1
|
Behers BJ, Melchor J, Behers BM, Meng Z, Swanson PJ, Paterson HI, Mendez Araque SJ, Davis JL, Gerhold CJ, Shah RS, Thompson AJ, Patel BS, Mouratidis RW, Sweeney MJ. Vitamins and Minerals for Blood Pressure Reduction in the General, Normotensive Population: A Systematic Review and Meta-Analysis of Six Supplements. Nutrients 2023; 15:4223. [PMID: 37836507 PMCID: PMC10574336 DOI: 10.3390/nu15194223] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
Hypertension is the leading preventable risk factor for cardiovascular disease and all-cause mortality worldwide. However, studies have shown increased risk of mortality from heart disease and stroke even within the normal blood pressure (BP) range, starting at BPs above 110-115/70-75 mm Hg. Nutraceuticals, such as vitamins and minerals, have been studied extensively for their efficacy in lowering BP and may be of benefit to the general, normotensive population in achieving optimal BP. Our study investigated the effects of six nutraceuticals (Vitamins: C, D, E; Minerals: Calcium, Magnesium, Potassium) on both systolic blood pressure (SBP) and diastolic blood pressure (DBP) in this population. We performed a systematic review and pairwise meta-analysis for all six supplements versus placebo. Calcium and magnesium achieved significant reductions in both SBP and DBP of -1.37/-1.63 mm Hg and -2.79/-1.56 mm Hg, respectively. Vitamin E and potassium only yielded significant reductions in SBP with values of -1.76 mm Hg and -2.10 mm Hg, respectively. Vitamins C and D were not found to significantly lower either SBP or DBP. Future studies should determine optimal dosage and treatment length for these supplements in the general, normotensive population.
Collapse
Affiliation(s)
- Benjamin J. Behers
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Julian Melchor
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Brett M. Behers
- College of Medicine, University of South Florida, 560 Channel Side Drive MDD 54, Tampa, FL 33602, USA; (B.M.B.); (S.J.M.A.)
| | - Zhuo Meng
- Department of Statistics, Florida State University, 117 N Woodward Ave., Tallahassee, FL 32306, USA; (Z.M.); (P.J.S.)
| | - Palmer J. Swanson
- Department of Statistics, Florida State University, 117 N Woodward Ave., Tallahassee, FL 32306, USA; (Z.M.); (P.J.S.)
| | - Hunter I. Paterson
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Samuel J. Mendez Araque
- College of Medicine, University of South Florida, 560 Channel Side Drive MDD 54, Tampa, FL 33602, USA; (B.M.B.); (S.J.M.A.)
| | - Joshua L. Davis
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Cameron J. Gerhold
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Rushabh S. Shah
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Anthony J. Thompson
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Binit S. Patel
- Internal Medicine Residency, Florida State University, 1700 South Tamiami Trail, Sarasota, FL 34239, USA;
| | - Roxann W. Mouratidis
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Michael J. Sweeney
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| |
Collapse
|
2
|
Juesas A, Gargallo P, Gene-Morales J, Babiloni-López C, Saez-Berlanga A, Jiménez-Martínez P, Casaña J, Benitez-Martinez JC, Ramirez-Campillo R, Chulvi-Medrano I, Colado JC. Effects of Microfiltered Seawater Intake and Variable Resistance Training on Strength, Bone Health, Body Composition, and Quality of Life in Older Women: A 32-Week Randomized, Double-Blinded, Placebo-Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4700. [PMID: 36981609 PMCID: PMC10048547 DOI: 10.3390/ijerph20064700] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/28/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
The aim was to explore the effects of a 32-week resistance training (RT) intervention with elastic bands with or without microfiltered seawater (SW) supplementation on isokinetic strength, bone mineral density (BMD), body composition, and subjective quality of life in postmenopausal women. Ninety-three untrained women (age: 70.00 ± 6.26 years; body mass index: 22.05 ± 3.20 kg/m2; body fat: 37.77 ± 6.38%; 6.66 ± 1.01 s up-and-go test) voluntarily participated in this randomized, double-blinded, controlled trial. Participants were allocated into four groups (RT+SW, RT+PLA, CON+SW, and CON+PLA). The RT intervention (twice weekly) consisted of different exercises for the whole body performed at submaximal intensities with elastic bands. Both control groups were not involved in any exercise program. A two-way mixed analysis of variance of repeated measures revealed significant improvements in almost all the variables in both intervention groups (p < 0.05). However, significant differences with controls were encountered in isokinetic strength, body fat percentage, and bodily pain. Although the group with SW supplementation obtained greater effect sizes, non-significant differences between both RT groups were observed. In conclusion, the determinant factor of the adaptations seems to be RT rather than SW.
Collapse
Affiliation(s)
- Alvaro Juesas
- Research Group in Prevention and Health in Exercise and Sport (PHES), University of Valencia, 46010 Valencia, Spain
| | - Pedro Gargallo
- Research Group in Prevention and Health in Exercise and Sport (PHES), University of Valencia, 46010 Valencia, Spain
| | - Javier Gene-Morales
- Research Group in Prevention and Health in Exercise and Sport (PHES), University of Valencia, 46010 Valencia, Spain
| | - Carlos Babiloni-López
- Research Group in Prevention and Health in Exercise and Sport (PHES), University of Valencia, 46010 Valencia, Spain
| | - Angel Saez-Berlanga
- Research Group in Prevention and Health in Exercise and Sport (PHES), University of Valencia, 46010 Valencia, Spain
| | - Pablo Jiménez-Martínez
- Research Group in Prevention and Health in Exercise and Sport (PHES), University of Valencia, 46010 Valencia, Spain
- ICEN Institute, 28840 Madrid, Spain
| | - Jose Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, 46010 Valencia, Spain
| | - Josep C. Benitez-Martinez
- Research Group in Physiotherapy Technology and Recovering (FTR), University of Valencia, 46010 Valencia, Spain
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile
| | - Ivan Chulvi-Medrano
- Department of Physical Education and Sports, University of Valencia, 46010, Valencia, Spain
| | - Juan C. Colado
- Research Group in Prevention and Health in Exercise and Sport (PHES), University of Valencia, 46010 Valencia, Spain
| |
Collapse
|
3
|
Zhou Z, Nagashima T, Toda C, Kobayashi M, Suzuki T, Nagayasu K, Shirakawa H, Asai S, Kaneko S. Vitamin D supplementation is effective for olanzapine-induced dyslipidemia. Front Pharmacol 2023; 14:1135516. [PMID: 36895943 PMCID: PMC9989177 DOI: 10.3389/fphar.2023.1135516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 02/13/2023] [Indexed: 02/23/2023] Open
Abstract
Olanzapine is an atypical antipsychotic drug that is clinically applied in patients with schizophrenia. It increases the risk of dyslipidemia, a disturbance of lipid metabolic homeostasis, usually characterized by increased low-density lipoprotein (LDL) cholesterol and triglycerides, and accompanied by decreased high-density lipoprotein (HDL) in the serum. In this study, analyzing the FDA Adverse Event Reporting System, JMDC insurance claims, and electronic medical records from Nihon University School of Medicine revealed that a co-treated drug, vitamin D, can reduce the incidence of olanzapine-induced dyslipidemia. In the following experimental validations of this hypothesis, short-term oral olanzapine administration in mice caused a simultaneous increase and decrease in the levels of LDL and HDL cholesterol, respectively, while the triglyceride level remained unaffected. Cholecalciferol supplementation attenuated these deteriorations in blood lipid profiles. RNA-seq analysis was conducted on three cell types that are closely related to maintaining cholesterol metabolic balance (hepatocytes, adipocytes, and C2C12) to verify the direct effects of olanzapine and the functional metabolites of cholecalciferol (calcifediol and calcitriol). Consequently, the expression of cholesterol-biosynthesis-related genes was reduced in calcifediol- and calcitriol-treated C2C12 cells, which was likely to be mediated by activating the vitamin D receptor that subsequently inhibited the cholesterol biosynthesis process via insulin-induced gene 2 regulation. This clinical big-data-based drug repurposing approach is effective in finding a novel treatment with high clinical predictability and a well-defined molecular mechanism.
Collapse
Affiliation(s)
- Zijian Zhou
- Department of Molecular Pharmacology, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto, Japan
| | - Takuya Nagashima
- Department of Molecular Pharmacology, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto, Japan.,Division of Pharmacology, Department of Biomedical Sciences, Nihon University School of Medicine, Tokyo, Japan
| | - Chihiro Toda
- Department of Molecular Pharmacology, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto, Japan
| | - Mone Kobayashi
- Department of Molecular Pharmacology, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto, Japan
| | - Takahide Suzuki
- Department of Molecular Pharmacology, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto, Japan
| | - Kazuki Nagayasu
- Department of Molecular Pharmacology, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto, Japan
| | - Hisashi Shirakawa
- Department of Molecular Pharmacology, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto, Japan
| | - Satoshi Asai
- Division of Pharmacology, Department of Biomedical Sciences, Nihon University School of Medicine, Tokyo, Japan
| | - Shuji Kaneko
- Department of Molecular Pharmacology, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto, Japan
| |
Collapse
|
4
|
Associations of Calcium Intake and Calcium from Various Sources with Blood Lipids in a Population of Older Women and Men with High Calcium Intake. Nutrients 2022; 14:nu14061314. [PMID: 35334971 PMCID: PMC8951296 DOI: 10.3390/nu14061314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/09/2022] [Accepted: 03/14/2022] [Indexed: 12/22/2022] Open
Abstract
Promoting calcium intake is a cornerstone for osteoporosis management. Some individuals limit dairy product consumption, a major calcium source, due to their high content in saturated fats and their perceived negative impact on lipid profiles. This study explored the associations of calcium from various sources with blood lipids in community-dwelling elderly (n = 717) from the GERICO cohort. Dietary calcium intake was assessed at several timepoints using a validated food frequency questionnaire (FFQ) and calcium supplement use was recorded. Blood lipids were treated as categorical variables to distinguish those with normal and abnormal levels. Increasing total calcium intake was associated with lower risks for high total cholesterol (p = 0.038) and triglycerides (p = 0.007), and low HDL-cholesterol (p = 0.010). Dairy calcium (p = 0.031), especially calcium from milk (p = 0.044) and milk-based desserts (p = 0.039), i.e., low-fat (p = 0.022) and non-fermented (p = 0.005) dairy products, were associated with a lower risk of high total cholesterol. Greater calcium intakes from total dairies (p = 0.020), milk (p = 0.020) and non-fermented dairies (p = 0.027) were associated with a lower risk of hypertriglyceridemia. No association was observed between calcium from non-dairy sources, cheese or high-fat dairies and blood lipids. Increasing calcium through supplements was associated with lower risks for hypertriglyceridemia (p = 0.022) and low HDL-cholesterol (p = 0.001), but not after adjustments. Our results suggest that higher calcium intakes from dietary sources or supplements are not adversely associated with blood lipids in the elderly, whilst total, and particularly low-fat, dairy products are valuable calcium sources potentially related to favorable lipid profiles.
