“I just don’t know what to do about my calcium …”
This complaint has been heard thousands of times across North America these past two years, as women have turned to their illness-care providers for advice about protecting themselves from osteoporosis. The problem started with extensive media coverage of a study published in the British Medical Journal, stating that calcium supplement use was associated with a slightly increased risk of heart attack. Many stopped taking their calcium supplements entirely, and physicians, blindsided by the report, immediately became more cautious in recommending use of calcium supplements.
The problem was clearly a serious one, as recommended calcium intakes for Canada and the United States range from 1000 to 1500 mg per day, with food typically providing only about half that amount. At least three separate Consensus Development Conference Reports, published by the National Institutes of Health in the U.S., had recommended calcium supplement use, both for total nutrition and specifically to reduce risk of osteoporosis.
Osteoporosis experts were quick to respond, pointing out serious flaws in the methods used by the investigators of the studies concerned. Unfortunately their refutation, though published in the medical literature, elicited little or no media coverage. So the confusion persisted and calcium supplement use has dropped by perhaps as much as 14% over the past two years. This has undoubtedly led to an increase in otherwise preventable osteoporotic fractures.
Finally, this fall, three definitive publications are appearing in major nutrition and osteoporosis journals, concluding that the calcium supplement scare was a false alarm – that there is no increased risk of coronary disease in individuals taking recommended amounts of calcium supplements. Among other approaches, the authors of these “all clear” publications reanalyzed the many papers published on this topic and simply found no significant evidence of a connection between calcium supplements and heart attacks.
In 2004 the U.S. Surgeon General, in his report on bone health and osteoporosis noted that “Calcium has been singled out as a major public health concern because it is critically important for bone health and the average American consumes levels of calcium that are far below the amount recommended …” As all the official statements on this topic stress, the best way to get the calcium we need is from food (because foods contain the many other nutrients needed for calcium to produce its full benefit). What we can’t or won’t get from food, we should get from supplements. That’s still true today, especially with the new reassurance that calcium supplements are safe.