Q&A
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“Several large, credible studies have reported a higher incidence of heart attacks in both men and women who take calcium supplements,” said Dr. Orli R. Etingin, director of the at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.
The total intake associated with these adverse outcomes was 1,200 milligrams a day, she said.
The mechanism by which calcium could promote heart attacks is entirely unclear, Dr. Etingin said. The studies were all done in men and women in their mid-50s and older, who are at highest risk for cardiovascular events, and it is not clear if the results apply to younger groups. Nevertheless, she said, many doctors are now recommending dropping calcium as a supplement at all ages, replacing it with dietary calcium.
Many patients ask if calcium is actually deposited in blood vessels, causing calcified atherosclerotic plaque, “but that does not seem to be the case, based on these and other studies,” Dr. Etingin said.
She added that she usually recommended, as a replacement guide, three or four portions of calcium-rich foods each day. Each serving of a dairy product, like cheese, yogurt or milk, contains about 300 to 400 milligrams of calcium, and many other foods, like orange juice, may have added calcium. Some green vegetables contain it as well.
For patients worried about bone density, she said, it could be monitored at intervals to verify its stability on the new regime.