Collapse
|
5
|
Cormick G, Ciapponi A, Cafferata ML, Cormick MS, Belizán JM. Calcium supplementation for prevention of primary hypertension. Cochrane Database Syst Rev 2022; 1:CD010037. [PMID: 35014026 PMCID: PMC8748265 DOI: 10.1002/14651858.cd010037.pub4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Hypertension is a major public health problem that increases the risk of cardiovascular and kidney diseases. Several studies have shown an inverse association between calcium intake and blood pressure, as small reductions in blood pressure have been shown to produce rapid reductions in vascular disease risk even in individuals with normal blood pressure ranges. This is the first update of the review to evaluate the effect of calcium supplementation in normotensive individuals as a preventive health measure. OBJECTIVES To assess the efficacy and safety of calcium supplementation versus placebo or control for reducing blood pressure in normotensive people and for the prevention of primary hypertension. SEARCH METHODS The Cochrane Hypertension Information Specialist searched the following databases for randomised controlled trials up to September 2020: the Cochrane Hypertension Specialised Register, CENTRAL (2020, Issue 9), Ovid MEDLINE, Ovid Embase, the WHO International Clinical Trials Registry Platform, and the US National Institutes of Health Ongoing Trials Register, ClinicalTrials.gov. We also contacted authors of relevant papers regarding further published and unpublished work. The searches had no language restrictions. SELECTION CRITERIA We selected trials that randomised normotensive people to dietary calcium interventions such as supplementation or food fortification versus placebo or control. We excluded quasi-random designs. The primary outcomes were hypertension (defined as blood pressure ≥ 140/90 mmHg) and blood pressure measures. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials for inclusion, abstracted the data and assessed the risks of bias. We used the GRADE approach to assess the certainty of evidence. MAIN RESULTS The 2020 updated search identified four new trials. We included a total of 20 trials with 3512 participants, however we only included 18 for the meta-analysis with 3140 participants. None of the studies reported hypertension as a dichotomous outcome. The effect on systolic and diastolic blood pressure was: mean difference (MD) -1.37 mmHg, 95% confidence interval (CI) -2.08, -0.66; 3140 participants; 18 studies; I2 = 0%, high-certainty evidence; and MD -1.45, 95% CI -2.23, -0.67; 3039 participants; 17 studies; I2 = 45%, high-certainty evidence, respectively. The effect on systolic and diastolic blood pressure for those younger than 35 years was: MD -1.86, 95% CI -3.45, -0.27; 452 participants; eight studies; I2 = 19%, moderate-certainty evidence; MD -2.50, 95% CI -4.22, -0.79; 351 participants; seven studies ; I2 = 54%, moderate-certainty evidence, respectively. The effect on systolic and diastolic blood pressure for those 35 years or older was: MD -0.97, 95% CI -1.83, -0.10; 2688 participants; 10 studies; I2 = 0%, high-certainty evidence; MD -0.59, 95% CI -1.13, -0.06; 2688 participants; 10 studies; I2 = 0%, high-certainty evidence, respectively. The effect on systolic and diastolic blood pressure for women was: MD -1.25, 95% CI -2.53, 0.03; 1915 participants; eight studies; I2 = 0%, high-certainty evidence; MD -1.04, 95% CI -1.86, -0.22; 1915 participants; eight studies; I2 = 4%, high-certainty evidence, respectively. The effect on systolic and diastolic blood pressure for men was MD -2.14, 95% CI -3.71, -0.59; 507 participants; five studies; I2 = 8%, moderate-certainty evidence; MD -1.99, 95% CI -3.25, -0.74; 507 participants; five studies; I2 = 41%, moderate-certainty evidence, respectively. The effect was consistent in both genders regardless of baseline calcium intake. The effect on systolic blood pressure was: MD -0.02, 95% CI -2.23, 2.20; 302 participants; 3 studies; I2 = 0%, moderate-certainty evidence with doses less than 1000 mg; MD -1.05, 95% CI -1.91, -0.19; 2488 participants; 9 studies; I2 = 0%, high-certainty evidence with doses 1000 to 1500 mg; and MD -2.79, 95% CI -4.71, 0.86; 350 participants; 7 studies; I2 = 0%, moderate-certainty evidence with doses more than 1500 mg. The effect on diastolic blood pressure was: MD -0.41, 95% CI -2.07, 1.25; 201 participants; 2 studies; I2 = 0, moderate-certainty evidence; MD -2.03, 95% CI -3.44, -0.62 ; 1017 participants; 8 studies; and MD -1.35, 95% CI -2.75, -0.05; 1821 participants; 8 studies; I2 = 51%, high-certainty evidence, respectively. None of the studies reported adverse events. AUTHORS' CONCLUSIONS An increase in calcium intake slightly reduces both systolic and diastolic blood pressure in normotensive people, particularly in young people, suggesting a role in the prevention of hypertension. The effect across multiple prespecified subgroups and a possible dose response effect reinforce this conclusion. Even small reductions in blood pressure could have important health implications for reducing vascular disease. A 2 mmHg lower systolic blood pressure is predicted to produce about 10% lower stroke mortality and about 7% lower mortality from ischaemic heart disease. There is a great need for adequately-powered clinical trials randomising young people. Subgroup analysis should involve basal calcium intake, age, sex, basal blood pressure, and body mass index. We also require assessment of side effects, optimal doses and the best strategy to improve calcium intake.
Collapse
Affiliation(s)
- Gabriela Cormick
- Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Buenos Aires, Argentina
| | - Agustín Ciapponi
- Argentine Cochrane Centre, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Buenos Aires, Argentina
| | - María Luisa Cafferata
- Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Buenos Aires, Argentina
| | - María Sol Cormick
- Departamento de Diagnóstico por Imágenes, Fleni, Buenos Aires, Argentina
| | - José M Belizán
- Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Buenos Aires, Argentina
| |
Collapse
|
6
|
Derakhshandeh-Rishehri SM, Ghobadi S, Akhlaghi M, Faghih S. No adverse effects of dairy products on lipid profile: A systematic review and meta-analysis of randomized controlled clinical trials. Diabetes Metab Syndr 2021; 15:102279. [PMID: 34562868 DOI: 10.1016/j.dsx.2021.102279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/04/2021] [Accepted: 09/09/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND AND AIMS The current study aimed to review the effects of dairy foods on lipid profile in randomized controlled clinical trials (RCTs). METHODS We searched PubMed, Scopus, Embase, and Central. RCTs that assess the effects of dairy foods on lipid profile were included. RESULTS The overall effects of dairy foods on lipid profile were non-significant. Dairy foods were associated with a non-significant reduction in triacylglycerol level, and a non-significant increase in total cholesterol, low density lipoprotein cholesterol, and high-density lipoprotein cholesterol level. CONCLUSION We conclude that dairy foods doesn't have any unfavorable effects on lipids.
Collapse
Affiliation(s)
| | - Saeed Ghobadi
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shiva Faghih
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
7
|
Lari A, Sohouli MH, Fatahi S, Cerqueira HS, Santos HO, Pourrajab B, Rezaei M, Saneie S, Rahideh ST. The effects of the Dietary Approaches to Stop Hypertension (DASH) diet on metabolic risk factors in patients with chronic disease: A systematic review and meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis 2021; 31:2766-2778. [PMID: 34353704 DOI: 10.1016/j.numecd.2021.05.030] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 05/26/2021] [Accepted: 05/26/2021] [Indexed: 12/17/2022]
Abstract
AIMS The DASH diet was designed for helping control of blood pressure but, fortunately, it can also be prescribed for many other chronic conditions. The current study intended to assess the potential effects of DASH diet on metabolic risk factors in patients with chronic disease. DATA SYNTHESIS We carried out a systematic literature search for RCTs from inception until July 2020. A total of 54 clinical trials were included in the final analysis. Compared to control groups, a significant lower effect of the DASH diet was noted for body weight (-1.59 kg; p < 0.001), BMI (-0.64 kg/m2; p < 0.001), and WC (-1.93 cm; p < 0.001) as well as for SBP (-3.94 mmHg; p < 0.001) and DBP (-2.44 mmHg; P < 0.001). The DASH diet significantly decreased TC (-5.12 mg/dl; p = 0.008) and LDL-C levels (-3.53 mg/dl; p = 0.041), but not HDL-C (0.30 mg/dl; p = 0.510), TG (-4.22 mg/dl; p = 0.067), and VLDL-C (-2.16 mg/dl; p = 0.062). No significant effect of the DASH diet was noted for blood glucose (-0.38 mg/dl; p = 0.216), insulin (-0.03 μIU/mL; p = 0.817), HOMA-IR (-0.15; p = 0.132), and CRP (-0.33 mg/l; p = 0.173). CONCLUSIONS The DASH diet is a feasible approach to weight loss and to control blood pressure and hypercholesterolemia.
Collapse
Affiliation(s)
- Abolfazl Lari
- Student Research Committee, Faculty of public health branch, Iran University of Medical Sciences, Tehran, Iran; Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad H Sohouli
- Student Research Committee, Faculty of public health branch, Iran University of Medical Sciences, Tehran, Iran; Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somaye Fatahi
- Student Research Committee, Faculty of public health branch, Iran University of Medical Sciences, Tehran, Iran; Pediatric Gastroenterology, Hepatology and Nutrition Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical sciences, Tehran, Iran
| | | | - Heitor O Santos
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Behnaz Pourrajab
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mahshid Rezaei
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Solaleh Saneie
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Seyedeh T Rahideh
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
8
|
Cormick G, Ciapponi A, Cafferata ML, Cormick MS, Belizán JM. Calcium supplementation for prevention of primary hypertension. Cochrane Database Syst Rev 2021; 8:CD010037. [PMID: 34693985 PMCID: PMC8543682 DOI: 10.1002/14651858.cd010037.pub3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hypertension is a major public health problem that increases the risk of cardiovascular and kidney diseases. Several studies have shown an inverse association between calcium intake and blood pressure, as small reductions in blood pressure have been shown to produce rapid reductions in vascular disease risk even in individuals with normal blood pressure ranges. This is the first update of the review to evaluate the effect of calcium supplementation in normotensive individuals as a preventive health measure. OBJECTIVES To assess the efficacy and safety of calcium supplementation versus placebo or control for reducing blood pressure in normotensive people and for the prevention of primary hypertension. SEARCH METHODS The Cochrane Hypertension Information Specialist searched the following databases for randomised controlled trials up to September 2020: the Cochrane Hypertension Specialised Register, CENTRAL (2020, Issue 9), Ovid MEDLINE, Ovid Embase, the WHO International Clinical Trials Registry Platform, and the US National Institutes of Health Ongoing Trials Register, ClinicalTrials.gov. We also contacted authors of relevant papers regarding further published and unpublished work. The searches had no language restrictions. SELECTION CRITERIA We selected trials that randomised normotensive people to dietary calcium interventions such as supplementation or food fortification versus placebo or control. We excluded quasi-random designs. The primary outcomes were hypertension (defined as blood pressure ≥ 140/90 mmHg) and blood pressure measures. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials for inclusion, abstracted the data and assessed the risks of bias. We used the GRADE approach to assess the certainty of evidence. MAIN RESULTS The 2020 updated search identified four new trials. We included a total of 20 trials with 3512 participants, however we only included 18 for the meta-analysis with 3140 participants. None of the studies reported hypertension as a dichotomous outcome. The effect on systolic and diastolic blood pressure was: mean difference (MD) -1.37 mmHg, 95% confidence interval (CI) -2.08, -0.66; 3140 participants; 18 studies; I2 = 0%, high-certainty evidence; and MD -1.45, 95% CI -2.23, -0.67; 3039 participants; 17 studies; I2 = 45%, high-certainty evidence, respectively. The effect on systolic and diastolic blood pressure for those younger than 35 years was: MD -1.86, 95% CI -3.45, -0.27; 452 participants; eight studies; I2 = 19%, moderate-certainty evidence; MD -2.50, 95% CI -4.22, -0.79; 351 participants; seven studies ; I2 = 54%, moderate-certainty evidence, respectively. The effect on systolic and diastolic blood pressure for those 35 years or older was: MD -0.97, 95% CI -1.83, -0.10; 2688 participants; 10 studies; I2 = 0%, high-certainty evidence; MD -0.59, 95% CI -1.13, -0.06; 2688 participants; 10 studies; I2 = 0%, high-certainty evidence, respectively. The effect on systolic and diastolic blood pressure for women was: MD -1.25, 95% CI -2.53, 0.03; 1915 participants; eight studies; I2 = 0%, high-certainty evidence; MD -1.04, 95% CI -1.86, -0.22; 1915 participants; eight studies; I2 = 4%, high-certainty evidence, respectively. The effect on systolic and diastolic blood pressure for men was MD -2.14, 95% CI -3.71, -0.59; 507 participants; five studies; I2 = 8%, moderate-certainty evidence; MD -1.99, 95% CI -3.25, -0.74; 507 participants; five studies; I2 = 41%, moderate-certainty evidence, respectively. The effect was consistent in both genders regardless of baseline calcium intake. The effect on systolic blood pressure was: MD -0.02, 95% CI -2.23, 2.20; 302 participants; 3 studies; I2 = 0%, moderate-certainty evidence with doses less than 1000 mg; MD -1.05, 95% CI -1.91, -0.19; 2488 participants; 9 studies; I2 = 0%, high-certainty evidence with doses 1000 to 1500 mg; and MD -2.79, 95% CI -4.71, 0.86; 350 participants; 7 studies = 8; I2 = 0%, moderate-certainty evidence with doses more than 1500 mg. The effect on diastolic blood pressure was: MD -0.41, 95% CI -2.07, 1.25; 201 participants; 2 studies; I2 = 0, moderate-certainty evidence; MD -2.03, 95% CI -3.44, -0.62 ; 1017 participants; 8 studies; and MD -1.35, 95% CI -2.75, -0.05; 1821 participants; 8 studies; I2 = 51%, high-certainty evidence, respectively. None of the studies reported adverse events. AUTHORS' CONCLUSIONS An increase in calcium intake slightly reduces both systolic and diastolic blood pressure in normotensive people, particularly in young people, suggesting a role in the prevention of hypertension. The effect across multiple prespecified subgroups and a possible dose response effect reinforce this conclusion. Even small reductions in blood pressure could have important health implications for reducing vascular disease. A 2 mmHg lower systolic blood pressure is predicted to produce about 10% lower stroke mortality and about 7% lower mortality from ischaemic heart disease. There is a great need for adequately-powered clinical trials randomising young people. Subgroup analysis should involve basal calcium intake, age, sex, basal blood pressure, and body mass index. We also require assessment of side effects, optimal doses and the best strategy to improve calcium intake.
