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Question
Posted by: Dr B | 2008-12-10

Calcium article

I have just read your article on the concerns ofwomen supplementing with calcium and have some questions.
Firstly was it made clear in the study which form of calcium was used? It is stated that 1000mg of elemental calcium was used but was it organic or inorganic?
There is numerous research confirming positive benefits of calcium supplementation. Should numerous research articles not be viewed before a opinion on calcium supplementation is made?

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Our expert says:
Expert ImageDietDoc

Dear Dr B
I have written many articles on the need for women (and men) throughout their lives, but particularly in their youth when calcium is deposited in the skeleton, to have a high calcium intake from natural sources such as foods. The present information emphasises that it is not taking calcium per se that is potentially linked to heart disease, but that the calcium should be accompanied by a concurrent intake (or production) of vitamin D and an intake of vit K2 (as would be the case it a well balanced diet is used).
Best regards
DietDoc

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Our users say:
Posted by: Dr B | 2008-12-11

Thanks Peter
Calcium when supplemented is not normally given in isolate so I feel that this study is potentially flawed. There have been numerous studies showing that even people who live in sunny climates are vitamin D deficient, what I do normally suggest is a combination of nutrients for bone health and not just calcium on it' s own. Prof Schurgers in Holland has been doing some great research on vitamin k2.

Reply to Dr B
Posted by: Dr B | 2008-12-11

Thanks for your reply Dietdoc, however should we not be recommending fermented foods as a source of vitamin K2. Green leafy vegetables provide K1 which has been shown to not have the same beneficial effects on activating matrix Gla and osteocalcin.

Reply to Dr B
Posted by: Peter | 2008-12-10

Hi, thanks for your reply.

The article is available free online (the Circulation one).
If you look at " Letter by Wallis and Penckofer Regarding Article, " Calcium/Vitamin D Supplementation and Cardiovascular Events" "  they even maintain that because
PTH levels were not evaluated in the study malabsorbtion
of Ca can' t be excluded (often OTC vit supplements are malabsorbed) and so possibly the Ca/Vit D may be beneficial.
Ok, this could also conversely imply that poorly absorbed Ca
could lead to less Ca and so less CV events.

The full text article and responses are located at:
circ.ahajournals.org

Reply to Peter
Posted by: Dr B | 2008-12-10

Thanks Peter I will check it out.
My concern is that calcium was given in isolate and not with other important minerals such as magnesium and boron. I am not knocking K2 or vitamin D supplementation as there has been numerous clinical research to support the use of these nutrients in bone and cardiovascular health.

Reply to Dr B
Posted by: Peter | 2008-12-10

Citation for the WHI:
(Circulation. 2007 115:846-854.)

Reply to Peter
Posted by: P2 | 2008-12-10

In Women' s Health Initiative (WHI) study, which included 36,000 postmenopausal women, found no difference in cardiovascular events between calcium supplement users and non-users. In that study, the women were younger-ages 50-79-and took calcium carbonate. (Not Ca-citrate).

Reply to P2
Posted by: Peter | 2008-12-10

Good point. The article is available FREE online at bmj.com
I can' t paste links here though here is an excerpt:

" Participants received either 1 g of elemental calcium daily as the citrate (Citracal  Mission Pharmacal, San Antonio, TX) or identical placebo. They were asked to take two tablets (each containing 200 mg elemental calcium) before breakfast and three in the evening. We used a validated food frequency questionnaire to assess dietary calcium intake.16 Compliance was assessed by tablet counts. The women were followed up every six months for five years" 

Reply to Peter

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