For more than 20 years, older women were encouraged by their healthcare providers to supplement their diets with calcium and vitamin D3 to reduce their risk of hip and other fractures. In recent years, evidence has been mounting that calcium supplementation, but not dietary calcium intake, is associated with increased risk of myocardial infarction and heart disease. At the same time, the validity of the recommendation to supplement the diet with calcium for bone health has been questioned. As of yet, there is no change in nonpharmacological clinical guidelines for bone and heart health. Patients, however, are asking if they should supplement diets that do not meet the recommended dietary allowance for calcium. We suggest they discuss their concern with their primary care provider. We present 2 cases from our family medicine practice to demonstrate an approach to answering the patient’s queries based on the patient-oriented evidence available. We also present a brief review of the evidence supporting our recommendations, recognizing this is a hot topic of discussion.
Jonathon M. Firnhaber, MD, is an associate professor and residency program director, Department of Family Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina.
Kathryn M. Kolasa, PhD, RDN, LDN, is professor emeritus, Departments of Family Medicine and Pediatrics, Brody School of Medicine, East Carolina University, Greenville, North Carolina, and a contributing author to Nutrition Today.
The authors have no conflicts of interest to disclose.
Correspondence: Kathryn M. Kolasa, PhD, RDN, LDN, Family Medicine and Pediatrics, East Carolina University, Family Medicine Department, 4 N 70 Brody, Brody School of Medicine, Greenville, NC 00002-7834 (firstname.lastname@example.org).