Best for Your Heart: Calcium From Food

Doctors weigh pluses, drawbacks in calcium supplements

Glass of Milk

If you are a heart patient or at risk for heart disease, cardiology experts suggest eating a high-calcium diet rather than taking calcium supplements for bone health, unless your doctor advises otherwise.

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Bone density declines as you age. The risk of bone fractures is particularly high in post-menopausal women. Calcium supplements can help, but the jury is still out on whether taking calcium in pill form can lead to unhealthy deposits in blood vessels.

Calcium not implicated in heart risk

Stories circulating in the media about how calcium supplements cause heart disease aren’t exactly accurate, says Stanley Hazen, MD, Head of the Section for Preventive Cardiology and Rehabilitation and Director for the Center for Cardiovascular Diagnostics and Prevention at Cleveland Clinic. “A causal or contributory relationship between supplemental calcium and heart disease — if there is one — is incredibly modest,” says Dr. Hazen.

Observation and proof are two separate things. “Some epidemiology studies that sift through large databases … have seen associations between calcium supplement use and heart disease,” says Dr. Hazen. “These findings don’t show cause and effect – just associations.”

Prevention

A lifetime of weight-bearing exercise and a calcium-rich diet are the best protection against brittle bones and the health risks associated with osteoporosis. Dairy products, such as non-fat milk and yogurt, are naturally high in calcium. Some foods and beverages, such as orange juice and cereal, are enriched with calcium.

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Unfortunately, most Americans don’t get the bone-building exercise they need. And many don’t include enough calcium in their diet to keep their bones strong through their later years.

Calcium-rich diet

For adults who have heart disease or are at risk of heart disease or stroke, a high-calcium diet is a safe way to help maintain bone strength. Slow, steady accumulation of calcium as part of an everyday diet is best.

Calcium supplementation

Calcium supplementation (with or without Vitamin D) might be appropriate for patients at high risk for bone fractures.

Leslie Cho, MD, Director of Cleveland Clinic’s Women’s Cardiovascular Center and Section Head, Preventive Cardiology and Rehabilitation, deals with the specialized needs of older female patients. “Most of the time we recommend dietary supplementation for calcium intake,” she says. “Vitamin D data is also quite unclear. There is association of very low vitamin D level with some increase in cardiovascular risk. However, good randomized control studies have not been done.”

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Treatment options

There is no one-size-fits-all rule for boosting bone strength in older adults. Anyone who is at risk for osteoporosis should discuss this issue with his or her doctor in order to make a decision based the on risks and benefits associated with calcium supplementation.

Dr. Hazen summarizes, “If your doctor recommends taking calcium, because you have thin bones, I recommend you follow your doctor’s advice.”

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