Who Doubted Safety and Benefits of Calcium and Vitamin D Supplementation?
Calcium and vitamin D are essential nutrients for bone health. Many people, especially women, do not consume recommended amounts of these two nutrients from their diet. With a few exceptions, i.e. dairy products, snack bars and ready-to-eat cereals, it has been difficult to fortify foods with calcium (a mineral) without negatively affecting taste (and consumer preference). Federal regulations restrict the types of foods which can be fortified with vitamin D. Dietary supplements become a primary option to fill calcium and vitamin D shortfalls.
In an important meta-analysis (18 randomized controlled trials involving 63,563 volunteers), Lewis and colleagues affirm the safety of calcium and vitamin D supplementation in women. This is an important report because Boland et al (2011) claimed that calcium supplementation increased risk of myocardial infarction, significantly reducing use of calcium supplements. Their call for a reassessment of the use of calcium supplements in older people is answered in this newer, more comprehensive analysis. The meta-analysis by Lewis et al confirms the findings of the Womens’ Health Initiative, the largest trial investigating the effect of vitamin D and calcium supplementation in women (Jackson et al, 2006) which found no adverse effects on cardiovascular events (Hsia et al, 2007).
Ideally, we should be obtaining our essential nutrients from our diet. However, many people do not choose wisely. Single nutrient supplements and multi-vitamin/mineral supplements are safe and can help fill nutrient gaps in the diet. Be assured, it is better to be adequately nourished than not.
Lewis JR, Radavelli-Bagatini S, Rejnmark L, Chen JS, Simpson JM, Lappe JM, Mosekilde L, Prentice RL, Prince RL. The effects of calcium supplementation on verified coronary heart disease hospitalization and death in postmenopausal women: A collaborative meta-analysis of randomized controlled trials. 2014 JBMR doi: 10.1002/jbmr.2311
Ward E. Addressing nutrient gaps with multivitamin and mineral supplements. 2014 Nutr J doi: 10.1186/1475-2891-13-72
Bolland MJ, Avenell A, Gamble GD, Reid IR. Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women's Health Initiative limited access dataset and meta-analysis. 2011 BMJ doi: 10.1136/mbj.d20140
Reid IR, Bolland MJ. Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women's Health Initiative limited access dataset and meta-analysis. 2011 BMJ 10.1136/mbj.d2040
Jackson RD, LaCroix AZ, Gass M, Wallace RB, Robbins J, Lewis CE, Bassford T, Beresford SA, Black HR, Blanchette P, Bonds DE, Brunner RL, Brzyski RG, Caan B, Cauley JA, Chlebowski RT, Cummings SR, Granek I, Hays J, Heiss G, Hendrix SL, Howard BV, Hsia J, Hubbell FA, Johnson KC, Judd H, Kotchen JM, Kuller LH, Langer RD, Lasser NL, Limacher MC, Ludlam S, Manson JE, Margolis KL, McGowan J, Ockene JK, O'Sullivan MJ, Phillips L, Prentice RL, Sarto GE, Stefanick ML, Van HL, Wactawski-Wende J, Whitlock E, Anderson GL, Assaf AR, and Barad D. Calcium plus vitamin D supplementation and the risk of fractures. 2006 N Engl J Med doi: 10.1056/NEJMoa055218
Hsia J, Heiss G, Ren H, Allison M, Dolan NC, Greenland P, Heckbert SR, Johnson KC, Manson JE, Sidney S, and Trevisan M. Calcium/vitamin D supplementation and cardiovascular events. 2007 Circulation doi: 10.1161/circulationaha.106.673491