The good, the bad, and the ugly of calcium supplementation: a review of calcium intake on human health

Calcium is an important integrative component of the human body and critical for human health. It has been well established that calcium intake is helpful in the prevention and treatment of osteoporosis, which has become one of the most serious public health problems across the world. However, community-dwelling adults with and without osteoporosis are rarely concerned or even not aware of the potential side effects of high or inappropriate doses of calcium intake. Some recent studies have revealed that excessive calcium intake might increase the risks of cardiovascular diseases. The purpose of this article was to review the health benefits, costs, and consequences of calcium supplementation on osteoporosis/osteoporotic fractures, cardiovascular events, kidney stones, gastrointestinal diseases, and other important diseases. In the end, we suggest that calcium supplementation should be prescribed and taken cautiously, accounting for individual patients’ risks and benefits. Clearly, further studies are needed to examine the health effects of calcium supplementation to make any solid recommendations for people of different genders, ages, and ethnicities.

[1]  Chyke A Doubeni,et al.  Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Fractures in Community-Dwelling Adults: US Preventive Services Task Force Recommendation Statement , 2018, JAMA.

[2]  Jia-Guo Zhao,et al.  Association Between Calcium or Vitamin D Supplementation and Fracture Incidence in Community-Dwelling Older Adults: A Systematic Review and Meta-analysis , 2017, JAMA.

[3]  I. Reid,et al.  Calcium and Cardiovascular Disease , 2017, Endocrinology and metabolism.

[4]  J. J. Noubiap,et al.  Calcium supplementation and cardiovascular risk: A rising concern , 2017, Journal of clinical hypertension.

[5]  C. Cooper,et al.  UK clinical guideline for the prevention and treatment of osteoporosis , 2017, Archives of Osteoporosis.

[6]  J. Reginster,et al.  The role of calcium supplementation in healthy musculoskeletal ageing , 2017, Osteoporosis International.

[7]  C. Gordon,et al.  The National Osteoporosis Foundation’s position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations , 2016, Osteoporosis International.

[8]  M. Chonchol,et al.  Renal control of calcium, phosphate, and magnesium homeostasis. , 2015, Clinical journal of the American Society of Nephrology : CJASN.

[9]  Wayne T. A. Enanoria,et al.  Self-reported Calcium Supplementation and Age-Related Macular Degeneration. , 2015, JAMA ophthalmology.

[10]  S. Seo,et al.  Associations between dietary calcium intake with prevalence of metabolic syndrome and changes in bone mineral density among Korean population , 2015 .

[11]  M. Michalak,et al.  Ca(2+) homeostasis and endoplasmic reticulum (ER) stress: An integrated view of calcium signaling. , 2015, Biochemical and biophysical research communications.

[12]  A. Shennan,et al.  Recent advances in the diagnosis and management of pre-eclampsia , 2015, F1000prime reports.

[13]  E. M. Lewiecki,et al.  Clinician’s Guide to Prevention and Treatment of Osteoporosis , 2014, Osteoporosis International.

[14]  M. Torloni,et al.  Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. , 2014, The Cochrane database of systematic reviews.

[15]  Samantha S. R. Crossfield,et al.  54 Calcium Supplementation in Patients with Chronic Heart Failure: Is it Safe? , 2014, Heart.

[16]  I. Reid.  Should We Prescribe Calcium Supplements For Osteoporosis Prevention? , 2014, Journal of bone metabolism.

[17]  J. Woo,et al.  A Prospective Cohort Study Examining the Associations of Dietary Calcium Intake with All-Cause and Cardiovascular Mortality in Older Chinese Community-Dwelling People , 2013, PloS one.

[18]  P. Camacho,et al.  A Closer Look at Calcium Absorption and the Benefits and Risks of Dietary Versus Supplemental Calcium , 2013, Postgraduate medicine.

[19]  E. Sochacka-Tatara,et al.  Does dietary calcium interact with dietary fiber against colorectal cancer? A case–control study in Central Europe , 2013, Nutrition Journal.

