Study Finds No Association Between Calcium Intake And Arterial Calcification

Study finds no association between calcium intake and arterial calcification

Tuesday, November 13, 2012. Research described in a report published online on November 7, 2012 in the American Journal of Clinical Nutrition failed to establish a relationship between greater calcium intake and increased calcification of the coronary artery, a condition that characterizes heart disease. The finding contradicts the conclusions of a recent, widely publicized study, which suggested that calcium supplements might increase heart attack risk.

American researchers analyzed data from 588 men and 690 women between the ages of 36 and 83 years enrolled in the Framingham Offspring Study, which includes children and spouses of participants in the Framingham Heart Study. Responses to questionnaires completed between 1998 and 2001 were analyzed for calcium intake from food and supplements. Computed tomography (CT) scans conducted between 2002 and 2005 evaluated coronary artery calcification, an indication of calcified plaque in the heart's arteries.

Participants' calcium intake ranged from 8 milligrams to 3,050 milligrams per day. Twenty-five percent of the men and 65 percent of the women in the study reported using calcium supplements. Adjusted analysis of the data failed to find a significant association between total calcium intake and coronary artery calcium scores. Similar findings were obtained in separate analyses of calcium supplements and calcium from food.

The authors note that the Institute of Medicine recently concluded that evidence from clinical trials currently does not support an effect of calcium intake on cardiovascular disease risk. "Although the discussion of methodologic issues of studies that reported an adverse effect of calcium supplements on cardiovascular events has been presented elsewhere, some concerns include a lack of adjudicated endpoints, the undermining of random assignment, a low compliance with calcium supplements, and inadequate access to patient-level data" they write.

"This study addresses a critical question about the association between calcium intake and a clinically measurable indicator of atherosclerosis in older adults," stated lead author Elizabeth Samelson, PhD, who is an associate scientist at the Institute for Aging Research in Boston and an assistant professor at Harvard Medical School. "There was no increased risk of calcified arteries with higher amounts of calcium intake from food or supplements."

Nevertheless, she added that, "it is critically important that each individual discuss with a health care provider whether the recommendations are appropriate given his or her personal medical history."

Women lacking calcium at risk of primary hyperparathyroidism

October 19, 2012, the British Medical Journal reported the finding of researchers at Brigham and Women's Hospital of a protective effect for calcium from diet and supplements against primary hyperparathyroidism, a condition in which overactive parathyroid glands secrete too much parathyroid hormone, which can result in bone weakness and fractures.

The current study evaluated data from 58,354 nurses who were between the ages of 39 and 66 years upon enrollment in the Nurses' Health Study I in 1986. Responses to dietary questionnaires completed after enrollment were evaluated for the intake of calcium from diet and supplements. Over a 22 year follow-up period, 277 cases of primary hyperparathyroidism were diagnosed.

Women whose dietary calcium was among the top one-fifth of participants had a 44 percent lower adjusted risk of developing primary hyperparathyroidism compared to those whose intake was among the lowest fifth. When the intake of calcium from supplements containing more than 500 milligrams per day was analyzed, the risk of primary hyperparathyroidism was 31 percent less among those who supplemented in comparison with those who did not use calcium supplements.

"To our knowledge, we report results from the first prospective study of the relation between calcium intake and risk of primary hyperparathyroidism," Julie M. Paik and her colleagues announced. "In women, increased dietary and supplemental calcium intake was associated with a reduced risk for developing primary hyperparathyroidism, independent of age, body size, diet, and other factors."

In an accompanying commentary, James Norman of the Norman Parathyroid Center concludes that "Paik and colleagues' study provides evidence to support physicians in confidently encouraging female patients to take calcium supplements. Daily calcium supplements in modest doses are likely to provide more benefits than risks given that even mild primary hyperparathyroidism has important clinical associations and, over many years, even a moderate increase in calcium concentration probably helps reduce the incidence of parathyroid tumors."

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