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The Calcium Supplement Controversy

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About two out of three Ameri­cans do not meet the Recommend­ed Daily Allowance for calcium, which partly explains why osteo­porosis or osteopenia (inadequate bone density) affects the majority of ...

About two out of three Ameri­cans do not meet the Recommend­ed Daily Allowance for calcium, which partly explains why osteo­porosis or osteopenia (inadequate bone density) affects the majority of post-menopausal women and is increasingly common in men. For that reason, next to multivitamins, calcium pills are the most commonly consumed daily over-the-counter supplement.

Unfortunately, re­cent studies suggest that traditional mono-nutrient calcium supplements might increase risk of heart issues by accelerating calcified plaque build-up in your coronary arteries. In this webinar Dr. James O'Keefe will teach you how to optimize bone strength, while at the same time promoting heart health through proper calcium consumption.

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    The Calcium Supplement Controversy The Calcium Supplement Controversy Presentation Transcript

    • The Calcium Supplement Controversy By James O’Keefe, MD Chief Medical Officer and Founder CardioTabs Presents
    • 2 • Calcium is best obtained from dietary sources • Standard calcium supplements may increase risk of CV disease • MicroCrystalline HydroxyApatite, along with vitamins and minerals, may help to improve bone health without increasing CV risk Key Messages
    • 3 • Calcium is the most ubiquitous mineral in the human body • Only 30% of the US population consumes the Recommended Dietary Allowance of calcium • We absorb only about 30% of calcium from foods depending on the specific source • The body will demineralize its own skeletal system to maintain serum calcium levels Calcium 101
    • 4 According to the US Surgeon General’s Report, one in two Americans over age 50 is expected to have or to be at risk of developing osteoporosis Osteoporosis
    • 5 • 1,000 mg for adults age 19-50 • 1,000 mg for males age 51-70 • 1,200 mg for females age 51- 70 • 1,200 mg for all adults age 71 and older Daily Recommended Intake
    • 6 Ancestors Ethnographic and anthropological studies indicate that adult human hunter- gatherers consumed most of their calcium in the form of bones from animals, including small and large mammals, birds, fish, reptiles etc. Hunter-Gatherer’s Diet
    • 7 • Dairy foods and beverages account for about 70% of all dietary calcium intake among Americans • On an evolutionary time scale, dairy is a relative “new- comer” to the hominin diet • Cow’s milk has up to four times more calcium than human milk, and this might contribute to problems with iron and zinc absorption • Consequently, chronic dairy consumption may have potential benefits as well potential hazards, which will require much more research to fully understand Obtain Calcium from Dairy?
    • 8 • Approximately 60% of middle-aged US women regularly use calcium supplements • The likely mechanism whereby calcium supplements increase CV risk is recurrent acute spiking in serum calcium levels • Elevated serum calcium concentrations are associated with carotid artery plaque thicknessarterial and aortic calcification, and incidence of MI Mono-Nutrient Calcium Supplements
    • 9 Strong epidemiologic associations exist between decreased bone mineral density and increased risk of both cardiovascular (CV) disease and CV death Mono-Nutrient Calcium Supplements and Heart Disease
    • 10 Other possible mechanisms that have linked calcium supplements with CV disease include: – Acceleration of coronary artery calcification – Induction of a hypercoagulable state – Effects on arterial stiffness – Parathyroid hormone Mono-Nutrient Calcium Supplements II
    • 11 In contrast, calcium from dietary sources or bone ingestion results in much smaller changes in circulating calcium levels Consuming Bone
    • 12 The homeostatic balance between various minerals appears to play a significant role in bone, vascular and overall health The Right Ratio of Minerals and Nutrients Magnesium Sodium/Potassium Vitamin K Vitamin D
    • 13 • Vitamin D plays a major role in both intestinal calcium absorption and bone health • In large meta-analyses calcium supplementation was most effective for preventing hip fractures when it was combined with vitamin D • Intake of protein plus calcium and/or vitamin D may reduce fracture rates through a mechanism independent of bone density Vitamin D
    • 14 • The benefit of vitamin K on bone may not be due to its ability to increase BMD, but rather to its effects at increasing bone strength • The oxidation of vitamin K results in: – Activation/carboxylation of bone metabolism of matrix Gla protein (MGP) – Gamma-carboxylation of osteocalcin • A recent meta-analysis concluded: – While vitamin K1 improved bone health, vitamin K2 was even more – High vitamin K2 levels were associated with reduced: • Vertebral fractures by ~60% • Hip fractures by 77% • All non-vertebral fractures by ~81% Vitamin K
    • 15 • Deposits calcium in appropriate locations like bones and teeth • Prevents calcium from depositing in locations where it does not belong, such as the soft tissues • K2 as MK-7: – Fermented dairy foods contain vitamin K2 as MK-7 – Research has shown to be a highly effective form – MK-7 increases the percentage of osteocalcin Vitamin K2
    • 16 • Dietary intakes of both potassium and sodium are important factors in CV health • Reducing excessive sodium intake is associated with resultant decreased urinary calcium excretion, which may help to prevent against bone demineralization • Moderate sodium diet (2 to 3 g/day) in conjunction with a high potassium intake (> 3g/day) might derive the optimal CV benefits for the general population Sodium/Potassium
    • 17 • Magnesium acts as a protective agent against soft tissue calcification and may reduce risk of MI • Circumstantial and experimental evidence have implicated magnesium deficiency in osteoporosis • Optimal dietary magnesium intake is about 7 to 10mg/kg/day, approximately a 2:1 calcium-to-magnesium ratio Magnesium
    • 18 We are genetically adapted to consume a large proportion of our dietary calcium from bones, where calcium is absorbed along with a matrix of nutrients including: – Magnesium – Phosphorus – Manganese – Zinc – Iron – Copper – Collagen protein – Osteocalcin Consuming Bone Supplements
    • 19 MCHA – Is the actual form of calcium found in bone – Produces less of an acute spike in blood calcium levels – Stimulates bone osteoblast cells – Contains virtually all of the essential building blocks of bone – Highly absorbed – Not just slows bone loss, but builds bone MicroCrystalline HydroxyApatite (MCHA)
    • 20 MCHA Thickness Study In a placebo controlled randomized trial women who took 1,000 mg of calcium in the form of hydroxyapatite in conjunction with oral vitamin D showed a significant increase in bone thickness whereas those who took 1,000 mg of a standard calcium supplement did not
    • 21 MCHA Bone Loss Prevention Study • HydroxyApatite (HA) was more effective than calcium carbonate at preventing bone loss – 40 randomly assigned osteoporotic patients – 1400 mg calcium /daily – After 20 months of treatment the loss of trabecular bone was 0.8 +/- 0.5% in the (HA) group versus 1.8 +/- 0.7% in the calcium carbonate group.
    • 22 BONE Essentials features MCHA combined with vitamin D, K2 as MK-7, potassium, magnesium and other essential vitamins and minerals to: – Support bone health – Promote bone density – Be well absorbed – Support heart health BONE Supplement