[20]  L. Rodríguez-Mañas,et al.  Low calcium intake and inadequate vitamin D status in postmenopausal osteoporotic women , 2013, The Journal of Steroid Biochemistry and Molecular Biology.

[21]  A. Haghighi,et al.  Calcium and vitamin D supplementation and risk of kidney stone formation in postmenopausal women. , 2013, Iranian journal of kidney diseases.

[22]  D. Houston,et al.  Dietary and supplemental calcium intake and cardiovascular disease mortality: the National Institutes of Health-AARP diet and health study. , 2013, JAMA internal medicine.

[23]  J. Park,et al.  Association between CASR Polymorphisms, Calcium Intake, and Colorectal Cancer Risk , 2013, PloS one.

[24]  A. Wolk,et al.  Long term calcium intake and rates of all cause and cardiovascular mortality: community based prospective longitudinal cohort study , 2013, BMJ : British Medical Journal.

[25]  Naoto Endo,et al.  Japanese 2011 guidelines for prevention and treatment of osteoporosis—executive summary , 2012, Archives of Osteoporosis.

[26]  Gregory R. Emkey,et al.  Calcium metabolism and correcting calcium deficiencies. , 2012, Endocrinology and metabolism clinics of North America.

[27]  R. Kaaks,et al.  Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition study (EPIC-Heidelberg) , 2012, Heart.

[28]  G. Lyritis,et al.  2011 guidelines for the diagnosis and treatment of osteoporosis in Greece. , 2012, Journal of musculoskeletal & neuronal interactions.

[29]  C. Meier,et al.  Calcium supplementation, osteoporosis and cardiovascular disease. , 2011, Swiss medical weekly.

[30]  M. Favus.  The risk of kidney stone formation: the form of calcium matters. , 2011, The American journal of clinical nutrition.

[31]  Rose Marino1,et al.  Bone Health in Primary Ovarian Insufficiency , 2011, Seminars in reproductive medicine.

[32]  A. Wolk,et al.  Dietary calcium intake and risk of fracture and osteoporosis: prospective longitudinal cohort study , 2011, BMJ : British Medical Journal.

[33]  Maryam I. Khan,et al.  Medical management of postsurgical hypoparathyroidism. , 2011, Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists.

[34]  David A Hanley,et al.  2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary , 2010, Canadian Medical Association Journal.

[35]  N. Watts,et al.  American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the diagnosis and treatment of postmenopausal osteoporosis. , 2010, Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists.

[36]  F. Coe,et al.  Clinical practice. Calcium kidney stones. , 2010, The New England journal of medicine.

[37]  A. Avenell,et al.  Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis , 2010, BMJ : British Medical Journal.

[38]  H. Viljakainen,et al.  Effect of vitamin D, calcium and multiple micronutrient supplementation on vitamin D and bone status in Bangladeshi premenopausal garment factory workers with hypovitaminosis D: a double-blinded, randomised, placebo-controlled 1-year intervention. , 2010, The British journal of nutrition.

[39]  R. Honkanen,et al.  Use of calcium supplements and the risk of coronary heart disease in 52-62-year-old women: The Kuopio Osteoporosis Risk Factor and Prevention Study. , 2009, Maturitas.

[40]  I. Reid,et al.  Randomized controlled trial of calcium supplementation in healthy, nonosteoporotic, older men. , 2008, Archives of internal medicine.

[41]  G. Curhan,et al.  Determinants of 24-hour urinary oxalate excretion. , 2008, Clinical journal of the American Society of Nephrology : CJASN.

[42]  Carolyn M. Brown,et al.  The relationship of calcium intake and exercise to osteoporosis health beliefs in postmenopausal women. , 2008, Research in social & administrative pharmacy : RSAP.

[43]  R. Doughty,et al.  Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial , 2008, BMJ : British Medical Journal.

[44]  D. Kiel,et al.  Calcium intake and hip fracture risk in men and women: a meta-analysis of prospective cohort studies and randomized controlled trials. , 2007, The American journal of clinical nutrition.

[45]  Alan Bensoussan,et al.  Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis , 2007, The Lancet.

