Does calcium supplementation increase the risk of cardiovascular disease and kidney stones? The truth is this!

Is the TV cabinet of your elderly family also piled with various dietary supplements?

Among the various supplements, there must be a bottle of calcium tablets .

We all know that calcium supplementation is good for health, but there are also some negative news about calcium supplementation on the Internet, such as "calcium supplementation increases the risk of cardiovascular disease" and "calcium supplementation increases the risk of kidney stones". Are these true? Let's talk about it.

1. Induce cardiovascular disease and kidney stones?

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The truth: Adequate calcium intake is beneficial to bone health, slowing bone loss, improving bone mineralization and maintaining bone health, and preventing osteoporosis and fractures. Proper calcium supplementation in the diet can also reduce the incidence of cardiovascular disease , while excessive intake of calcium supplements may increase the risk of cardiovascular disease and kidney stones.

The rumor that "calcium supplementation increases the risk of cardiovascular disease" does not refer to normal calcium supplementation. Most literature shows that adequate dietary calcium intake is helpful in lowering blood pressure and reducing the incidence of cardiovascular disease. However, if calcium supplements are taken in large quantities, blood calcium concentration will increase suddenly, causing blood vessels to harden. Unreasonable excessive calcium supplementation may increase the risk of cardiovascular disease. [1]

Studies have shown that compared with people who consume 600-1000 mg of calcium per day, those who consume 1400 mg of calcium have a 40% higher risk of all-cause mortality, a 49% higher risk of cardiovascular disease mortality, and a 114% higher risk of ischemic heart disease. Moreover, if a person consumes more than 1400 mg of calcium in their diet and takes more than 500 mg of calcium tablets per day, their risk of all-cause mortality increases by 157%. [2]

As for kidney stones, modern research suggests that stones are mainly caused by an imbalance in calcium metabolism. Some studies have suggested that calcium intake of 2100 mg/d can increase the risk of kidney stones. Other studies have found that moderate dietary calcium intake (850 mg/d) is associated with a reduced risk of kidney stone formation. [3]

Although the research data is like this, we ordinary people don’t need to worry, because many people’s calcium intake does not reach the amount that causes harm in the study, and even does not reach the recommended intake. In 2015, the average calcium intake in China was only 356.3 mg, less than half of the recommended amount, and far from the calcium intake in the study. Therefore, we don’t need to worry about the harm caused by calcium supplementation in our daily life, but we should spend more time to supplement calcium as much as possible.

2. How much calcium should be supplemented? How to supplement?

Different people have different calcium requirements. The recommended daily intake for the general population is 800 mg/d .

The main foods that supplement calcium in the diet include milk, soy products, green leafy vegetables and some nuts and seeds.

In addition, black sesame and sesame paste also have good calcium content, 780mg/100g and 1170mg/100g respectively.

For example, an adult needs 800 mg of calcium per day, so he can choose to eat the following throughout the day:

300~500ml of milk + 300~500g of green leafy vegetables + 100g of northern tofu. When eating green leafy vegetables, you can use sesame paste to make a salad, or spread sesame paste on bread slices.

This way you can replenish 800 mg/d of calcium as much as possible.

100g of green leafy vegetables is about the size of one fist after cooking, and 100g of northern tofu is about the size of one fist. Save the data in the above table and use it to estimate how much calcium you eat every day when you eat food. In addition, vegetables with high oxalic acid should be blanched before eating , otherwise oxalic acid will affect the absorption and utilization of minerals and increase the risk of kidney stones, such as spinach, amaranth, purslane, water spinach, kale, spring bamboo shoots, etc.

3. Don’t ignore vitamin D

Vitamin D can promote the absorption and utilization of calcium, and it should never be ignored. Although sun exposure can help us replenish some vitamin D, it can only replenish 78-80% at most, which is still not enough.

It is best to supplement vitamin D preparations every day . The general population needs 10 micrograms (400 IU) per day, the elderly over 65 years old need 15 micrograms/day (600 IU), and those over 70 years old need 20 micrograms/day (800 IU).

4. Choose small dose calcium tablets

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If it is difficult to make food into food, and you don’t eat enough calcium-rich foods, then you have to use dietary nutritional supplements!

In terms of calcium content, it is recommended to choose a small dose of calcium tablets , such as one with a calcium content of no more than 300 mg per tablet. It is also easier for the body to process, with a higher absorption rate, and a smaller dose can be supplemented multiple times a day.

Don't choose a tablet with a particularly high calcium content, for example, one with a calcium content of more than 500 mg per tablet. After eating this tablet, the body will be forced to take in 500 mg of calcium at once, which is really stressful to digest and absorb. If you accidentally eat one or two more tablets, it is easy to overdose.

In addition, organic calcium can be chosen for the elderly , such as calcium glucose, calcium lactate, calcium amino acid chelate, calcium citrate, etc., which have little irritation to the gastrointestinal tract. Common calcium carbonate is inorganic calcium, which needs the action of gastric acid to be better absorbed and utilized, and will have a certain irritation to the gastrointestinal tract. It is best to take it with meals . It is not suitable for the elderly with insufficient gastric acid secretion and people with weak gastrointestinal function.

Summarize:

Proper calcium supplementation for healthy bones.

You can try to get enough calcium from food on a daily basis. If that's not possible, choose a small dose of calcium tablets. Remember to supplement vitamin D~

References:

[1] Peng Jinxiang, Wang Ting. Research progress on the relationship between calcium supplementation and cardiovascular disease[J]. Chinese Journal of Chronic Disease Prevention and Control, 2014(4):65-66.

[2]Michaëlsson K, Melhus H, Lemming EW, et al. Long term calcium intake and rates of all cause and cardiovascular mortality: community based prospective longitudinal cohort study. BMJ, 2013, 346:f228

[3] Yang Yuexin, Ge Keyou. Chinese Nutrition Science Encyclopedia 2nd Edition (Volume 2)[M]. People's Medical Publishing House, 2019

[4] Chinese Nutrition Society. Dietary Guidelines for Chinese Residents[M]. People's Medical Publishing House. 2022

[5] Yang Yuexin. Chinese Food Composition Table 6th Edition Volume 1[M]. Peking University Medical Press, 2018

[6] Yang Yuexin. Chinese Food Composition Table 6th Edition Volume 2[M]. Peking University Medical Press, 2019