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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 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

  1. 1. The Calcium Supplement Controversy By James O’Keefe, MD Chief Medical Officer and Founder CardioTabs Presents
  2. 2. 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. 3. 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. 4. 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. 5. 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. 6. 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. 7. 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. 8. 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. 9. 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. 10. 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. 11. 11 In contrast, calcium from dietary sources or bone ingestion results in much smaller changes in circulating calcium levels Consuming Bone
  12. 12. 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. 13. 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. 14. 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. 15. 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. 16. 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. 17. 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. 18. 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. 19. 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. 20. 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. 21. 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. 22. 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