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High calcium intake linked to increased risk for CVD death in men
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High intake of supplemental calcium appears to be associated with increased risk for CVD death in men, but not in women, according to new study results.
Qian Xiao, PhD, from the division of cancer epidemiology and genetics, National Cancer Center Institute, and colleagues conducted a large, prospective study of more than 388,000 men and women aged 50 to 71 years. All were included in the NIH-American Association of Retired Persons Diet and Health Study in six states and two cities from 1995 to 1996.
During a mean 12 years of follow-up, 7,904 men and 3,874 women died of CVD causes. Supplements containing calcium were used by 51% of men and 70% of women. Compared with non-supplement users, men whose supplemental calcium intake was more than 1,000 mg/day had an increased risk for total CVD death (RR=1.2; 95% CI, 1.05-1.36), more specifically with heart disease (RR=1.19; 95% CI, 1.03-1.37) but not significantly with cerebrovascular disease (RR=1.14; 95% CI, 0.81-1.61). In women, calcium supplement use was not associated with CVD death (RR=1.06; 95% CI, .96-1.18), heart disease death or cerebrovascular death.
When obtained through calcium-rich food sources, like kale, beans, dairy and non-dairy sources, intake was unrelated to CVD death in men or women.
“Whether there is a sex difference in the CV effect of calcium supplements warrants further investigation,” the researchers wrote.
In a related commentary, Susanna C. Larsson, PhD, from the division of nutritional epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden, said additional large studies are required to assess potential benefits and health risks of calcium supplementation on CVD mortality and morbidity.
Larsson wrote: “The lack of association of calcium supplement use with CVD mortality in women is perplexing, especially given the results from the Women’s Health Initiative Calcium Vitamin D Study reporting an increased risk of CVD in women allocated to calcium supplementation. The paradigm ‘the more the better’ is invalid for calcium supplementation.”
Consumption of calcium-rich foods, such as low-fat dairy foods, beans and green leafy vegetables may be a safe alternative to calcium supplements, she wrote.
For more information:
Larsson SC. JAMA Arch Intern Med. 2013;doi:10.1001/jamainternmed.2013.3769.
Xiao Q. JAMA Arch Intern Med. 2013;doi:10.1001/jamainternmed.2013.3283.
Disclosure: The study was supported by the Intramural Research Program of the NIH, National Cancer Institute and National Institute of Aging. Larsson and Xiao report no relevant financial disclosures.