Collapse
Affiliation(s)
- Gabriela Cormick
- Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Buenos Aires, Argentina
| | - Agustín Ciapponi
- Argentine Cochrane Centre, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Buenos Aires, Argentina
| | - María Luisa Cafferata
- Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Buenos Aires, Argentina
| | - María Sol Cormick
- Departamento de Diagnóstico por Imágenes, Fleni, Buenos Aires, Argentina
| | - José M Belizán
- Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Buenos Aires, Argentina
| |
Collapse
|
9
|
Mulet-Cabero AI, Wilde PJ. Role of calcium on lipid digestion and serum lipids: a review. Crit Rev Food Sci Nutr 2021; 63:813-826. [PMID: 34281429 DOI: 10.1080/10408398.2021.1954873] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Calcium is an essential nutrient for humans that can be taken as supplement or in a food matrix (e.g. dairy products). It is suggested that dietary calcium may have a beneficial effect on cardiovascular risk but the mechanism is not clear. In this review, the main mechanisms of the possible cholesterol-lowering effect of calcium, i.e. interaction with fatty acids and bile acids, are described and clinical evidences are presented. The observations from interventional studies of the possible cholesterol-lowering effect in terms of the main related mechanisms are variable and do not seem to fulfill all the related aspects. It seems that the interplay of calcium in blood lipid metabolism might be due to its complex and multiple roles in the lipid digestion in the small intestine. The interactions between calcium and, fatty acids and bile may lead to impaired mixed micelle formation and solubilization, which is crucial in the lipid absorption and metabolism. In addition, the calcium source and its surrounding matrix will have an influence over the physiological outcome. This research is important for the delivery and formulation of calcium, particularly with the move toward plant-based diets.
Collapse
Affiliation(s)
| | - Peter J Wilde
- Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk, UK
| |
Collapse
|
10
|
Das S, Choudhuri D. Role of dietary calcium and its possible mechanism against metabolic disorders: A concise review. J Food Biochem 2021; 45:e13697. [PMID: 33694258 DOI: 10.1111/jfbc.13697] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 01/19/2021] [Accepted: 02/22/2021] [Indexed: 12/21/2022]
Abstract
The global prevalence of metabolic disorders including hypertension, dyslipidemia, insulin resistance, nonalcoholic fatty liver, and cardiovascular diseases seemed to affect people of all ages cutting across the national, economic, and demographic barrier. Therefore, the prevention of metabolic disorders is considered of paramount importance. The dietary role of nutrients including vitamins and minerals is one of the recommended preventive measures against metabolic disorders in modern society. Recently, dietary calcium, a common nutrient not only showed a beneficial effect against obesity through weight management, but also gained great attention against the risk of metabolic disorders. Though dietary calcium shows several beneficial effects against metabolic disorders but some inconsistent results were also reported. So, the present review aims to extract recent knowledge as well as their possible underlying mechanisms regarding the role of dietary calcium against metabolic disorders. The present review also discusses the negative impact as well as prospect of calcium intake on health issues. In summary, high calcium diet prevents the harmful consequences of metabolic disorders by regulating hormonal actions, alteration in intracellular calcium level, renin-angiotensin system, intestinal fat absorption, fecal fat excretion, lipid metabolism, carbohydrate metabolism, inflammation, and oxidative stress which together improve the metabolic health of an individual. PRACTICAL APPLICATIONS: Metabolic disorder is a global health issue across all sections of society and is growing rapidly in spite of several attempts by the scientific community to prevent it. Recently dietary calcium gained great attention in the last few years for its role in the management and treatment of metabolic disorders. The current review highlights the beneficial role of dietary calcium against several metabolic complications by exploring their underlying mechanisms at cellular level. This study will provide valuable information regarding the recommendation of dietary calcium in health policy as well as its inclusion in the dietary chart through calcium-rich foods and/or taking calcium supplements which can be a useful approach in preventing the risk of metabolic disorder depending on the health status of an individual.
Collapse
Affiliation(s)
- Sandeep Das
- Reproductive Physiology and Endocrinology Laboratory, Department of Human Physiology, Tripura University (A Central University), Agartala, India
| | - Dipayan Choudhuri
- Reproductive Physiology and Endocrinology Laboratory, Department of Human Physiology, Tripura University (A Central University), Agartala, India
| |
Collapse
|
11
|
Curtis EM, Cooper C, Harvey NC. Cardiovascular safety of calcium, magnesium and strontium: what does the evidence say? Aging Clin Exp Res 2021; 33:479-494. [PMID: 33565045 PMCID: PMC7943433 DOI: 10.1007/s40520-021-01799-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 01/13/2021] [Indexed: 12/20/2022]
Abstract
Calcium, magnesium and strontium have all been implicated in both musculoskeletal and cardiovascular health and disease. However, despite these three elements being closely chemically related, there is marked heterogeneity of their characteristics in relation to cardiovascular outcomes. In this narrative review, we describe the relevant evidential landscape, focusing on clinical trials where possible and incorporating findings from observational and causal analyses, to discern the relative roles of these elements in musculoskeletal and cardiovascular health. We conclude that calcium supplementation (for bone health) is most appropriately used in combination with vitamin D supplementation and targeted to those who are deficient in these nutrients, or in combination with antiosteoporosis medications. Whilst calcium supplementation is associated with gastrointestinal side effects and a small increased risk of renal stones, purported links with cardiovascular outcomes remain unconvincing. In normal physiology, no mechanism for an association has been elucidated and other considerations such as dose response and temporal relationships do not support a causal relationship. There is little evidence to support routine magnesium supplementation for musculoskeletal outcomes; greater dietary intake and serum concentrations appear protective against cardiovascular events. Strontium ranelate, which is now available again as a generic medication, has clear anti-fracture efficacy but is associated with an increased risk of thromboembolic disease. Whilst a signal for increased risk of myocardial infarction has been detected in some studies, this is not supported by wider analyses. Strontium ranelate, under its current licence, thus provides a useful therapeutic option for severe osteoporosis in those who do not have cardiovascular risk factors.
Collapse
Affiliation(s)
- Elizabeth M Curtis
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- Rheumatology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| |
Collapse
|
12
|
Hong JY, Lee JS, Woo HW, Om AS, Kwock CK, Kim MK. Meta-analysis of randomized controlled trials on calcium supplements and dairy products for changes in body weight and obesity indices. Int J Food Sci Nutr 2020; 72:615-631. [PMID: 33292017 DOI: 10.1080/09637486.2020.1856794] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This meta-analysis was performed to investigate whether calcium supplements and dairy products change obesity indices including fat mass. Original articles published in English between July 2009 and August 2019 were identified. Ten and 14 randomised controlled trials (RCTs) with ≥ 12 weeks interventions of calcium supplements and dairy products among overweight or obese adults aged ≥18 were critically reviewed. Mean difference (MD) or standardised mean difference (SMD) with 95% confidence interval (CI) were obtained using a random effect meta-analysis. Dairy products significantly changed fat mass (SMD, 95% CI; -0.40 [-0.77, -0.02]) and BMI (MD, 95% CI: -0.46 kg/m2 [-0.67, -0.26]), and calcium supplements also showed changes in fat mass (SMD, 95% CI; -0.15[-0.28, -0.02]). However, in the analysis of RCTs with low risk of bias scores, the significant changes remained only in the dairy-products intervention. Our findings suggest that dairy products without distinction of fat percentage may help reduce fat mass and BMI, but calcium supplements may not.
Collapse
Affiliation(s)
- Jee Yeon Hong
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, Korea.,Institute for Health and Society, Hanyang University, Seoul, Korea.,Department of Food and Nutrition, College of Human Ecology, Hanyang University, Seoul, Korea
| | - Ji Seon Lee
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, Korea.,Institute for Health and Society, Hanyang University, Seoul, Korea
| | - Hye Won Woo
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, Korea.,Institute for Health and Society, Hanyang University, Seoul, Korea
| | - Ae Son Om
- Department of Food and Nutrition, College of Human Ecology, Hanyang University, Seoul, Korea
| | | | - Mi Kyung Kim
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, Korea.,Institute for Health and Society, Hanyang University, Seoul, Korea
| |
Collapse
|
13
|
Derakhshandeh-Rishehri SM, Ghobadi S, Akhlaghi M, Faghih S. The effect of calcium supplement intake on lipid profile: a systematic review and meta-analysis of randomized controlled clinical trials. Crit Rev Food Sci Nutr 2020; 62:2093-2102. [PMID: 33226265 DOI: 10.1080/10408398.2020.1850414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Despite the potential role of dietary calcium in fat excretion, the favorable effects of calcium supplements on lipid profile remains inconclusive. The current study aimed to review the effect of calcium supplement intake on lipid profile in randomized controlled clinical trials (RCTs). This systematic review and meta-analysis was conducted in PubMed, Scopus, Embase, and Central. RCTs which assessed the effects of calcium supplementation on lipid profile were included. All outcomes were recorded as continuous variables, and the effect size was measured. We classified studies according to dose of supplement, study duration, and dyslipidemia. Calcium supplement intake was associated with a significant reduction in low density lipoprotein cholesterol (LDL-C) level (WMD:-0.08; 95%CI:-0.16,-0.01)(mmol/l), especially with intakes of at least 1000 mg/day (WMD:-0.13; 95%CI:-0.23,-0.03)(mmol/l), with intakes of at least 12 weeks (WMD:-0.08; 95%CI: -0.16,-0.00)(mmol/l), and in individuals without dyslipidemia (WMD:-0.15; 95%CI:-0.26,-0.04)(mmol/l). Also, in another subgroup analysis, consumption of less than 1000 mg/day calcium supplement caused a significant increase in Total Cholesterol (TC) level (WMD: 0.24; 95%CI: 0.05,0.42) (mmol/l). In other blood lipids or study subgroups we observed no significant effect. We concluded that calcium supplements had a favorable effect on LDL-C level, especially in individuals without dyslipidemia, higher calcium intakes, and longer period of consumption.
