Calcium and its importance
Calcium is one of the body's most common and plentiful minerals and has many essential biologic functions. The body tightly controls circulating calcium levels, usually maintaining a constant range of 1.0 to 1.2 mmol/L. Many medical professionals have suggested increasing calcium intake because of its proposed bone health benefits.خطای یادکرد: برچسب تمامکنندهٔ </ref>
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Comparison between the effects of calcium intake from food sources and calcium supplements
Cardiovascular diseases
In the meta-analysis of calcium monotherapy (without coadministered vitamin D), there was an interaction between dietary calcium intake and the risk of myocardial infarction (MI) with calcium supplements when the cohort was divided by median dietary calcium intake. However, when the cohort was divided by quintile of dietary calcium intake,[۱] there was no interaction, and the risk of myocardial infarction (MI) with calcium was similar in the groups with the lowest and highest calcium intake.
In the meta-analysis of calcium monotherapy, there was no interaction between dietary calcium intake and the risk of stroke or the composite cardiovascular endpoint in this meta-analysis and no interaction between dietary calcium intake and cardiovascular events in the Women's Health Initiative CaD trial (WHI CaD).[۲] [۳] Therefore, the increased cardiovascular risk from calcium supplements appears to be independent of dietary calcium intake.[۴].
Researchers in another study concluded that calcium intake from dietary sources does not sufficiently increase the risk of cardiovascular disease, including coronary heart disease and stroke. In contrast, calcium supplements might increase coronary heart disease risk, especially myocardial infarction.[۵]
Metabolic syndrome
Additionally, a dose-response analysis showed that the risk of metabolic syndrome decreased by 7% for every 300 mg/day increase in dietary calcium consumption. According to these data, the risk of metabolic syndrome may be inversely correlated with dietary calcium consumption. [۶]
The cause of the increased cardiovascular risk from calcium supplements remains unclear, but potential mechanisms have been extensively reviewed. The finding of increased cardiovascular risk from calcium supplements but not dietary calcium intake in most observational studies have led to the hypothesis that the rapid and sustained increases in serum calcium after ingestion of a calcium supplement may have a central role.[۷]
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Conclusion
Recently research suggests a significant increase in incident coronary artery calcification with calcium supplementation. Along with previous data associating calcium supplementation with cardiovascular mortality and all-cause mortality, this new evidence stresses the need for an evidence-based approach to calcium supplementation. Moreover, educating health care providers on the possible risk of excessive and unnecessary calcium supplementation is critical. From a cardiovascular perspective, dietary calcium intake by eating foods high in calcium appears safer than calcium loading with supplements.[۸]
Resources
- ↑ Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis
- ↑ Subgroup analysis for the risk of cardiovascular disease with calcium
- ↑ Calcium/vitamin D supplementation and cardiovascular events.
- ↑ Calcium supplements and cardiovascular risk: 5 years on
- ↑ The Evidence and Controversy Between Dietary Calcium Intake and Calcium Supplementation and the Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Cohort Studies and Randomized Controlled Trials
- ↑ Dietary Calcium Intake and the Risk of Metabolic Syndrome: A Systematic Review and Meta-Analysis
- ↑ Calcium intake and serum concentration in relation to risk of cardiovascular death in NHANES III
- ↑ Calcium supplementation and cardiovascular risk: A rising concern