[46]  Deborah A. Straub.  Calcium supplementation in clinical practice: a review of forms, doses, and indications. , 2007, Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition.

[47]  I. Reid,et al.  Randomized controlled trial of calcium in healthy older women. , 2006, The American journal of medicine.

[48]  S. Dhaliwal,et al.  Effects of calcium supplementation on clinical fracture and bone structure: results of a 5-year, double-blind, placebo-controlled trial in elderly women. , 2006, Archives of internal medicine.

[49]  S. Weisman,et al.  Calcium supplementation during pregnancy and lactation: effects on the mother and the fetus. , 2006, American journal of obstetrics and gynecology.

[50]  J. Manson,et al.  Calcium plus vitamin D supplementation and the risk of fractures. , 2006, The New England journal of medicine.

[51]  I. Reid,et al.  Effects of calcium supplementation on body weight and blood pressure in normal older women: a randomized controlled trial. , 2005, The Journal of clinical endocrinology and metabolism.

[52]  L. Holmberg,et al.  Dietary Calcium and Vitamin D Intake and Risk of Colorectal Cancer: A Prospective Cohort Study in Women , 2002, Nutrition and cancer.

[53]  I. Reid,et al.  Effects of calcium supplementation on serum lipid concentrations in normal older women: a randomized controlled trial. , 2002, The American journal of medicine.

[54]  T. Cole,et al.  Effect of calcium supplementation on bone mineral accretion in gambian children accustomed to a low-calcium diet. , 2000, The American journal of clinical nutrition.

[55]  T. Sellers,et al.  Relation of calcium, vitamin D, and dairy food intake to ischemic heart disease mortality among postmenopausal women. , 1999, American journal of epidemiology.

[56]  G. Beck,et al.  Calcium supplements for the prevention of colorectal adenomas. Calcium Polyp Prevention Study Group. , 1999, The New England journal of medicine.

[57]  F. Speizer,et al.  Comparison of Dietary Calcium with Supplemental Calcium and Other Nutrients as Factors Affecting the Risk for Kidney Stones in Women , 1997, Annals of Internal Medicine.

[58]  P. van’t Veer,et al.  Calcium Does Not Protect against Colorectal Neoplasia , 1996, Epidemiology.

[59]  E. Rimm,et al.  A Prospective Study of Nutritional Factors and Hypertension Among US Men , 1989, Circulation.

[60]  S. Massry,et al.  The clinical physiology of calcium homeostasis, parathyroid hormone an, and calcitonin. I. , 1971, California medicine.

[61]  B. Riggs.  Diagnosis and Treatment of Primary Osteoporosis , 1968 .

[62]  I. Reid,et al.  The Auckland calcium study: 5-year post-trial follow-up , 2013, Osteoporosis International.

[63]  M. Brini,et al.  Intracellular calcium homeostasis and signaling. , 2013, Metal ions in life sciences.

[64]  Balla Bernadett.  Adverse events from calcium supplementation: relationship to errors in myocardial infarction self-reporting in randomized controlled trials of calcium supplementation , 2012 .

[65]  P. Lumbiganon,et al.  Calcium supplementation (other than for preventing or treating hypertension) for improving pregnancy and infant outcomes. , 2011, The Cochrane database of systematic reviews.

[66]  Christine L. Taylor,et al.  Committee to Review Dietary Reference Intakes for Vitamin D and Calcium , 2011 .

[67]  S. Jamal,et al.  Effects of calcium on cardiovascular events in patients with kidney disease and in a healthy population. , 2010, Clinical journal of the American Society of Nephrology : CJASN.

[68]  S. Krasnokutsky.  Calcium Plus Vitamin D Supplementation and the Risk of Fractures , 2006 .

[69]  R. Vandermeer,et al.  Calcium and the prevention of colon cancer. , 1991, Scandinavian journal of gastroenterology. Supplement.

[70]  W. Willett,et al.  A prospective study of nutritional factors and hypertension among US women. , 1989, Circulation.

[71]  submit your manuscript | www.dovepress.com , 2022 .