter Willett, MD, DrPH, and Michael Castleman, author of Building Bone Vitality: A Revolutionary Diet Plan to Prevent Bone Loss and Reverse Osteoporosis.
