Editor’s Note: Calcium Supplements and Heart Disease

Calcium supplementation for women has become a controversial topic in practice lately. Most of my pa-tients, having heeded previous advice, are taking supplements, especially in their postmenopausal years.

Based on a study in 2010, which suggested that calcium supplements increased the risk of coronary artery disease and heart attacks, many physicians advocated stopping the supplementation altogether. This study, which was published in the British Medical Journal, was a conglomerate of many previous studies, and was not a direct look at randomized populations, so it had some limitations. Now, another study, which was conducted the same way and presented in April 2014 at the World Congress on Osteoporosis, Osteoarthritis, and Musculoskeletal Disease, refutes the previous findings, and says there’s no increase in heart disease risk in women who take calcium supplements.

So, what do I tell my patients?

It is always preferable to get your nutrients the natural way, from food. Also, calcium-rich foods, such as yogurt, cheese, salmon (with bones), and fortified orange juice and cereals, are good sources of other important vitamins and minerals as well. These foods are particularly important for women, since they contain added vita-min D, which is necessary for proper calcium absorption.

Whether we are talking about calcium or another mineral, food sources are better for absorption than sup-plements, and they contain fewer preservatives and have no side effects. So, whether calcium increases heart risk or not, meet your calcium goals by choosing dietary sources if at all possible. If you’re lactose intol-erant or can’t eat these foods, then supplemental calcium is a reasonable trade-off for you.

—Editor-in-Chief Orli R. Etigin, MD

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