Wednesday, September 30, 2015

BMJ calcium study: our thoughts

Bonnie and Steve: While many of you have experienced media sensationalism over a supplement study before, others may have not. So once again, we will try to explain the correct position on calcium.

This week, BMJ published a meta-analysis with the conclusion: "Increasing calcium intake from dietary sources or by taking calcium supplements produces small non-progressive increases in BMD, which are unlikely to lead to a clinically significant reduction in risk of fracture." This is not the first negative study BMJ has published about calcium, and it will not be the last.

Of course, the media picked up on the authors' suggestion that excess calcium can cause kidney stones, heart attacks, and scared the heck out of everyone.

Too much malabsorbed calcium can cause kidney stones and calcification in the arteries, including those in the heart. However, too little calcium has also been implicated in increased death risk. It is all about the calcium source, the amount, and if it is accompanied by vitamin D and magnesium.

The concluding statement that "unlikely to lead to clinically significant reduction in risk of fracture". The authors state that on average, an individual over 50 can get a 5-10% reduction in fracture risk from extra dietary and supplemental calcium. In the medical world, this is clinically significant.

Total calcium recommendations by the medical community and the Institute of Medicine are too high. We have been fighting these calcium recommendations for years.

You and I could look at all the calcium data over time and pick the studies we want to use to steer it to our desired outcome. This is called a meta-analysis. We are very wary of these authors because they discuss better effectiveness with bone resorptive drugs without mentioning the severe side effects that come with them. The authors failed to mention that bone resorptive drugs should never be taken for more than five years because they have minimal effectiveness past five years and troubling side effects.

Missing In Action
As with just about every study ever done on calcium, while these authors did include a few with vitamin D, magnesium was never considered. Why have there never been any major studies, even meta-analyses on bone fracture prevention for subjects taking calcium, vitamin D, AND magnesium? We do not know. However, any nutritional expert will tell you that the effectiveness of calcium is dependent upon not only vitamin D, but magnesium.

For example, magnesium blocks entry of calcium into brain neurons until the appropriate moment to avoid ion imbalance. Not enough magnesium allows calcium to enter our neurons willy-nilly, causing them to misfire and act erratically.

Inadequate magnesium intake depletes the extracellular magnesium ion and consequently leads to the activation of inflammatory macrophages and influx of calcium ions into cells. The increased calcium level in the cells causes whatever magnesium is still there to try to block the influx of calcium ion, which leads to more inflammation.

The worst that can come of this media storm is that people will stop taking calcium supplementally or lower their dietary intake. This would be a huge mistake. Numerous studies have shown that taking too little calcium can be more detrimental than taking too much. Even the new Dietary Guidelines for Americans admit that most do not get enough calcium from their diet.

As we have always said, nutrient intakes should always be based upon individual needs. However, the range of total calcium that we recommend to our clients are as follows:

Women: 800-1200 mg.
Men: 800 mg.
Kids 1-10 years: 800 mg.
Kids 11-18 years: 1000 mg.

Women: 500-600 mg.
Men: 500 mg.
Kids: health professional recommendation

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