Collapse
Affiliation(s)
| | - Saeed Ghobadi
- Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Masoumeh Akhlaghi
- Department of community nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shiva Faghih
- Department of community nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.,Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
14
|
Janmohammadi P, Djafari F, Farsani GM, Shab-Bidar S, Mehrizi AAH. Parathyroid Hormone and 25-Hydroxyvitamin D Do Not Mediate the Association between Dietary Calcium, Protein and Vitamin D Intake and Adiposity and Lipid Profile in Patients with Type 2 Diabetes: a Structural Equation Modeling Approach. Clin Nutr Res 2020; 9:271-283. [PMID: 33204667 PMCID: PMC7644370 DOI: 10.7762/cnr.2020.9.4.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 11/19/2022] Open
Abstract
This study aimed to utilize structural equation modeling (SEM) techniques to determine the effects of dietary calcium, protein and vitamin D on adiposity and lipidemia and to assess mediatory effects of parathyroid hormone (PTH) and 25-hydroxyvitamin D (25(OH)D) in patients with type 2 diabetes. In this cross-sectional study, a total of 150 diabetic patients (93 females and 57 males) were randomly selected. Anthropometric measures, biochemical analyses, and fat mass percent were recorded. Nutritional data were collected. SEM was performed. Based on the primary hypothesis, adiposity and lipidemia were fitted in a model. The direct effects of dietary calcium (λ = -0.165, p value = 0.002) and PTH (λ = -0.143, p value = 0.011) were significantly associated with lipidemia. There were no significant effects for dietary protein on PTH (λ = -0.270, p value = 0.057), 25(OH)D (λ = -0.071, p value = 0.613), lipidemia (λ = -0.044; p value = 0.638) or adiposity (λ = -0.009, p value = 0.949) as well as for dietary vitamin D on PTH (λ = -0.119, p value = 0.194), 25(OH)D (λ = 0.023, p value = 0.806), lipidemia (λ = 0.034, p value = 0.587) or adiposity (λ = -0.221, p value = 0.118). The correlation between calcium intake and lipidemia, and adiposity are not mediated by 25(OH)D and PTH. There were the direct effects of dietary calcium on adiposity in patients with type 2 diabetes. The model can be tested in future longitudinal and intervention studies to identify the predictors of obesity.
Collapse
Affiliation(s)
- Parisa Janmohammadi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
| | - Farhang Djafari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
| | - Gholamreza Mohammadi Farsani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
| | - Ali Asghar Haeri Mehrizi
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, Academic Center for Education, Culture and Research, Tehran 13145-1756, Iran
| |
Collapse
|
15
|
Muscogiuri G, Barrea L, Altieri B, Di Somma C, Bhattoa HP, Laudisio D, Duval GT, Pugliese G, Annweiler C, Orio F, Fakhouri H, Savastano S, Colao A. Calcium and Vitamin D Supplementation. Myths and Realities with Regard to Cardiovascular Risk. Curr Vasc Pharmacol 2019; 17:610-617. [DOI: 10.2174/1570161117666190408165805] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 02/09/2019] [Accepted: 02/20/2019] [Indexed: 01/05/2023]
Abstract
Vitamin D and calcium are considered crucial for the treatment of bone diseases. Both vitamin
D and calcium contribute to bone homeostasis but also preserve muscle health by reducing the risk
of falls and fractures. Low vitamin D concentrations result in secondary hyperparathyroidism and contribute
to bone loss, although the development of secondary hyperparathyroidism varies, even in patients
with severe vitamin D deficiency. Findings from observational studies have shown controversial
results regarding the association between bone mineral density and vitamin D/calcium status, thus
sparking a debate regarding optimum concentrations of 25-hydroxyvitamin D and calcium for the best
possible skeletal health. Although most of the intervention studies reported a positive effect of supplementation
with calcium and vitamin D on bone in patients with osteoporosis, this therapeutic approach
has been a matter of debate regarding potential side effects on the cardiovascular (CV) system. Thus, the
aim of this review is to consider the current evidence on the physiological role of vitamin D and calcium
on bone and muscle health. Moreover, we provide an overview on observational and interventional studies
that investigate the effect of vitamin D and calcium supplementation on bone health, also taking into
account the possible CV side-effects. We also provide molecular insights on the effect of calcium plus
vitamin D on the CV system.
Collapse
Affiliation(s)
- Giovanna Muscogiuri
- Endocrinology Unit, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Medical School of Naples, Naples, Italy
| | - Luigi Barrea
- Endocrinology Unit, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Medical School of Naples, Naples, Italy
| | - Barbara Altieri
- Endocrinology Unit, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Medical School of Naples, Naples, Italy
| | | | - Harjit pal Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Daniela Laudisio
- Endocrinology Unit, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Medical School of Naples, Naples, Italy
| | - Guillaume T. Duval
- Department of Geriatric Medicine, University Memory Center, Research Center on Autonomy and Longevity (CeRAL), Angers University Hospital, Angers, France, School of Medicine and UPRES EA 4638, University of Angers, Angers, France
| | - Gabriella Pugliese
- Endocrinology Unit, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Medical School of Naples, Naples, Italy
| | - Cédric Annweiler
- Department of Geriatric Medicine, University Memory Center, Research Center on Autonomy and Longevity (CeRAL), Angers University Hospital, Angers, France, School of Medicine and UPRES EA 4638, University of Angers, Angers, France
| | - Francesco Orio
- Department of Sports Science and Wellness, "Parthenope" University Naples, Naples, Italy
| | - Hana Fakhouri
- Department of Biochemistry and Molecular Biology, College of Medicine, Al Faisal University, Riyadh, Saudi Arabia
| | - Silvia Savastano
- Endocrinology Unit, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Medical School of Naples, Naples, Italy
| | - Annamaria Colao
- Endocrinology Unit, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Medical School of Naples, Naples, Italy
| |
Collapse
|
16
|
Cormick G, Belizán JM. Calcium Intake and Health. Nutrients 2019; 11:nu11071606. [PMID: 31311164 PMCID: PMC6683260 DOI: 10.3390/nu11071606] [Citation(s) in RCA: 130] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/10/2019] [Accepted: 07/10/2019] [Indexed: 12/20/2022] Open
Abstract
There are striking inequities in calcium intake between rich and poor populations. Appropriate calcium intake has shown many health benefits, such as reduction of hypertensive disorders of pregnancy, lower blood pressure particularly among young people, prevention of osteoporosis and colorectal adenomas, lower cholesterol values, and lower blood pressure in the progeny of mothers taking sufficient calcium during pregnancy. Studies have refuted some calcium supplementation side effects like damage to the iron status, formation of renal stones and myocardial infarction in older people. Attention should be given to bone resorption in post-partum women after calcium supplementation withdrawal. Mechanisms linking low calcium intake and blood pressure are mediated by parathyroid hormone raise that increases intracellular calcium in vascular smooth muscle cells leading to vasoconstriction. At the population level, an increase of around 400–500 mg/day could reduce the differences in calcium intake between high- and middle-low-income countries. The fortification of food and water seems a possible strategy to reach this goal.
Collapse
Affiliation(s)
- Gabriela Cormick
- Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Emilio Ravignani 2024, Buenos Aires 1414, Argentina.
- Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town 7725, South Africa.
- Departamento de Salud, Universidad Nacional de La Matanza, San Justo 1903, Argentina.
| | - Jose M Belizán
- Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Emilio Ravignani 2024, Buenos Aires 1414, Argentina
| |
Collapse
|
17
|
Chandran M, Tay D, Mithal A. Supplemental calcium intake in the aging individual: implications on skeletal and cardiovascular health. Aging Clin Exp Res 2019; 31:765-781. [PMID: 30915723 DOI: 10.1007/s40520-019-01150-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 02/11/2019] [Indexed: 12/12/2022]
Abstract
Adequate calcium intake during childhood is necessary to achieve optimal peak bone mass and this has the potential by increasing bone reserves, to modulate the rate of age-associated bone loss. However, data regarding the efficacy of calcium obtained either through the diet or in the form of medicinal supplementation, for prevention of bone loss and osteoporotic fractures in the elderly is conflicting. Calcium alone is unlikely to be of benefit for this purpose though the co-administration of calcium and vitamin D may have modest fracture risk benefits. Supplemental calcium with or without vitamin D has recently come into the spotlight after the publication of the findings from a controversial randomized controlled trial that associated calcium supplementation with an increased risk of myocardial infarction. Since then, multiple studies have explored this potential link. The data remains conflicting and the potential mechanistic link if any exists, remains elusive. This review examines the relationship between supplemental calcium intake and skeletal and cardiovascular health in the aging individual through an appraisal of studies done on the subject in the last three decades. It also briefly details some of the studies evaluating fractional absorption of calcium in the elderly and the rationale behind the current recommended dietary allowances of calcium.
Collapse
Affiliation(s)
- Manju Chandran
- Osteoporosis and Bone Metabolism Unit, Department of Endocrinology, Singapore General Hospital, 20 College Road, 169856, Academia, Singapore.
| | - Donovan Tay
- Department of Medicine, Sengkang General Hospital, Singapore, Singapore
| | - Ambrish Mithal
- Division of Endocrinology and Diabetes, Medanta-The Medicity, Gurgaon, New Delhi, India
| |
Collapse
|
18
|
Alomaim H, Griffin P, Swist E, Plouffe LJ, Vandeloo M, Demonty I, Kumar A, Bertinato J. Dietary calcium affects body composition and lipid metabolism in rats. PLoS One 2019; 14:e0210760. [PMID: 30629707 PMCID: PMC6328234 DOI: 10.1371/journal.pone.0210760] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 12/30/2018] [Indexed: 12/28/2022] Open
Abstract
Calcium (Ca) intakes may affect cardiovascular disease risk by altering body composition (body weight and fat) and serum lipid profile, but results have been inconsistent and the underlying mechanisms are not well understood. The effects of dietary Ca on body composition and lipid metabolism were examined in rats. Male Sprague-Dawley rats were fed high-fat, high-energy diets containing (g/kg) low (0.75Ca, 0.86 ± 0.05; 2Ca, 2.26 ± 0.02), normal (5Ca, 5.55 ± 0.08) or high (10Ca, 11.03 ± 0.17; 20Ca, 21.79 ± 0.15) Ca for 10 weeks. Rats fed the lowest Ca diet (0.75Ca) had lower (p < 0.05) body weight and fat mass compared to other groups. Rats fed the high Ca diets had lower serum total and LDL cholesterol compared to rats fed normal or low Ca. Liver total cholesterol was lower in rats fed high compared to low Ca. In general, liver mRNA expression of genes involved in cholesterol uptake from the circulation (Ldlr), cholesterol synthesis (Hmgcr and Hmgcs1), fatty acid oxidation (Cpt2) and cholesterol esterification (Acat2) were higher in rats fed higher Ca. Apparent digestibility of total trans, saturated, monounsaturated and polyunsaturated fatty acids was lower in rats fed the high compared to the low Ca diets, with the largest effects seen on trans and saturated fatty acids. Fecal excretion of cholesterol and total bile acids was highest in rats fed the highest Ca diet (20Ca). The results suggest little effect of dietary Ca on body composition unless Ca intakes are very low. Decreased bile acid reabsorption and reduced absorption of neutral sterols and saturated and trans fatty acids may contribute to the better serum lipid profile in rats fed higher Ca.
