Osteoporosis, Cardiology Organizations Issue Calcium Guideline

A new evidence-based guideline from the National Osteoporosis Foundation (NOF) and the American Society for Preventive Cardiology (ASPC) says that calcium with or without vitamin D intake from food or supplements that does not exceed 2, 000 to 2, 500 mg/day should be considered safe from a cardiovascular standpoint.

A total of 31 studies were reviewed by researchers from the Tufts University School of Medicine. According to the October 24, 2016 news release, “Of the four randomized trials reviewed, none found a statistically significant difference in risk for cardiovascular events or mortality between groups receiving supplements of calcium alone or calcium plus vitamin D compared to those receiving placebo. None of the 27 cohort studies included in the review conclusively linked total, dietary, or supplemental calcium intake levels to cardiovascular disease and cerebrovascular disease, mortality, or all-cause mortality. Because excessive calcium intake is nearly impossible to achieve via diet, safety of supplementation had been an area of concern. Of the three supplementation-specific trials included in the review, none found a statistically significant effect of calcium supplementation on cardiovascular disease outcomes. Based on this moderate-quality evidence, the review team concluded that calcium intake from food or supplement sources at levels within the recommended tolerable range should be considered safe for generally healthy adults.”

Andrea Singer, M.D., NOF clinical director and trustee, told OTW, “Given the confusion on this topic, the NOF felt it was very important to partner with the ASPC to review all of the science currently available around the health risks and benefits of calcium intake from food and/or supplements on cardiovascular and cerebrovascular disease incidence, mortality, and all-cause mortality in generally healthy adults to determine what is known at this time and how to help those who treat osteoporosis patients with recommendations for calcium and vitamin D intake. From a cardiovascular standpoint, calcium intake from food or supplements at levels within the recommended tolerable range of 2, 000 to 2, 500 mg per day is safe for generally healthy adults.”

“There is moderate-quality evidence (B level) that calcium with or without vitamin D intake from food or supplements has no relationship (beneficial or harmful) to the risk for cardiovascular and cerebrovascular disease, mortality, or all-cause mortality in generally healthy adults at this time. As NOF has always said, ‘Calcium from food sources is preferred, but supplements can be used to address dietary shortfalls.’”

“We hope these new clinical guidelines will help all healthcare professionals address patient concerns about calcium intake from food and supplements. We know that calcium is essential for bone health and there is evidence to show its benefit to fracture prevention among high-risk individuals. We must help patients understand the need for dietary calcium and that they should only supplement for any shortfall in their diet.”