Not-so-super calcium pills?

Calcium pills, which are taken by around five million people in the UK, are popular among those who don’t get enough calcium in their diet. However, there are potential downsides to popping the OTC pills, according to researchers.

Taking the bone-strengthening supplements may double the risk of having a heart attack. There are around 124,000 heart attacks in the UK every year, according to the British Heart Foundation. Around three million people, mostly post-menopausal women, suffer from osteoporosis – brittle bone disease.

Researchers at the University of Auckland in New Zealand, who carried out the large-scale study which was published in November 2015, said that people should be discouraged from taking the boosters. They believe that rapid changes of calcium levels in the blood causes damage leading to hardening of the arteries.

Amy Thompson, Senior Cardiac Nurse at the British Heart Foundation, disagrees. “People who are taking calcium supplements usually have good medical reasons for doing so, including for the devastating bone-thinning disease, osteoporosis.”

Sarah Leyland, senior nurse and helpline manager at the National Osteoporosis Society says that taking a calcium supplement should be based on individual circumstances.  “The current advice is that you need to take a calcium supplement if you are not getting enough calcium in your diet. In the UK, adults should have 700mg of calcium each day, which is the equivalent of a pint of milk or an ounce of cheese.”

Pregnant women, breastfeeding women and people over the age of 65 may need to supplement their diets with calcium boosters. Women who take osteoporosis drugs may benefit from taking 1000mg each day to be on the safe side.

“We always advise people to go and see their GP to discuss their concerns,” says Amy Thompson from the BHF.  “Don’t take any urgent action but go and see your doctor and discuss if your calcium dose needs to be adjusted. It is a matter of weighing up the risks and benefits to you as an individual and perhaps some people will decide, with their doctor, that the risk is too high. That said, painful disabling fractures do affect a lot of people and seriously harm their quality of life. One in two women and one in five men over the age of 50 will have a fracture and the problem is growing as we are all living longer.”

People who are fit and healthy and eating a sensible balanced diet should probably not be taking calcium supplements as a precaution, according to Leyland of the NOS. “There is no evidence that popping a calcium pill will prevent bone thinning in this case. We already know that calcium supplements can cause constipation and increase the risk of developing painful kidney stones. Now that there is some uncertainty over whether these supplements may be linked to increased risk of heart attack, it probably is time to review the use of calcium supplements as preventatives.”  Instead of taking supplements, the scientists who undertook this latest study suggested that people should eat more calcium-rich foods like milk, cheese or fortified soya products.” It certainly makes sense to try and get your calcium from your diet,” says registered dietitian Sue Baic, who is a spokesperson for the British Dietetic Association. “Often dietary calcium is more easily absorbed by the body and it comes in a package with many other useful nutrients such as protein,  B vitamins and other essential minerals that your body needs to stay healthy.”

One pint of milk or three separate portions of dairy foods each day will give you the recommended adult daily allowance of 700mg – a portion being around 1/3 pint of milk or a small pot of yoghurt or a small chunk of cheese. However, the requirement  rises to 1000mg a day for  boys aged 11-18 years 800 mg a day for teenage girls of same ages who are going through a period of rapid growth.” ” Women going through the menopause, or post-menopausal, generally do not need more than the standard adult dose of 700mg a day unless they already have or are at high risk of osteoporosis when slightly higher levels may be advised by your doctor.” Dairy products – including low-fat versions such as skimmed and semi-skimmed milk are rich in calcium, as are oily fish where you eat the bones such canned pilchards or sardines, sesame seeds, tofu and calcium-fortified white bread. Five slices of fortified white bread, a small portion (60g) of sardines or steamed tofu (50g) gives the equivalent calcium found in a third of a pint of milk. You would have to eat a pound or 5 portions of green leafy vegetables to get the same benefit as a third of a pint of milk, however. Dried figs are also a good source- 4-5 will give you the equivalent of one portion of dairy foods.

“For those who don’t eat dairy products at all, You could get the recommended daily allowance through your diet but it would take quite a lot of planning,” explains dietitian Sue Baic, who says that many people on restricted diets find it easier to take calcium boosters. “ Calcium-fortified soya products are invaluable in a milk free diet as can be fortified rice milk Other options include  sesame seeds – 35g  will give you the equivalent calcium of a third of a pint of milk as will three servings of baked beans or kidney beans.”

Vitamin D, which is essential for the absorption of calcium into the body from the gut, is only found in relatively few foods as it is mainly synthesised in the skin in the presence of sunlight. People who do not have enough exposure to sunlight throughout the year may need to take supplements of Vitamin D in order to make sure that they absorb enough calcium.

According to The Dairy Council, some foods taken together with calcium providing foods can inhibit the absorption of calcium. For example foods such as cereals and vegetables contain compounds known as phytates, oxalates and urates which bind to calcium in the gut and prevent it from being absorbed into the blood. “Some cereal fibres, rhubarb and spinach can all have this inhibitory effect but it is not really significant unless you are eating large quantities of them,” says dietitian Sue Baic.