Collapse
Affiliation(s)
- Haya Alomaim
- Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada
- King Saud bin Abdulaziz University for Health Sciences, Al Hars Al Watani, Ar Rimayah, Riyadh, Saudi Arabia
| | - Philip Griffin
- Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Eleonora Swist
- Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Louise J. Plouffe
- Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Michelle Vandeloo
- Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Isabelle Demonty
- Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Ashok Kumar
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada
| | - Jesse Bertinato
- Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada
- * E-mail:
| |
Collapse
|
19
|
Dietary calcium status during maternal pregnancy and lactation affects lipid metabolism in mouse offspring. Sci Rep 2018; 8:16542. [PMID: 30410113 PMCID: PMC6224457 DOI: 10.1038/s41598-018-34520-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 10/18/2018] [Indexed: 12/12/2022] Open
Abstract
Calcium plays important roles in lipid metabolism and adipogenesis, but whether its status in early life affects later lipid profiles needs to be clarified. Three to four-week old C57BL/6J female mice were fed with three different reproductive diets containing normal, low (insufficient) and high (excessive) calcium concentrations respectively throughout pregnancy and lactation. At postnatal 21 days, the weaning male and female pups from each group were sacrificed for experiments and the remaining were fed with the normal chow diet for 16 weeks. Meanwhile, some of the weaning female pups from maternal low calcium diet group were fed with the normal calcium, low calcium and high calcium mature diets respectively for 8 weeks. Maternal insufficient or excessive calcium status during pregnancy and lactation programmed an abnormal expression of hepatic and adipose genes (PPAR-γ, C/EBP-α, FABP4, Fasn, UCP2, PPAR-α, HMG-Red1, Acc1, and SREBP-1c) in the offspring and this may lead to dyslipidemia and accumulation of hepatic triglyceride (TG) and total cholesterol (TC) in later life. The effects of maternal calcium status on lipid metabolism were found only in the female adult offspring, but were similar between offspring males and females at postnatal 21 days. Additionally, the dyslipidemia and hepatic lipid accumulation caused by insufficient calcium status in early life may be reversed to some extent by dietary calcium supplementation in later life.
Collapse
|
20
|
Choi MJ, Jung YJ. Effects of Taurine and Vitamin D on Antioxidant Enzyme Activity and Lipids Profiles in Rats Fed Diet Deficient Calcium. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 975 Pt 2:1081-1092. [PMID: 28849524 DOI: 10.1007/978-94-024-1079-2_86] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Calcium deficiency is a worldwide problem affecting both developed and developing countries. The deficiency in calcium leads to a marked decrease of superoxide dismutase. It is known that vitamin D protects cells against oxidative damages while taurine plays an anti-inflammatory and antioxidant role. In this study, we examined whether vitamin D and taurine supplementation had a protective effect on oxidative stress in rats fed calcium deficient diet. Female SD rats (mean weight 60 ∼ 70 g) were divided into four groups; control, taurine, vitamin D, taurine + vitamin D for 6 weeks (taurine: 2 g/100 g diet, vitamin D: 0.5 mg/100 g diet). We then analyzed the level of triglyceride (TG), total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C) in serum and level of TC, TG in liver. We investigated antioxidative enzyme activities such as catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px). We observed that weight gain was not significantly different in the experimental groups. Food efficiency ratio (FER) was significantly higher in the normal control group than the taurine and vitamin D groups (p < 0.05). The level of liver TC was significantly lower in taurine, vitamin D, taurine + vitamin D groups than control group (p < 0.05). The concentration of malondialdehyde (MDA) was significantly lower in the taurine group than the control group. The activity of SOD was higher in taurine group than other experimental groups (p < 0.05), but GSH-Px and CAT were not significantly different. In conclusion, taurine has a positive effect on SOD activity but not on vitamin D. Also taurine and vitamin D have a protective effect as observed in liver TC in rats fed with a diet which lacks calcium.
Collapse
Affiliation(s)
- Mi-Ja Choi
- Department of Food and Nutrition, Keimyung University, Daegu, South Korea.
| | - Yun-Jung Jung
- Department of Food and Nutrition, Keimyung University, Daegu, South Korea
| |
Collapse
|
21
|
Harvey NC, D'Angelo S, Paccou J, Curtis EM, Edwards M, Raisi‐Estabragh Z, Walker‐Bone K, Petersen SE, Cooper C. Calcium and Vitamin D Supplementation Are Not Associated With Risk of Incident Ischemic Cardiac Events or Death: Findings From the UK Biobank Cohort. J Bone Miner Res 2018; 33:803-811. [PMID: 29314248 PMCID: PMC5915292 DOI: 10.1002/jbmr.3375] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 12/20/2017] [Accepted: 12/23/2017] [Indexed: 12/20/2022]
Abstract
We investigated associations between calcium/vitamin D supplementation and incident cardiovascular events/deaths in a UK population-based cohort. UK Biobank is a large prospective cohort comprising 502,637 men and women aged 40 to 69 years at recruitment. Supplementation with calcium/vitamin D was self-reported, and information on incident hospital admission (ICD-10) for ischemic heart disease (IHD), myocardial infarction (MI), and subsequent death was obtained from linkage to national registers. Cox proportional hazards models were used to investigate longitudinal relationships between calcium/vitamin D supplementation and hospital admission for men/women, controlling for covariates. A total of 475,255 participants (median age 58 years, 55.8% women) had complete data on calcium/vitamin D supplementation. Of that number, 33,437 participants reported taking calcium supplements; 19,089 vitamin D; and 10,007 both. In crude and adjusted analyses, there were no associations between use of calcium supplements and risk of incident hospital admission with either IHD, or subsequent death. Thus, for example, in unadjusted models, the hazard ratio (HR) for admission with myocardial infarction was 0.97 (95% confidence interval [CI] 0.79-1.20, p = 0.79) among women taking calcium supplementation. Corresponding HR for men is 1.16 (95% CI 0.92-1.46, p = 0.22). After full adjustment, HR (95% CI) were 0.82 (0.62-1.07), p = 0.14 among women and 1.12 (0.85-1.48), p = 0.41 among men. Adjusted HR (95% CI) for admission with IHD were 1.05 (0.92-1.19), p = 0.50 among women and 0.97 (0.82-1.15), p = 0.77 among men. Results were similar for vitamin D and combination supplementation. There were no associations with death, and in women, further adjustment for hormone-replacement therapy use did not alter the associations. In this very large prospective cohort, there was no evidence that use of calcium/vitamin D supplementation was associated with increased risk of hospital admission or death after ischemic cardiovascular events. © 2018 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Nicholas C Harvey
- MRC Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Stefania D'Angelo
- MRC Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
| | - Julien Paccou
- MRC Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
- Université Lille Nord‐de‐FranceLilleFrance
| | | | - Mark Edwards
- MRC Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
- Portsmouth Hospitals NHS TrustPortsmouthUK
| | - Zahra Raisi‐Estabragh
- NIHR Barts Biomedical Research CentreWilliam Harvey Research InstituteQueen Mary University of LondonLondonUK
| | - Karen Walker‐Bone
- MRC Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
| | - Steffen E Petersen
- NIHR Barts Biomedical Research CentreWilliam Harvey Research InstituteQueen Mary University of LondonLondonUK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
- NIHR Oxford Biomedical Research CentreUniversity of OxfordOxfordUK
| |
Collapse
|
22
|
Heshmati J, Sepidarkish M, Namazi N, Shokri F, Yavari M, Fazelian S, Khorshidi M, Shidfar F. Impact of Dietary Calcium Supplement on Circulating Lipoprotein Concentrations and Atherogenic Indices in Overweight and Obese Individuals: A Systematic Review. J Diet Suppl 2018; 16:357-367. [PMID: 29561197 DOI: 10.1080/19390211.2018.1440685] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Dyslipidemia is the main risk factor for developing cardiovascular disease. There are discrepancies in the effects of calcium supplementation on modulation of lipid status. Therefore, we aimed to summarize the effects of dietary calcium supplement on circulating lipoprotein concentrations and atherogenic indices in overweight and obese individuals. We conducted a systematic literature search from 2000 until July 2016. PubMed, Scopus, Cochran Library, and ISI Web of Science databases were searched for clinical trials written in English. Placebo controlled clinical trials on calcium or calcium with vitamin D supplement in overweight and obese indiciduals were considered. Finally, 11 clinical trials met the criteria and were included. Most studies (n = 9) evaluated Ca/D co-supplementation. Positive effects of calcium supplementation alone or with vitamin D were as follows: serum levels of total cholesterol (TC; n = 1), triglyceride (TG) concentrations (n = 1), serum levels of low-density lipoprotein cholesterol (LDL-C; n = 5) and high-density lipoprotein cholesterol (HDL-C; n = 3). Seven clinical trials reported atherogenic indices and three of them demonstrated beneficial effects of calcium supplementation on at least one atherogenic index. Calcium supplementation may not be helpful to reduce serum levels of TC and TG in overweight and obese individuals. However, it may modulate LDL-C and HDL-C concentration. More studies are warranted to clarify the effects of calcium supplementation on each atherogenic index.
