Friday, February 15, 2013

Fluke or Trend? Calcium vs Heart Disease Part 4

When it rains, it pours.  Just a week ago, I commented on a study published in JAMA Internal Medicine in which the authors concluded that consumption of calcium supplements was associated w/heart disease in men.  Of course, the devil is in the details, as dietary calcium was not associated w/heart disease in either women or men.

In a prospective longitudinal cohort study published in BMJ earlier this week, the authors concluded that high calcium consumption was associated w/greater risk of death from any cause, especially heart disease but not stroke.  The nutritional supplement manufacturers jumped all over this study, and perhaps rightly so, because it was originally designed to look at mammography & breast cancer.  61,433 women for followed for an average of 19 years and dietary calcium was assessed just once, rather than serially.

While the statistical manipulations found a link between dietary calcium more than 1,400mg/d and deaths, calcium supplements were linked to death only in those who were already consuming more than 1,400mg/d in their food.  Bottom line, as I mentioned last time, it now appears that calcium is a double-edged sword for both women & men.  We aren't currently clear as to the mechanism of disease nor to the differences between dietary & supplemental calcium.  But let's also not forget that we do have cause & effect evidence of benefit from calcium while we only have circumstantial observational evidence of its harm.  So choose wisely even as we await further developments in this story.



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