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Calcium confusion Nov. 12, 2012
Written by: Marilyn Linton, QMI Agency
 
Conflicting advice about supplements leaves women wondering how to best protect their bones

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Milk or pills: What’s the best way to get your calcium?

Calcium is essential for the achievement and maintenance of normal bone health, an important health issue considering bone loss accelerates with age and one in three women will suffer a fracture due to insufficient bone density.

But since obtaining the daily, recommended 1,000 to 1,200 mg from our diet is difficult, many people – some 60% of women over the age of 60 -- have opted for calcium supplements.

But are supplements good or bad? Research published in the last few years suggested a link between calcium supplements and heart attacks – a possibility that has made many women ditch their supplements. Men, also at risk for osteoporosis, have been wary of supplements following research that indicates high calcium intake may increase the risk of prostate cancer. So what to do to protect your bones?

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Supplements are still the way to go, says Toronto naturopath Penny Kendall-Reed who told me that many of her female patients suffered from calcium confusion when they heard about the research linking high calcium intake with cardiovascular events. In her view those studies were “incomplete.”

Women should know that fractures are more common than heart attacks, stroke and breast cancer combined. “We simply can’t get enough calcium from our diets,” she says, adding supplements are safe, as long as they are not taken in high doses of 1,000 mg at once.

In fact, the average calcium consumption is only 600 mg a day, says Dr. Robert Heaney, an osteoporosis expert and professor of medicine-endocrinology at Creighton University, Omaha, Neb. People need their calcium and most men and women don’t get enough.

“Calcium works both by protecting bone mass and by reducing the excess bone remodelling that is the main cause of osteoporotic fragility.

“In the process of ordinary metabolic activity, all of our tissues develop structures they can’t use anymore,” he says. “We are constantly shedding skin; we turn over the lining of our intestines every five days. All of our body tissues are constantly replacing themselves.” Calcium is essential to keep that repair process going in our bones.

In his view, calcium supplements are not harmful but “the preferred source of calcium is food because it’s food that provides all the other nutrients.”

In addition to calcium, vitamins D and K are required to build bone and slow the pace of bone deterioration. “Nutrients are like the instruments in a symphony orchestra – the total being more than the sum of its parts,” says Dr. Heaney.

According to a recent article in MedPage Today, calcium supplements do not appear to be associated with the increased cardiovascular risk that previous studies have shown. At a recent meeting of the American Society for Bone and Mineral Research, Harvard Medical School’s Dr. Julie Paik reported on an analysis based on outcomes for 74,272 women enrolled in the Nurses’ Health Study, who filled out a questionnaire in 1984. “We found no association between calcium supplementation and cardiovascular risk,” Dr. Paik concluded.

Another study, published in the last few days in the American Journal of Clinical Nutrition, confirms this further.

But for some, calcium frustration, if not confusion, continues. Reacting to the story that taking extra calcium in supplements is no longer thought to be associated with cardiovascular events, “Lynne” posted this on a British osteoporosis forum: “I find the whole calcium subject confusing. We have seen papers saying just the opposite…”

Here at home, Osteoporosis Canada remains cautious, noting on their website that eating extra calcium from your diet is not harmful. “However, getting more calcium than you need from supplements can be harmful. Excess calcium from supplements has been associated with kidney stones, heart problems, prostate cancer, constipation and digestive problems.”

What to eat?

At the end of the day, just by eating, you will have consumed about 300 mg of calcium from a variety of foods. Choose from the following to add to your calcium load: Each contains 300 mg of calcium: 1 cup of milk, 1 cup of fortified soy, almond or rice beverage, 1 cup of fortified orange juice, 3/4 cup yogurt, 2 slices cheese. – www.osteoporosis.ca

Protect your bones

“It’s really best to get calcium from your diet,” says Dr. Carter Thorne, an osteoporosis expert at Southlake Regional Health Centre in Newmarket, Ont., where a new virtual osteoporosis initiative teaches people in remote communities how to protect their bones through good nutrition. “If you need to take a supplement, take as little as you can.”

Calcium hormone link

When overactive parathyroid glands secrete too much hormone, the condition, primary hyperparathyroidism or PHPT, results in weak bones. The condition, which affects one in 800 people, primarily women, is linked to low calcium intake.

Building bone

Naturopath Penny Kendall-Reed’s suggestion for building bone in healthy women in their 40s and 50s includes 500 mg calcium twice a day; 250 mg magnesium twice a day; 3,000 IU vitamin D daily, 60 mcg vitamin K2 daily; and 500 mcg boron daily. —Jamieson Vitamin’s Calcium Confusion panel.

Build or break?

“Bone is living tissue,” says naturopath Penny Kendall-Reed. “Every single day it is breaking down and rebuilding. We have the capacity to change that ratio.”

 

MORE COLUMNS BY MARILYN LINTON, QMI AGENCY

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