To supplement or not to supplement?

            In my clinical setting I see quite a few elderly patients for annual wellness exams. Many of these patients have osteopenia or osteoporosis and take calcium supplements. These supplements include calcium-only supplements and combination supplements containing both calcium and vitamin D. For years healthcare providers have been recommending these supplements without fail. However, the provider I work with has recently changed his recommendations in light of a new study indicating calcium supplementation may increase the risk for having a myocardial infarction (MI). Earlier this year an article (which can be found here) was published that looked at the relationship between dietary and supplemental calcium intake with myocardial infarction, stroke risk, and overall cardiovascular mortality. The study findings indicated that when compared with those who did not use any supplements, those who used calcium supplements had a statistically significant increased risk for having a MI. This risk was even more pronounced for patients who used calcium-only supplements versus those who took calcium with another supplement. No elevated heart attack risk with was found with intake of dietary calcium (Li, Kaaks, Linseisen, & Rohrmann, 2012). No associations were found between calcium intake of either type and stroke risk or overall cardiovascular mortality. In light of these findings, the provider I work with now recommends completely discontinuing calcium-only supplements. If the patient is taking calcium with vitamin D he advises them of the potential increased MI risk and if they are able to take calcium in their diet he advises them to eat a diet high in calcium and continue vitamin D-only supplementation. Just some food for thought.

 

References

Li, K., Kaaks, R., Linseisen, J., & Rohrmann, S. (2012). Association of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European prospective investigation into cancer and nutrition study (EPIC-Heidelberg). Heart, 98, 920-925. doi: 10.1136/heartjnl-2011-301345