Cal­cium sup­ple­ments could boost heart at­tacks

Study shows more risk than with veg­eta­bles, other food

Baltimore Sun - - NEWS - By An­drea K. McDaniels am­c­daniels@balt­

Cal­cium sup­ple­ments that many women take to boost bone health in­crease their risk for heart dis­ease, a new study by re­searchers at Johns Hop­kins Medicine and other in­sti­tu­tions has found.

The re­sults show cal­cium sup­ple­ments make peo­ple more prone to plaque buildup in ar­ter­ies, which con­trib­utes to the risk of a heart at­tack.

The study, pub­lished Tues­day in the Jour­nal of the Amer­i­can Heart As­so­ci­a­tion, is the lat­est salvo in a nearly decade-long de­bate about whether the sup­ple­ments do more harm than good.

The re­searchers said their find­ings give pa­tients rea­son to use cau­tion when tak­ing the sup­ple­ments. It is bet­ter for peo­ple to get cal­cium from food such as dairy prod­ucts, leafy green veg­eta­bles, and for­ti­fied ce­real and juices, they said.

When cal­cium plaque builds up in the ar­ter­ies, it in­hibits blood flow, in­creas­ing heart at­tack risk.

About 43 per­cent of men and women take a sup­ple­ment that in­cludes cal­cium, ac­cord­ing to the Na­tional In­sti­tutes of Health.

“We think the body me­tab­o­lizes sup­ple­ments and di­etary cal­cium dif­fer­ently,” said Dr. Erin Mi­chos, as­so­ci­ate di­rec­tor of pre­ven­tive car­di­ol­ogy and as­so­ci­ate pro­fes­sor of medicine at the Cic­carone Cen­ter for the Pre­ven­tion of Heart Dis­ease at the Johns Hop­kins Univer­sity School of Medicine. “If you are wor­ried about your bones, then get your cal­cium through food.”

Mi­chos said the study adds to grow­ing ev­i­dence that cal­cium sup­ple­ments are bad for the heart. But the Coun­cil for Re­spon­si­ble Nu­tri­tion, which rep­re­sents man­u­fac­tur­ers of di­etary sup­ple­ments, said just as many stud­ies show the op­po­site.

The group pointed to ev­i­dence in the study that peo­ple who get a high dose of cal­cium from a mix of foods and di­etary sup­ple­ments had the low­est risk of cal­ci­fi­ca­tion in the coro­nary artery.

“This con­firms the safety of cal­cium sup­ple­men­ta­tion for heart health, which has been the con­clu­sion of sev­eral large stud­ies in re­cent years,” said Duffy MacKay, the coun­cil’s se­nior vice pres­i­dent of sci­en­tific and reg­u­la­tory af­fairs. “Con­sumers should have con­fi­dence in the safety of cal­cium sup­ple­ments, and women in par­tic­u­lar should be aim­ing to get the tar­geted daily amount of cal­cium through a com­bi­na­tion of diet and sup­ple­men­ta­tion.”

The study was prompted in large part be­cause the sci­en­tists wanted to build on pre­vi­ous re­search by oth­ers that found cal­cium sup­ple­ments never ac­tu­ally make it to a pa­tient’s bones and in­stead ac­cu­mu­late in soft tis­sue and mus­cles, such as the heart.

The re­searchers, who worked with sci­en­tists from sev­eral other uni­ver­si­ties, looked at data from the Multi-Eth­nic Study of Ath­er­o­scle­ro­sis. The study, funded by the Na­tional Heart, Lung, and Blood In­sti­tute, col­lected med­i­cal in­for­ma­tion from more than 6,000 pa­tients over time to look at the risk fac­tors and char­ac­ter­is­tics of car­dio­vas­cu­lar dis­ease.

Mi­chos and the team of re­searchers fo­cused on 2,742 par­tic­i­pants who com­pleted di­etary ques­tion­naires and had CT scans taken at the be­gin­ning of the study and 10 years later.

They found that peo­ple who used sup­ple­ments showed a 22 per­cent in­creased like­li­hood of de­vel­op­ing heart dis­ease over the decade. This was after tak­ing into ac­count de­mo­graphic fac­tors such as ex­er­cise habits, smok­ing, weight, blood sugar and fam­ily med­i­cal his­tory.

The re­search did find that those who con­sumed the high­est lev­els of cal­cium — from both foods and sup­ple­ments — were 27 per­cent less likely to de­velop heart dis­ease. It reached that con­clu­sion by com­par­ing the 20 per­cent of par­tic­i­pants with the high­est cal­cium in­take, from both diet and sup­ple­ments, to the 20 per­cent with the low­est cal­cium in­take.

Mi­chos called the study lim­ited be­cause it was ob­ser­va­tional and looked at pa­tient data. A larger, more ex­ten­sive clin­i­cal trial needs to be done, she said.

Dr. Michael Miller, pro­fes­sor of car­dio­vas­cu­lar medicine, epi­demi­ol­ogy and pub­lic health at the Univer­sity of Maryland School of Medicine, said that the study pro­vides fur­ther ev­i­dence that most sup­ple­ments in gen­eral are not the best way to fight dis­ease. Sup­ple­ments are not reg­u­lated by the Food and Drug Ad­min­is­tra­tion like other drugs.

“We have known this for years from Vi­ta­min A, Vi­ta­min C and other sup­ple­ments,” said Miller, who writes about sup­ple­ments in his book “Heal Your Heart.” “They just don’t work. But if you eat the foods that con­tain these vi­ta­mins, the body will ab­sorb them bet­ter.”

Re­searchers from the Univer­sity of Wash­ing­ton, In­di­ana Univer­sity, Wake For­est Univer­sity, Emory Univer­sity, the Pa­tient-Cen­tered Out­comes Re­search In­sti­tute, the Univer­sity of North Carolina at Chapel Hill and other uni­ver­si­ties and UCLA Med­i­cal Cen­ter also par­tic­i­pated in the study.

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