Since calcium and calcium risks have been in the news lately, it’s important for you to decide who to trust when taking this important mineral. Remember, we can’t live without calcium in our diet. So here is what Dr. Stephen Chaney says in an email to me today:
Some of you have been asking me about the latest
headlines warning that calcium supplements may increase
the risk of heart attacks.
These headlines were based on an European study that
followed 24,000 Europeans aged 34-64 from 1994-1998 and
2005-2009 (Li et al, Heart, 98: 920-925, 2012).
That study was seriously flawed because it did not
report how much calcium was in the calcium supplements;
did not compare the effect of calcium supplements on
subjects with high or low dietary calcium intake; and
did not report what was in the calcium supplements
besides calcium (I’ll talk more about the importance of
this in a minute).
In spite of what the news hype would have you believe,
a number of health experts have cautioned against
reading too much into this study.
The concern is that inadequate calcium intake
predisposes to osteoporosis. For example, British
health expert Dr. Carrie Ruxton was quoted as saying
“Osteoporosis is real issue for women and it is
irresponsible for scientists to advise women to cut out
calcium supplements on the basis of one flawed study,
particularly when the link between calcium, vitamin D
and bone health is endorsed by the European Food Safety
Authority” (that same link is also endorsed by the Food
and Nutrition Board of the National Academy of Sciences
in this country).
I don’t think anyone would disagree with the statement
that inadequate calcium intake is undesirable. The
question is whether calcium supplements are an
important part of assuring adequate calcium intake.
The chief author of the study, Dr. Sabina Rohrmann,
said “…the current [calcium] recommendations…can be
met by a balanced diet that includes low-fat milk and
dairy products”. That is, of course, the position of
many health experts.
In theory, I don’t think anyone would disagree with
that statement either – but let’s look at the facts.
It would take 4-6 servings/day of dairy product to meet
the current calcium RDAs (1,300 mg/day between age 13
and 18, 1,000 mg/day between age 19 and 50 and 1,200
mg/day for over 50). Most people simply don’t consume
that much dairy. Of course, some dark green leafy
vegetables are also good sources of calcium, but most
people don’t consume enough leafy greens either.
As a result most people in this country simply aren’t
getting enough calcium in their diet.
I have seen estimates that as many as 86% of teenage
girls and 64% of teenage boys aren’t getting enough
calcium from their diets. And, this statistic is
particularly troubling because the teenage years are
when 90% of the adult bone mass is formed.
We don’t do much better as adults. Somewhere between 35
and 50% of adults aren’t getting enough calcium from
their diet on a regular basis. And, of course, a lot of
the milk that Americans used to drink has been replaced
with soft drinks that actually leach calcium out of the
So most reasonable people would conclude that, short of
a major change in the American diet, calcium
supplements can and should play an important role in
But is it possible to actually use calcium supplements
without increasing your risk of heart disease?
My answer is that question is yes – provided that the
calcium supplement is well designed.
I have covered the issue of how a calcium supplement
should be designed previously in my “Tips From the
Professor” entitled “Toxic Calcium?” and “Calcium and
Heart Disease Risk Revisited” (see
all of my past “Tips”).
Basically, my premise is that most of the previous
studies on calcium utilization from supplements have
focused on how quickly and how efficiently the calcium
gets into the bloodstream.
When you combine that with the desire to manufacture
the calcium supplements as cheaply as possible, many of
the calcium supplements that people in the studies in
which heart disease risk was observed contained calcium
alone – in whatever form the manufacturer thought would
be best absorbed.
However, that is really the wrong question to ask
because if the calcium gets into the bloodstream and
isn’t used for bone formation right away it can cause
bad things to happen. For example, that excess calcium
can be deposited in the arteries, and that can lead to
hardening of the arteries, which increases the risk of
heart attack and stroke.
So the right question to ask is how quickly and
efficiently can the calcium in supplements be used for
Of course, most people recognize that vitamin D is
important for bone formation.
However, some of the supplements used in those studies
contained no vitamin D at all, and, for those
supplements designed prior to the change in vitamin D
RDAs in 2011, most contained inadequate levels of
Of course, bone contains significant amounts of
magnesium and phosphorous, and these minerals are also
required for optimal bone formation. We get plenty of
phosphorous from our diet, but 68-80% of Americans
aren’t getting enough magnesium from our diet – and
many of the calcium supplements used in those studies
didn’t contain magnesium.
But if we really want to optimize bone formation, even
calcium, magnesium and vitamin D are not enough. I came
across a recent study showing that vitamin K is also
required for bone formation (Kanellakis et al,
Calcified Tissue International, 90: 251-262, 2012).
This study simply re-confirms a number of previous
studies that came to the same conclusion. Those studies
have largely been ignored because it had been assumed
that vitamin K deficiency is rare, but a recent study
(Thrombosis and Haematosis, 98: 120-125, 2007) showed
that vitamin K deficiency is more common than we had
And finally, Dr. Paul Saltman, who was my wife’s thesis
advisor, showed over 20 years ago that the trace
minerals zinc, copper and manganese were required for
optimal bone formation. (Vitamin C is also required but
most of us get enough vitamin C from our diet and/or
So what’s your bottom line if you want to prevent
osteoporosis and minimize your risk of heart attack or
1) Add as many servings of dairy and dark leafy greens
to your diet as possible. If you don’t like either of
those, go online to search for other good dietary
sources of calcium that you do like.
2) Don’t just buy the cheapest calcium supplement that
you can find. Instead, choose one that has been
optimized for bone formation. That would be one
containing calcium, magnesium, vitamin D, vitamin K,
zinc, copper and manganese. The perfect calcium
supplement may be difficult to find, but it’s worth the
3) Don’t be fooled by chelated calcium supplements or
other calcium supplements that brag about how
efficiently they are absorbed into the bloodstream.
Unless the calcium supplement is optimized for bone
formation, rapid absorption into the bloodstream may
actually cause more harm than good.
3) Don’t go overboard with your calcium supplement.
Start with the RDA recommendation (see above). Then
multiply the number of servings per day of dairy in
your diet by 250 mg and subtract that from the RDA.
That is normally the amount of supplemental calcium you
need for optimal bone health on a daily basis (unless,
of course, you have higher than normal calcium needs).
4) Make sure that you are getting RDA levels of vitamin
D from diet and supplementation (current RDA
recommendations for vitamin D in adults are 600 – 800
5) Finally, spread your calcium supplements out over
the day so that you are taking in relatively small
amounts of calcium at any one time – just as you would
To Your Health!
Dr. Stephen G Chaney
P.S. Shaklee’s OsteoMatrix is a complete calcium
supplement that can be used by itself to promote bone
health, which is no surprise because Shaklee has
consulted experts like Dr. Saltman in the design of
their calcium supplements. The Chewable Cal Mag Plus is
best used along with Vita-Lea or Vitalizer for optimal
P.P.S. Visit http://www.
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Dr. Stephen G Chaney