Your bones or your heart? The calcium and vitamin D confusion

It seems that just when we get the word out to women about the benefits of something, a confusing report comes out suggesting “oh oh” now you are putting yourself at risk for something else.

This is exactly what happened when recent the British Medical Journal suggested that calcium supplementation increases the risk of heart disease.

But after a thorough review of all of the literature, I still recommend a calcium intake of 1000 mg daily for women in early and middle adulthood until age 50, and 1200 mg daily for women after age 50. There is no convincing evidence that this amount of calcium, which is important for maintaining bone health, boosts the risk for cardiovascular events in women.

One of the reasons for the confusion is that the BMJ only looked at supplemental calcium without the addition of vitamin D and not dietary sources.

There are several studies suggesting that higher intake of nonfat or low-fat dairy products is associated with a lower risk for type 2 diabetes, hypertension, and cardiovascular events.

What are some good dietary sources of calcium? Dairy products and fortified juices and cereals as well as kale, collard greens, and other calcium-rich greens are good sources.

I do recommend avoiding intakes above 2000 mg of calcium daily for women age 50 and older; this is considered the upper tolerable intake level. Many women will be able to achieve the recommended doses of 1000 mg daily or 1200 mg daily of calcium through dietary sources alone, and the women who need supplements may need only an additional 500 mg per day in supplemental form. Very few women will require more than 1000 mg daily as a supplement.

As for vitamin D, there is much evidence that many women are deficient and that it impacts many areas of health. There is evidence that Vitamin D can help to reduce falls in women, prevent osteoporosis, decrease risk for some cancers, decrease risk for influenza, and help maintain normal weight. It also may decrease the risk of some autoimmune diseases like Rheumatoid Arthritis and Multiple Sclerosis.

Doses between 400 and 4000 IU of D3 (cholecalciferol) are thought to be safe and getting a vitamin D level checked will help you to know what dose you should be taking.

Make sure you review your dietary intake of both calcium and vitamin D and we can talk about supplements at your annual well woman appointment.

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