Calcium is the dominant mineral present in bone and a shortfall nutrient in the American diet. Supplements have been recommended for individuals who do not consume adequate calcium from the diet as a standard strategy for the prevention of osteoporosis and related fractures. Concern has arisen as to whether calcium with or without vitamin D supplementation is beneficial or detrimental to vascular health. The National Osteoporosis Foundation and American Society for Preventive Cardiology convened an Expert Panel to evaluate the effects on cardiovascular disease of dietary and supplemental calcium based on the existing peer-reviewed scientific literature. The Expert Panel considered the findings of an updated Evidence Report provided by an independent Evidence Review Team at Tufts University, as well as animal and mechanistic data provided in the peer-reviewed literature. NOF and ASPC adopt the position that at this time there is B-level or “moderate” evidence that calcium with or without vitamin D intake from food or supplements has no relationship (beneficial or detrimental) to the risk of cardiovascular and cerebrovascular disease incidence, mortality, and all-cause mortality in generally healthy adults. In light of the evidence available to date, calcium intake from food and supplements that does not result in an individual exceeding the 2000-2500 mg/d tolerable upper intake levels (UL), as defined by the National Academy of Medicine, should be considered safe.
1. Relate the importance of calcium intake for optimal bone health and physiologic functioning.
2. State recent concerns about calcium supplementation and its impact on vascular health.
3. Summarize the effect of calcium supplementation on cardiovascular events.
4. List the proper safe dosage and indications for calcium supplementation.
5. Apply recommendations in patient counseling and practice situations.
Acknowledgement of Funding: Funding from Pfizer Consumer Healthcare was received by the National Osteoporosis Foundation (NOF) for the educational symposium. Support for the Scientific Evidence Report was provided through an unrestricted educational grant from the National Osteoporosis Foundation (NOF) through the support of Pfizer Consumer Healthcare.
National Osteoporosis Foundation
251 18th Street South, Suite 630, Arlington, VA 22202 I [p] 1 (800) 231-4222 • [f] 1 (703) 414-3742
The National Osteoporosis Foundation is a qualified 501(c)(3) tax-exempt organization and all donations to the organization are
tax deductible to the full extent allowable by law. NOF’s tax ID number is 36-3350532.