What’s Good for the Goose…

…Isn’t Good for the Gander, at all.

This may not really be the breaking news you expected when opening this page to read our breathtaking column, but wait…

Amongst food supplements most commonly used are pills, which could and should be swapped for oranges and lemons – you are guessing correctly: vitamin C. These are closely followed by calcium and magnesium tablets, which could be swapped for 1.55 litres of milk or corresponding amounts of yoghurt or cheese, but unfortunately there is cholesterol and calories found in the latter ones and therefore most people would opt for bodyweight-neutral calcium tablets. Doctors would generally support that and recommend between 1,000 and 1,200 mg per day.

But now new evidence suggests that calcium supplements hasten vascular calcification and mortality in patients with kidney failure and raise risk for myocardial infarction (heart attacks) in healthy older women.

To further investigate the association between supplemental calcium and adverse cardiovascular events, researchers conducted a meta-analysis of 15 previously conducted trials in which participants received either a minimum of 500 mg supplemental calcium per day or calcium-free placebo. Patient data were available for over 20,000 participants of which three quarters were women (the high percentage of women reflects the fact, that calcium is mostly taken by women after menopause to counteract the risk of osteoporosis due to lowered levels of oestrogen).

Myocardial infarction occurred in 143 calcium-users and 111 placebo-users –a scientifically significant difference. No association was found with excess risk for stroke or death (BMJ 2010 Jul 29; 341:c3691).

If calcium supplementation is associated with excess risk for heart attacks, medics must weigh this risk against the marginal to modest benefits on bone density and risk of fractures. Based on the this study, the authors estimate that treating 1,000 people with calcium supplements over five years would prevent only 26 fractures (!) but would cause an additional 14 heart attacks.

So …what is more important: bones & fractures or heart & infarction? What’s good for one part of us seems detrimental for another. There is surely no answer good enough for everybody other than: do discuss it with a professional! Everybody is different and a good health care professional will be able to weigh personal risks against possible benefits.

The possibly most important message, though: even innocuous looking supplements can cause health problems. Most non-medics would believe rather than know. And their belief in supplemental vitamins and minerals seem to be closer to religion than to science and knowledge.

Is there any alternative, then? Yes – we can!
Adding nuts to your diet does not only supply minerals and vitamins, it lowers your cholesterol levels and it is not associated with weight gain! 2,.4 ounces, which is approximately 60 grams, do the trick. Walnuts, almonds and even peanuts do the trick. And they do the trick for seven different nationalities tested – that should do for us ex-pats in Almuñécar (ArchInternMed 2010 May 10; 170:821).

As so often: it is simple but not easy, because the habit of nut-eating seems to require a dense fur and a black snout.

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