Guideline: Supplemental, dietary calcium both heart safe – Philippine Star
Both dietary and supplemental calcium should be considered safe for the cardiovascular system as long as total intake doesn’t exceed 2,000 – 2,500 mg/day – the maximal tolerable level defined by the National Academy of Medicine, according to an updated Clinical Practice Guideline published online in Annals of Internal Medicine.
For generally healthy patients who don’t consume adequate calcium and take supplements, either alone or in combination with vitamin D, to prevent osteoporosis and related fractures, “discontinuation of supplemental calcium for safety reasons is not necessary and may be harmful to bone health,” said by the Mayo Clinic, Rochester Minn., and on the expert panel that wrote the new guideline.
The US Agency for Healthcare Research and Quality published an Evidence Report in 2009 concerning the effect both calcium and vitamin D on health outcomes, including cardiovascular disease. But since the conflicting reports have suggested that calcium intake, particularly from supplements, may have either beneficial or harmful effects on cardiovascular outcomes.
The National Osteoporosis Foundation (NOF) and the American Society for Preventive Cardiology (ASPC) commissioned an independent review of the current evidence to update the Evidence Report and assembled the expert panel to write the guideline based on the new findings.
Separately, the department of public health and community medicine, and associates at Tufts University, Boston, reviewed four recent randomized clinical trials, one nested case-control study, and 26 cohort studies that assessed the effects of calcium intake on 17 health outcomes in generally healthy adults of all ages. None of the studies revaluated cardiovascular disease risk as a primary outcome. Conclude that calcium intake (from either food or supplement sources) at levels within the recommended tolerable upper intake range (2,000 2,500 mg/d) are not associated with CVD risks in generally healthy adults.
Although a few trials and cohort studies reported increased risks with higher calcium intake, risk estimates in most of those studies were small (10 percent relative risk) and not considered clinically important, even if they were statistically significant.
According to the guideline, “The NOF and the ASPC now adopt the position that there is moderate-equality evidence that calcium with or without vitamin D intake from food or supplements has no relationship (beneficial or harmful) with the risk for cardiovascular or cerebrovascular disease, mortality, or all-cause mortality in generally healthy adults at this time.
In addition, currently, no established biological mechanism supports an association between calcium and cardiovascular disease.