Collapse
Affiliation(s)
- Javad Heshmati
- a Songhor Healthcare Center , Kermanshah University of Medical Science , Kermanshah , Iran
| | - Mahdi Sepidarkish
- c Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center , Royan Institute for Reproductive Biomedicine, ACECR , Tehran , Iran
| | - Nazli Namazi
- d Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute , Tehran University of Medical Sciences , Tehran , Iran
| | - Fatemeh Shokri
- e Department of Health Education and Health Promotion , School of Public Health, Iran University of Medical Sciences , Tehran , Iran
| | - Mahsa Yavari
- b Department of Nutrition, School of Public Health , Iran University of Medical Sciences , Tehran , Iran
| | | | - Masoud Khorshidi
- f Department of Clinical Nutrition , School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences , Tehran , Iran
| | - Farzad Shidfar
- b Department of Nutrition, School of Public Health , Iran University of Medical Sciences , Tehran , Iran
| |
Collapse
|
23
|
In-vitro in-vivo correlation (IVIVC) in nanomedicine: Is protein corona the missing link? Biotechnol Adv 2017; 35:889-904. [DOI: 10.1016/j.biotechadv.2017.08.003] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/04/2017] [Accepted: 08/19/2017] [Indexed: 12/17/2022]
|
24
|
|
25
|
Effet des médicaments de l’ostéoporose sur les maladies cardiovasculaires et effet des médicaments à visée cardiovasculaire sur l’ostéoporose. Presse Med 2017; 46:159-164. [DOI: 10.1016/j.lpm.2016.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 08/03/2016] [Accepted: 11/06/2016] [Indexed: 11/21/2022] Open
|
26
|
Harvey NC, Biver E, Kaufman JM, Bauer J, Branco J, Brandi ML, Bruyère O, Coxam V, Cruz-Jentoft A, Czerwinski E, Dimai H, Fardellone P, Landi F, Reginster JY, Dawson-Hughes B, Kanis JA, Rizzoli R, Cooper C. The role of calcium supplementation in healthy musculoskeletal ageing : An expert consensus meeting of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the International Foundation for Osteoporosis (IOF). Osteoporos Int 2017; 28:447-462. [PMID: 27761590 PMCID: PMC5274536 DOI: 10.1007/s00198-016-3773-6] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 09/11/2016] [Indexed: 12/27/2022]
Abstract
The place of calcium supplementation, with or without concomitant vitamin D supplementation, has been much debated in terms of both efficacy and safety. There have been numerous trials and meta-analyses of supplementation for fracture reduction, and associations with risk of myocardial infarction have been suggested in recent years. In this report, the product of an expert consensus meeting of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the International Foundation for Osteoporosis (IOF), we review the evidence for the value of calcium supplementation, with or without vitamin D supplementation, for healthy musculoskeletal ageing. We conclude that (1) calcium and vitamin D supplementation leads to a modest reduction in fracture risk, although population-level intervention has not been shown to be an effective public health strategy; (2) supplementation with calcium alone for fracture reduction is not supported by the literature; (3) side effects of calcium supplementation include renal stones and gastrointestinal symptoms; (4) vitamin D supplementation, rather than calcium supplementation, may reduce falls risk; and (5) assertions of increased cardiovascular risk consequent to calcium supplementation are not convincingly supported by current evidence. In conclusion, we recommend, on the basis of the current evidence, that calcium supplementation, with concomitant vitamin D supplementation, is supported for patients at high risk of calcium and vitamin D insufficiency, and in those who are receiving treatment for osteoporosis.
Collapse
Affiliation(s)
- N C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - E Biver
- Service of Bone Diseases, University Hospitals Geneva, Geneva, Switzerland
| | - J-M Kaufman
- Department of Internal Medicine, section Endocrinology, Ghent University, Ghent, Belgium
| | - J Bauer
- Department of Geriatric Medicine, Klinikum, Carl von Ossietzky University, Ammerländer Heerstrasse 114-118, 26129, Oldenburg, Germany
| | - J Branco
- CEDOC - NOVA Medical School, UNL and Rheumatology Department, CHLO/Hospital Egas Moniz, Lisbon, Portugal
| | - M L Brandi
- Head, Bone and Mineral Metabolic Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - O Bruyère
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - V Coxam
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63000, Clermont-Ferrand, France
- Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000, Clermont-Ferrand, France
| | - A Cruz-Jentoft
- Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (Irycis), Madrid, Spain
| | - E Czerwinski
- Department of Bone and Joint Diseases, Faculty of Health Sciences, Krakow Medical Centre, Jagiellonian University, Krakow, Poland
| | - H Dimai
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - P Fardellone
- CHU Amiens, Université Picardie - Jules Verne, INSERM U 1088, Amiens, France
| | - F Landi
- Geriatric Department, Catholic University of Sacred Heart, Milan, Italy
| | - J-Y Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - B Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - J A Kanis
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
- Institute for Health and Ageing, Catholic University of Australia, Melbourne, Australia
| | - R Rizzoli
- Service of Bone Diseases, University Hospitals Geneva, Geneva, Switzerland
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, The Botnar Research Centre, University of Oxford, Oxford, UK.
| |
Collapse
|
27
|
Hjerpsted J, Tholstrup T. Cheese and Cardiovascular Disease Risk: A Review of the Evidence and Discussion of Possible Mechanisms. Crit Rev Food Sci Nutr 2017; 56:1389-403. [PMID: 25603014 DOI: 10.1080/10408398.2013.769197] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Currently, the effect of dairy products on cardiovascular risk is a topic much debated and with conflicting results. The purpose of this review is to give an overview of the existing literature regarding the effect of cheese intake and risk of cardiovascular disease (CVD). Studies included reporting the intake of cheese and risk of CVD or risk markers of CVD represent four human intervention studies, nine prospective studies, one prospective case-cohort study, one prospective nested case-control study, five case-control studies, five cross-sectional studies and three correlation studies. The possible mechanisms that may be of importance include calcium, protein, fermentation and the fatty acid composition of cheese. Results from four prospective studies reported no association between cheese intake and CVD risk, whereas one reported an increased risk, two reported a decreased risk and one reported no association in men but a decreased risk in women. In addition, results from four intervention studies indicated no harmful effect on cholesterol concentrations when comparing fat intake from cheese with fat from butter. The underlying mechanisms for these findings still need to be elucidated.
Collapse
Affiliation(s)
| | - Tine Tholstrup
- a Department of Nutrition, Exercise and Sports, Faculty of Science , University of Copenhagen , Frederiksberg , Denmark
| |
Collapse
|
28
|
Golzarand M, Shab-Bidar S, Koochakpoor G, Speakman J R, Djafarian K. Effect of vitamin D3 supplementation on blood pressure in adults: An updated meta-analysis. Nutr Metab Cardiovasc Dis 2016; 26:663-673. [PMID: 27287826 DOI: 10.1016/j.numecd.2016.04.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 04/13/2016] [Accepted: 04/15/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS Previous randomized clinical trials (RCTs) of the effects of vitamin D3 supplementation (VD3S) on blood pressure have generated inconsistent results. We evaluated the effect of VD3S on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in a meta-analysis. DATA SYNTHESIS Literature searches of PubMed, Scopus, Ovid, and Google scholar for publications in English were conducted up to April 2015. RCTs that assessed the effect of VD3S on SBP and DBP were selected. CONCLUSIONS A total of 30 RCTs with 41 arms including 4744 participants were included. The mean duration of the studies was 5.6 ± 4.0 months, and doses of VD3S varied between 200 and 12,000 IU/day. VD3S had no effect on SBP (-0.68 mmHg, 95%CI: -2.19 to 0.84), and DBP (-0.57 mmHg, 95%CI: -1.36 to 0.22). Subgroup analysis revealed that daily vitamin D3 therapy at a dose of >800 IU/day for <6 months in subjects ≥50 years old reduced both SBP and DBP (p < 0.001). In addition, VD3S showed hypotensive effects in healthy subjects and hypertensive patients, but a hypertensive effect in overweight and obese subjects. However, after excluding overweight and obese subjects, VD3S significantly reduced SBP and DBP. VD3S in combination with calcium supplementation significantly elevated SBP (3.64 mmHg, 95%CI: 3.15-4.13) and DBP (1.71 mmHg, 95%CI: 1.25-2.18). No evidence of publication bias was found. The effects of VD3S on blood pressure depend on dose of supplementation, treatment regimens, trial duration, and population subgroup. Supplementation may be beneficial at daily doses >800 IU/day for <6 months in subjects ≥50 years old.
Collapse
Affiliation(s)
- M Golzarand
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - S Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - G Koochakpoor
- School of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Tehran, Iran
| | - R Speakman J
- Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, Scotland, UK; Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China.
| | - K Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
29
|
Lima GAC, Lima PDA, de Barros MDGCRM, Vardiero LP, de Melo EF, Paranhos FDP, Madeira M, de Farias MLF. Calcium intake: good for the bones but bad for the heart? An analysis of clinical studies. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2016; 60:252-63. [PMID: 27355855 PMCID: PMC10522307 DOI: 10.1590/2359-3997000000173] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 03/10/2016] [Indexed: 11/22/2022]
Abstract
The proper dietary calcium intake and calcium supplementation, when indicated, are important factors in the acquisition of peak bone mass during youth and in the prevention of fractures in old age. In addition to its deposition in bone, calcium confers an increase in its resistance and exhibits important activities in different enzymatic pathways in the body (e.g., neural, hormonal, muscle-related and blood clotting pathways). Thus, calcium supplementation can directly or indirectly affect important functions in the body, such as the control of blood pressure, plasma glucose, body weight, lipid profile and endothelial function. Since one publication reported increased cardiovascular risk due to calcium supplementation, many researchers have studied whether this risk actually exists; the results are conflicting, and the involved mechanisms are uncertain. However, studies that have evaluated the influence of the consumption of foods rich in calcium have reported no increase in the cardiovascular risk, which suggests that nutritional intake should be prioritized as a method for supplementation and that the use of calcium supplements should be reserved for patients who truly need supplementation and are unable to achieve the recommended daily nutritional intake of calcium.
Collapse
Affiliation(s)
- Guilherme Alcantara Cunha Lima
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Serviço de Endocrinologia da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
- Faculdade de Medicina de CamposCampos dos GoytacazesRJBrasil Serviço de Clínica Médica da Faculdade de Medicina de Campos (FMC), Campos dos Goytacazes, RJ, Brasil
| | - Priscilla Damião Araújo Lima
- Faculdade de Medicina de CamposCampos dos GoytacazesRJBrasil Serviço de Clínica Médica da Faculdade de Medicina de Campos (FMC), Campos dos Goytacazes, RJ, Brasil
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Serviço de Reumatologia da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Maria da Glória Costa Reis Monteiro de Barros
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Serviço de Reumatologia da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
- Centro Universitário Serra dos ÓrgãosTeresópolisRJBrasil Serviço de Clínica Médica do Centro Universitário Serra dos Órgãos (Unifeso), Teresópolis, RJ, Brasil
| | - Lívia Paiva Vardiero
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Serviço de Reumatologia da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Elisa Fernandes de Melo
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Serviço de Reumatologia da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Francisco de Paula Paranhos
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Serviço de Endocrinologia da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Miguel Madeira
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Serviço de Endocrinologia da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
- Universidade do Grande RioRio de JaneiroRJBrasil Serviço de Clínica Médica da Universidade do Grande Rio (Unigranrio), Rio de Janeiro, RJ, Brasil
| | - Maria Lucia Fleiuss de Farias
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Serviço de Endocrinologia da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| |
Collapse
|
30
|
Feasibility of a clinical trial to assess the effect of dietary calcium v. supplemental calcium on vascular and bone markers in healthy postmenopausal women. Br J Nutr 2016; 116:104-14. [PMID: 27181505 DOI: 10.1017/s0007114516001677] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Whether supplemental Ca has similar effects to dietary Ca on vascular and bone markers is unknown. The present trial investigated the feasibility of applying dietary and supplemental interventions in a randomised-controlled trial (RCT) aiming to estimate the effect of supplemental Ca as compared with dietary Ca on vascular and bone markers in postmenopausal women. In total, thirteen participants were randomised to a Ca supplement group (CaSuppl) (750 mg Ca from CaCO3+450 mg Ca from food+20 µg vitamin D supplement) or a Ca diet group (CaDiet) (1200 mg Ca from food+10 µg vitamin D supplement). Participants were instructed on Ca consumption targets at baseline. Monthly telephone follow-ups were conducted to assess adherence to interventions (±20 % of target total Ca) using the multiple-pass 24-h recall method and reported pill count. Measurements of arterial stiffness, peripheral blood pressure and body composition were performed at baseline and after 6 and 12 months in all participants who completed the trial (n 9). Blood and serum biomarkers were measured at baseline and at 12 months. Both groups were compliant to trial interventions (±20 % of target total Ca intake; pill count ≥80 %). CaSuppl participants maintained a significantly lower average dietary Ca intake compared with CaDiet participants throughout the trial (453 (sd 187) mg/d v. 1241 (sd 319) mg/d; P<0·001). There were no significant differences in selected vascular outcomes between intervention groups over time. Our pilot trial demonstrated the feasibility of conducting a large-scale RCT to estimate the differential effects of supplemental and dietary Ca on vascular and bone health markers in healthy postmenopausal women.
