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Calcium Supplementation Does Not Improve Bone Health

And may increase heart disease risk with Chris Kresser.

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In This Episode

Overview of Calcium Supplementation … 00:05:49
Summary of Calcium Benefit and Risk Data … 00:08:06
Harmful Effects of Calcium … 00:13:57
Calcium With Vitamin D & Vitamin K2 … 00:19:34
Calcium and Dairy Products … 00:23:33
Calcium-Rich Foods … 00:30:55
Calcium Synergists … 00:33:04
Other Ways to Support Bone Health … 00:43:07

Calcium Supplements May Be Harmful

  • 10% of American women have osteoporosis, and many women supplement with calcium to avoid risk.
  • While dietary calcium is important to prevent osteoporosis, calcium supplements have been shown to increase risk of heart attack or stroke.

Calcium Supplements Don’t Improve Bone Density

  • Several studies suggest calcium supplements increase the risk of osteoporosis.
    • A 2012 analysis found calcium intake beyond recommended guidelines provided no benefit at all for hip or lumbar vertebral bone mineral density. [1]
    • A 2007 study published in the American Journal of Clinical Nutrition found that calcium supplements don’t reduce fracture rates in postmenopausal women, and may even increase the rate of hip fractures. [2]
    • Calcium supplements get absorbed into the bloodstream quickly which may lead to distribution into soft tissues instead of into the bones.
  • Dietary Calcium Does Increase Bone Density
    • Foods may have a more bioavailable form, perhaps due to more gradual absorption

Calcium Supplements Increase Risk of Cardiovascular Disease

  • A 2012 study in the British Medical Journal found that calcium supplements heart attack risk by 140%. [3]
  • A 2010 meta-analysis in the British Medical Journal found calcium supplements was associated with a 31% increased risk of heart attack, a 20% increased risk of stroke, and a 5% increase of risk of death from all causes. [4]
  • A 2013 study published in the Journal of the American Medical Association found that 1,000mg/day of calcium supplementation was associated with a 20% increase of death from cardiovascular disease. [5]

Cancer and Kidney Stones   

  • A Swedish study reported a significantly higher risk of death among men and women with much higher calcium intakes. Some of those deaths were from prostate cancer, and there was also an increase in kidney stones. [6]

Do Vitamin D and Vitamin K2 Reduce Calcium Risk?

  • Using Vitamin D and Vitamin K2 with calcium might diminish risk, but we don’t know.
  • Some evidence suggests adequate doses of vitamin D and K reduce the dietary need for calcium.
  • 700-900mg calcium per day may be adequate.
  • Calcium should probably be consumed with vitamin D (or safe sun exposure) and K2 (fermented foods).

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Calcium-Rich Foods and Calcium Sources

  • Dairy products
  • Leafy greens (Are OK, but not as bioavailable as dairy)
  • Cruciferous vegetables (good bioavailability)
  • Seeds and almonds
  • Canned, bone-in fish

Dairy Products

  • Dairy products generally correlate with better bone health.
  • The vast majority of clinical studies have shown that drinking milk or consuming other dairy products leads to a positive calcium balance. 

Other Bone Health Synergists

  • Weight bearing exercise, weights
  • Magnesium is especially important
  • Collagen
  • Glycine, lysine, and proline with vitamin C: good sources are animal proteins, organ meats, bones, joints, and tendons.

Non-Nutrition Bone Health Supports

  • Balance hormones
  • Reduce inflammation
  • Support sleep (melatonin is involved with bone density)
  • Reduce stress

References (click to expand)

  1. Anderson JJ, Roggenkamp KJ, Suchindran CM. Calcium intakes and femoral and lumbar bone density of elderly U.S. men and women: National Health and Nutrition Examination Survey 2005-2006 analysis. J Clin Endocrinol Metab. 2012;97(12):4531-4539. doi:10.1210/jc.2012-1407
  2. Bischoff-Ferrari HA, Dawson-Hughes B, Baron JA, et al. Calcium intake and hip fracture risk in men and women: a meta-analysis of prospective cohort studies and randomized controlled trials. Am J Clin Nutr. 2007;86(6):1780-1790. doi:10.1093/ajcn/86.5.1780
  3. Li K, Kaaks R, Linseisen J, Rohrmann S. Associations 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. 2012;98(12):920-925. doi:10.1136/heartjnl-2011-301345
  4. Bolland MJ, Avenell A, Baron JA, et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ. 2010;341:c3691. Published 2010 Jul 29. doi:10.1136/bmj.c3691
  5. Xiao Q, Murphy RA, Houston DK, Harris TB, Chow WH, Park Y. Dietary and supplemental calcium intake and cardiovascular disease mortality: the National Institutes of Health-AARP diet and health study. JAMA Intern Med. 2013;173(8):639-646. doi:10.1001/jamainternmed.2013.3283
  6. Michaëlsson K, Melhus H, Warensjö Lemming E, Wolk A, Byberg L. Long term calcium intake and rates of all cause and cardiovascular mortality: community based prospective longitudinal cohort study. BMJ. 2013;346:f228. Published 2013 Feb 12. doi:10.1136/bmj.f228


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