Calcium Intake From Diet and Supplements and the Risk of Coronary Artery Calcification and its Progression Among Older Adults: 10‐Year Follow‐up of the Multi‐Ethnic Study of Atherosclerosis (MESA) (Anderson JJB et al.)

Results of a longitudinal cohort study evaluating the association between calcium intake, from both foods and supplements, and atherosclerosis, as measured by coronary artery calcification (CAC) have recently been published in the Journal of the American Heart Association. The modern way of life has risen awareness of osteoporosis among older adults and its treatment with calcium supplements has become a common worldwide routine. According to NHANES data, calcium supplements are used by 43% of US adults. These facts determine that this population would appear to be at greater risk of developing the adverse consequences of positive calcium balance, including vascular calcification.


The verification of such an assumption has been undertaken in the present study. Its authors consider it to be the first research that evaluated total dietary intake of calcium with progression of CAC scores in a large multiethnic population of men and women. They studied 5448 adults from MESA free of clinically diagnosed CVD (52% female; aged 45–84 years). Baseline total calcium intake was assessed from diet (using a food frequency questionnaire) and calcium supplements (by a medication inventory) and categorized into quintiles. Baseline CAC was measured by computed tomography, and CAC measurements were repeated in 2742 participants approximately 10 years later. At baseline, mean calcium intakes across quintiles were 313.3, 540.3, 783.0, 1168.9, and 2157.4 mg/day. Women had higher calcium intakes than men. After adjustment for potential confounders, among 1567 participants without baseline CAC, the relative risk (RR) of developing incident CAC over 10 years, by quintile 1 to 5 of calcium intake, were 1 (reference), 0.95 (0.79–1.14), 1.02 (0.85–1.23), 0.86 (0.69–1.05), and 0.73 (0.57–0.93). After accounting for total calcium intake, calcium supplement use was associated with increased risk for incident CAC (RR=1.22 [1.07–1.39]). No relation was found between baseline calcium intake and 10-year changes in log-transformed CAC among those participants with baseline CAC >0.

The authors point out that their findings add further support to previously published reports by suggesting that the relationship between calcium intake and CVD risk is complex and appears to depend on the source of calcium intake, with dietary calcium generally showing a protective effect, but calcium supplement use being associated with increased risk. Rather than promoting bone health, excess calcium from the diet and supplements is postulated to accrue in vascular tissues.

“There is a hypothesis, that if the right amount of Vitamin K2 is added to a high calcium regimen it can be beneficial for cardiovascular system. Vitamin K2 promotes arterial flexibility by preventing arterial calcium accumulation, which could correct the imbalance of calcium in the body,” says Dr. Katarzyna Maresz, president of the International Science and Health Foundation. “Thus, calcium in tandem with Vitamin K2 may well be the solution for bringing necessary bone benefits while circumventing an increased risk for heart disease,” she emphasizes.

“However, there is lacking clinical trial, which proves this hypothesis. At least for now, we can say that supplementary calcium can be dangerous for your cardiovascular health, when vitamin K2 supplementation can bring beneficial effect,” Dr. Maresz concludes.


Anderson JJB, Kruszka B, Delaney JAC, He K, Burke GL, Alonso A, Bild DE, Budoff M and Michos ED.  Calcium Intake From Diet and Supplements and the Risk of Coronary Artery Calcification and its Progression Among Older Adults: 10‐Year Follow‐up of the Multi‐Ethnic Study of Atherosclerosis (MESA). Journal of the American Heart Association. 2016;5:e003815, originally published October 11, 2016

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