Collapse
|
31
|
Castro Burbano J, Fajardo Vanegas P, Robles Rodríguez J, Pazmiño Estévez K. Relationship between dietary calcium intake and adiposity in female adolescents. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.endoen.2016.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
|
32
|
Castro Burbano J, Fajardo Vanegas P, Robles Rodríguez J, Pazmiño Estévez K. Relationship between dietary calcium intake and adiposity in female adolescents. ACTA ACUST UNITED AC 2015; 63:58-63. [PMID: 26718194 DOI: 10.1016/j.endonu.2015.10.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 10/21/2015] [Accepted: 10/27/2015] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND OBJECTIVE The prevalence and magnitude of obesity in children and adolescents increase rapidly. Besides genetic and environmental factors, calcium intake has recently been identified as a dietary factor that is inversely related with body mass index and development of overweight and obesity. The purpose of this study was to assess the correlation between dietary calcium intake and body mass index and fat distribution in female adolescents. MATERIALS AND METHODS This was a cross-sectional study where anthropometric variables (weight, height, body mass index, waist and hip circumference) were collected in 244 female adolescents to establish total body adiposity and fat distribution. A 24-hour recall and a food frequency questionnaire were used to assess total calorie, calcium, and dairy products intake. RESULTS Calcium intake was inversely related to body mass index (P<.05), waist circumference(P<.05), hip circumference (P>.05), and waist to hip ratio (P<.05).Overweight (8.3%) and obese (0.7%) adolescents had a lower mean calcium intake than adolescents of normal weight (P=.06). CONCLUSIONS Dietary calcium intake and, to a lesser extent, consumption of dairy products are inversely related to total and abdominal adiposity, and also to the prevalence of overweight in this group of adolescents.
Collapse
Affiliation(s)
- José Castro Burbano
- Escuela de Nutriología, Universidad Internacional del Ecuador, Quito, Ecuador.
| | | | | | | |
Collapse
|
33
|
Effects of supplementation with a calcium-rich marine-derived multi-mineral supplement and short-chain fructo-oligosaccharides on serum lipids in postmenopausal women. Br J Nutr 2015; 115:658-65. [DOI: 10.1017/s0007114515004948] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
AbstractRecent literature suggests that Ca supplements have adverse effects on cardiovascular health. The effects of a Ca-rich supplement administered alone or in combination with short-chain fructo-oligosaccharides (scFOS) on serum lipids in postmenopausal women were examined using secondary data from a 24-month double-blind randomised controlled study. A total of 300 postmenopausal women were randomly assigned to daily supplements of 800 mg of Ca (2·4 g Aquamin) (Ca), 800 mg of Ca with 3 g of scFOS (CaFOS) or control (maltodextrin) (MD). A full lipid profile, body composition, blood pressure and a range of cytokines were measured at baseline and after 24 months. Intention-to-treat ANCOVA assessed treatment effects between the groups. A significant time-by-treatment effect was observed for LDL and total cholesterol for the Ca and CaFOS groups, with both groups having lower LDL and total cholesterol concentrations compared with MD after 24 months. The control group had mean (5·2 mmol/l) total cholesterol concentrations above the normal range (≤5 mmol/l) at 24 months, whereas values remained within the normal range in the treatment groups. There was no significant treatment effect on HDL-cholesterol, TAG, body composition, blood pressure or cytokine concentrations at 24 months, with the exception of IL-4, where there was a significant increase in the CaFOS group compared with the placebo. This study demonstrates a lipid-lowering effect of both the Ca-rich supplement alone and the supplement with scFOS. At the 4-year follow-up, there was no significant difference between the groups for reported diagnosed cardiovascular conditions.
Collapse
|
34
|
Effect of increasing dietary calcium through supplements and dairy food on body weight and body composition: a meta-analysis of randomised controlled trials. Br J Nutr 2015; 114:1013-25. [PMID: 26234296 DOI: 10.1017/s0007114515001518] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This meta-analysis of randomised controlled trials assessed the effect of Ca on body weight and body composition through supplementation or increasing dairy food intake. Forty-one studies met the inclusion criteria (including fifty-one trial arms; thirty-one with dairy foods (n 2091), twenty with Ca supplements (n 2711). Ca intake was approximately 900 mg/d higher in the supplement groups compared with control. In the dairy group, Ca intake was approximately 1300 mg/d. Ca supplementation did not significantly affect body weight (mean change ( - 0·17, 95% CI - 0·70, 0·37) kg) or body fat (mean change ( - 0·19, 95% CI - 0·51, 0·13) kg) compared to control. Similarly, increased dairy food intake did not affect body weight ( - 0·06, 95% CI - 0·54, 0·43) kg or body fat change ( - 0·36, 95% CI - 0·80, 0·09) kg compared to control. Sub-analyses revealed that dairy supplementation resulted in no change in body weight (nineteen studies, n 1010) ( - 0·32, 95% CI - 0·93, 0·30 kg, P= 0·31), but a greater reduction in body fat (thirteen studies, n 564) ( - 0·96, 95% CI - 1·46, - 0·46 kg, P < 0·001) in the presence of energy restriction over a mean of 4 months compared to control. Increasing dietary Ca intake by 900 mg/d as supplements or increasing dairy intake to approximately 3 servings daily (approximately 1300 mg of Ca/d) is not an effective weight reduction strategy in adults. There is, however, an indication that approximately 3 servings of dairy may facilitate fat loss on weight reduction diets in the short term.
Collapse
|
35
|
Cormick G, Ciapponi A, Cafferata ML, Belizán JM. Calcium supplementation for prevention of primary hypertension. Cochrane Database Syst Rev 2015:CD010037. [PMID: 26126003 PMCID: PMC6486289 DOI: 10.1002/14651858.cd010037.pub2] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Hypertension is a major public health problem that increases the risk of cardiovascular and kidney diseases. Several studies have shown an inverse association between calcium intake and blood pressure. As small reductions in blood pressure have been shown to produce rapid reductions in vascular disease risk even in individuals with normal blood pressure ranges, this review intends to evaluate the effect of calcium supplementation in normotensive individuals as a preventive health measure. OBJECTIVES To assess the efficacy and safety of calcium supplementation versus placebo or control for reducing blood pressure in normotensive people. SEARCH METHODS We searched the Cochrane Hypertension Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE In-Process, EMBASE and ClinicalTrials.gov for randomised controlled trials up to October 2014. The WHO International Clinical Trials Registry Platform (ICTRP) is searched for inclusion in the Group's Specialised Register. We also reviewed reference lists from retrieved studies and contacted authors of relevant papers. We applied no language restrictions. SELECTION CRITERIA We selected trials that randomised normotensive people to dietary calcium interventions such as supplementation or food fortification versus placebo or control. We excluded quasi-random designs. The primary outcomes were hypertension (defined as blood pressure ≥ 140/90 mmHg) and blood pressure measures. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials for inclusion, abstracted the data and assessed the risks of bias. MAIN RESULTS We included 16 trials with 3048 participants. None of the studies reported hypertension as a dichotomous outcome. The effect on systolic and diastolic blood pressure was mean difference (MD) -1.43 mmHg (95% confidence interval (CI) -2.15 to -0.72) and -0.98 mmHg (95%CI -1.46 to -0.50) respectively. The effect on systolic and diastolic blood pressure for those younger than 35 years (7 trials with 399 participants) was -2.11 mmHg (95%CI -3.58 to -0.64) / -2.61 mmHg (95% CI -3.74, -1.49). The effect on systolic and diastolic blood pressure for those 35 years or more (9 trials with 2649 participants) was -0.96 mmHg (95%CI -1.83 to -0.09) / -0.59 mmHg (95%CI -1.13 to -0.06). The effect on systolic and diastolic blood pressure for women (6 trials with 1823 participants) was -1.45 mmHg (95% CI -2.78 to -0.12) / -0.92 mmHg (95% CI -1.71 to -0.14). The effect on systolic and diastolic blood pressure for men (5 trials with 617 participants) was -2.07 (95%CI -3.56 to -0.59] / -1.91 (95%CI -2.80 to -1.02).The quality of evidence for each of these outcomes was high. The effect is consistent in both genders regardless of baseline calcium intake.The effect on systolic blood pressure was 0.08 mmHg (95% CI -2.16 to 2.32) with doses less than 1000 mg, -1.14 mmHg (95% CI -2.01 to -0.27) with 1000 - 1500 mg, and -2.79 mmHg (95% CI -4.71 to -0.86) with more than 1500 mg. The effect on diastolic blood pressure was -0.54 mmHg (95% CI -2.23 to 1.15), -0.71 mmHg (95% CI -1.37 to -0.06) and -1.43 mmHg (95% CI -2.22 to -0.64) respectively. The quality of evidence for each of these outcomes was high.None of the studies reported adverse events. AUTHORS' CONCLUSIONS An increase in calcium intake slightly reduces both systolic and diastolic blood pressure in normotensive people, particularly in young people, suggesting a role in the prevention of hypertension. These results should be interpreted with caution, since the proposed biological mechanism explaining the relationship between calcium and blood pressure has not been fully confirmed. The effect across multiple prespecified subgroups and a possible dose response effect reinforce this conclusion. Even small reductions in blood pressure could have important health implications for reducing vascular disease.There is a great need for adequately-powered clinical trials randomising young people. Subgroup analysis should involve basal calcium intake, age, sex, basal blood pressure, and body mass index. We also require assessment of side effects, optimal doses and the best strategy to improve calcium intake.
Collapse
Affiliation(s)
- Gabriela Cormick
- Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy (IECS), Dr. Emilio Ravignani 2024, Buenos Aires, Argentina, C1414CPV
| | | | | | | |
Collapse
|
36
|
Challoumas D, Stavrou A, Pericleous A, Dimitrakakis G. Effects of combined vitamin D--calcium supplements on the cardiovascular system: should we be cautious? Atherosclerosis 2014; 238:388-98. [PMID: 25558033 DOI: 10.1016/j.atherosclerosis.2014.12.050] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 12/18/2014] [Accepted: 12/19/2014] [Indexed: 01/16/2023]
Abstract
Despite the growing body of evidence on the potential effects of calcium and vitamin D as monotherapies on different cardiovascular (CV) parameters, the combined supplementation with calcium and vitamin D (CaD), which is most frequently encountered in clinical practice, has not received the attention it deserves. A literature search was conducted via EMBASE and Medline and identified 14 randomised controlled trials (RCTs) and 2 meta-analyses reporting on effects of combined supplementation with CaD on CV events, CV death, blood pressure, lipids, glucose metabolism and weight. Overall, the existing evidence does not support beneficial properties of supplementation with CaD on the CV system, nor does it suggest that a re-appraisal of the use of CaD is necessary due to adverse effects, although increased risk of CV events has been reported by some authors. The guidelines for the use of CaD supplementation need not change until well-conducted RCTs that have CV effects as primary outcomes and adjust for major confounders indicate otherwise.
Collapse
Affiliation(s)
- Dimitrios Challoumas
- Department of Upper GI Surgery, Gloucestershire Royal Hospital, Great Western Road, Gloucester, GL1 3NN, UK.
| | - Antonio Stavrou
- School of Medicine, Cardiff University, University Hospital of Wales, Heath Park Campus, Cardiff, CF 14 4XW, UK
| | - Agamemnon Pericleous
- School of Medicine, Cardiff University, University Hospital of Wales, Heath Park Campus, Cardiff, CF 14 4XW, UK
| | - Georgios Dimitrakakis
- Department of Cardiothoracic Surgery, University Hospital of Wales, Heath Park Campus, Cardiff, CF 14 4XW, UK
| |
Collapse
|
37
|
Abstract
A number of drug classes are licensed for the treatment of osteoporosis including bisphosphonates, recombinant human parathyroid hormone (PTH), strontium, hormone replacement therapy (HRT), selective oestrogen receptor modulators (SERMS) and denosumab. This review discusses the safety of osteoporosis treatments and their efficacies. Recent concerns about the safety of calcium and high-dose vitamin D are discussed. Bisphosphonates have substantial postmarketing experience and a clearer picture of safety issues is emerging. Along with the well recognized effects on the gastrointestinal tract and kidney function, recently described adverse effects such as osteonecrosis of the jaw, oesophageal cancer, atrial fibrillation, subtrochanteric femur fractures and ocular complications of bisphosphonate therapy are discussed. Therapy with PTH is limited to two years' duration because of the development of osteogenic sarcomas in animal studies, which appeared related to dose, duration and timing of therapy. Strontium should be used with caution in patients with renal impairment and its use has been associated with venous thromboembolism. The role of HRT and SERMs in the treatment of postmenopausal osteoporosis is restricted as a result of an increased risk of stroke, venous thromboembolism and breast cancer. Postmarketing experience with denusomab is limited but a number of potential safety concerns including osteonecrosis of the jaw are emerging. All of these drugs have been proven to reduce fractures. The decision to use a drug to reduce fracture risk should be based on risk-benefit analysis of the drug and its suitability for individual patients.
Collapse
Affiliation(s)
- Cora McGreevy
- Department of Medicine for the Elderly, RCSI and Beaumont Hospital, Dublin 9, Ireland
| | - David Williams
- Department of Medicine for the Elderly, RCSI and Beaumont Hospital, Dublin, Ireland
| |
Collapse
|
38
|
Soerensen KV, Thorning TK, Astrup A, Kristensen M, Lorenzen JK. Effect of dairy calcium from cheese and milk on fecal fat excretion, blood lipids, and appetite in young men. Am J Clin Nutr 2014; 99:984-91. [PMID: 24622806 DOI: 10.3945/ajcn.113.077735] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Calcium from different dairy sources might affect blood lipids and fecal fat excretion differently because of differences in the food matrix and nutritional composition. OBJECTIVE We investigated whether milk- and cheese-based diets with similar calcium contents affect a saturated fatty acid-induced increase in blood lipids differently. DESIGN Fifteen healthy, young men participated in a randomized 3 × 2-wk crossover study in which the following 3 isocaloric diets that were similar in fat contents and compositions were compared: control diet [nondairy diet (~500 mg Ca/d)], milk diet [semiskimmed milk-based diet (1700 mg Ca/d)], and cheese diet [semihard cow-cheese-based diet (1700 mg Ca/d)]. Blood was drawn before and after each period, and feces were collected for 5 d during each period. RESULTS Saturated fatty acid-induced increases in total and low-density lipoprotein (LDL) cholesterol were lower with the milk diet (mean ± SD: 0.57 ± 0.13 and 0.53 ± 0.11 mmol/L, respectively) (P < 0.01) and cheese diet (0.41 ± 0.15 and 0.47 ± 0.12 mmol/L, respectively) (P < 0.05) than with the control diet (0.89 ± 0.12 and 0.84 ± 0.11 mmol/L, respectively). Fecal fat excretion increased more with the consumption of both the milk (5.2 ± 0.4 g/d) and cheese (5.7 ± 0.4 g/d) diets than with the control diet (3.9 ± 0.3 g/d) (P < 0.001). Changes in blood pressure, high-density lipoprotein cholesterol, triglycerides, and lipid ratios did not differ. CONCLUSIONS Compared with the control diet, milk- and cheese-based diets attenuated saturated fatty acid-induced increases in total and LDL cholesterol and resulted in increased fecal fat excretion; however, effects of milk and cheese did not differ. Because the diets contained similar amounts of saturated fat, similar increases in total and LDL cholesterol could be expected; however, both milk and cheese attenuated these responses, which seem to be explained by their calcium contents. This trial was registered at clinicaltrials.gov as NCT01317251.
Collapse
Affiliation(s)
- Karina V Soerensen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
| | | | | | | | | |
Collapse
|
39
|
Hypocalcemia is related to left ventricular diastolic dysfunction in patients with chronic kidney disease. J Cardiol 2014; 63:198-204. [DOI: 10.1016/j.jjcc.2013.08.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 07/25/2013] [Accepted: 08/05/2013] [Indexed: 11/21/2022]
|
40
|
Reid IR. Should we prescribe calcium supplements for osteoporosis prevention? J Bone Metab 2014; 21:21-8. [PMID: 24707464 PMCID: PMC3970298 DOI: 10.11005/jbm.2014.21.1.21] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 02/03/2014] [Accepted: 02/03/2014] [Indexed: 01/24/2023] Open
Abstract
Advocacy for the use of calcium supplements arose at a time when there were no other effective interventions for the prevention of osteoporosis. Their promotion was based on the belief that increasing calcium intake would increase bone formation. Our current understandings of the biology of bone suggest that this does not occur, though calcium does act as a weak antiresorptive. Thus, it slows postmenopausal bone loss but, despite this, recent meta-analyses suggest no significant prevention of fractures. In sum, there is little substantive evidence of benefit to bone health from the use of calcium supplements. Against this needs to be balanced the likelihood that calcium supplement use increases cardiovascular events, kidney stones, gastrointestinal symptoms, and admissions to hospital with acute gastrointestinal problems. Thus, the balance of risk and benefit seems to be consistently negative. As a result, current recommendations are to obtain calcium from the diet in preference to supplements. Dietary calcium intake has not been associated with the adverse effects associated with supplements, probably because calcium is provided in smaller boluses, which are absorbed more slowly since they come together with quantities of protein and fat, resulting in a slower gastric transit time. These findings suggest that calcium supplements have little role to play in the modern therapeutics of osteoporosis, which is based around the targeting of safe and effective anti-resorptive drugs to individuals demonstrated to be at increased risk of future fractures.
Collapse
Affiliation(s)
- Ian R Reid
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| |
Collapse
|
41
|
Bu SY, Kang MH, Kim EJ, Choi MK. Dietary Intake Ratios of Calcium-to-Phosphorus and Sodium-to-Potassium Are Associated with Serum Lipid Levels in Healthy Korean Adults. Prev Nutr Food Sci 2014; 17:93-100. [PMID: 24471069 PMCID: PMC3866749 DOI: 10.3746/pnf.2012.17.2.093] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Accepted: 04/23/2012] [Indexed: 11/06/2022] Open
Abstract
The purpose of this study was to identify food sources for major minerals such as calcium (Ca), phosphorus (P), sodium (Na) and potassium (K), and to evaluate the relationship between dietary intake of these minerals and serum lipids in healthy Korean adults. A total of 132 healthy men and women completed a physical examination and dietary record and provided blood samples for lipid profile analysis. Results showed the following daily average mineral intakes: 373.4 mg of calcium, 806.0 mg of phosphorous, 3685.8 mg of sodium, and 1938.3 mg of potassium. The calcium-to-phosphorus and sodium-to-potassium ratio was about 0.5 and 2.0, respectively. The primary sources for each mineral were: vegetables (24.9%) and fishes (19.0%) for calcium, grains (31.4%) for phosphorus, seasonings (41.6%) and vegetables (27.0%) for sodium, and vegetables (30.6%) and grains (18.5%) for potassium. The correlation analysis, which has been adjusted for age, gender, total food consumption, and energy intake, showed significantly positive correlations between Ca/P and serum HDL cholesterol levels, between Na intake and the level of serum total cholesterol, and between Na/K and the level of serum cholesterol and LDL cholesterol. Our data indicates that the level of mineral consumption partially contributes to serum lipid profiles and that a diet consisting of a low Ca/P ratio and a high Na/K ratio may have negative impacts on lipid metabolism.
Collapse
Affiliation(s)
- So-Young Bu
- Division of Food Science, Kyungil University, Gyeongbuk 712-701, Korea
| | - Myung-Hwa Kang
- Department of Food Science and Nutrition, Hoseo University, Chungnam 336-795, Korea
| | - Eun-Jin Kim
- Division of Food Science, Kongju National University, Chungnam 340-702, Korea
| | - Mi-Kyeong Choi
- Division of Food Science, Kongju National University, Chungnam 340-702, Korea
| |
Collapse
|
42
|
Effects of calcium intake on the cardiovascular system in postmenopausal women. Atherosclerosis 2013; 231:1-7. [DOI: 10.1016/j.atherosclerosis.2013.08.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Revised: 07/28/2013] [Accepted: 08/21/2013] [Indexed: 11/15/2022]
|
43
|
New reference values for calcium. ANNALS OF NUTRITION AND METABOLISM 2013; 63:186-92. [PMID: 24356454 DOI: 10.1159/000354482] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 07/19/2013] [Indexed: 01/09/2023]
Abstract
The nutrition societies of Germany, Austria and Switzerland are the joint editors of the 'reference values for nutrient intake'. They have revised the reference values for the intake of calcium and published them in June 2013. The reference values for the calcium intake for infants are derived from the calcium content of breast milk. For infants from 4 to <12 months of age, the calcium intake from solid foods is included in addition to the calcium intake from breast milk. Thus, the reference values for infants are estimated values; they are 220 mg/day for infants to <4 months and 330 mg/day for infants from 4 to <12 months of age. As a parameter for determining the calcium requirement in children and adolescents, calcium retention is taken into account. The average requirement is calculated by the factorial method. A balanced calcium metabolism is calculated based upon calcium balance studies and used as a parameter for the determination of the calcium requirement in adults. On the basis of the average requirement, recommended calcium intake levels for children, adolescents and adults are derived. Depending on age, the recommended calcium intake ranges between 600 mg/day for children aged 1 to <4 years and 1,200 mg/day for adolescents aged 13 to <19 years; for adults, it is 1,000 mg/day.
Collapse
|
44
|
Mao PJ, Zhang C, Tang L, Xian YQ, Li YS, Wang WD, Zhu XH, Qiu HL, He J, Zhou YH. Effect of calcium or vitamin D supplementation on vascular outcomes: a meta-analysis of randomized controlled trials. Int J Cardiol 2013; 169:106-11. [PMID: 24035175 DOI: 10.1016/j.ijcard.2013.08.055] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 08/07/2013] [Accepted: 08/18/2013] [Indexed: 12/31/2022]
Abstract
BACKGROUND Whether calcium or vitamin D supplementation reduces serious vascular outcomes in older people remains unclear. We conducted a meta-analysis based on randomized controlled trials to evaluate the effect of calcium or vitamin D supplementation on the risk of major cardiovascular outcomes. METHODS We performed electronic searches in PubMed, Embase, and the Cochrane Library to identify relevant randomized controlled trials. Odds ratios (ORs) were used to measure the effect of calcium or vitamin D supplementation on the risk of major vascular outcomes with a random-effect model. RESULTS Of the 1643 identified studies, we included 11 trials reporting data on 50,252 individuals. These studies reported 2685 major cardiovascular events, 1097 events of myocardial infarction, and 1350 events of stroke. Calcium or vitamin D supplementation did not have an effect on major cardiovascular events (OR, 1.03; 95% confidence interval [CI]: 0.94-1.12; P=0.54), myocardial infarction (OR, 1.08; 95% CI: 0.96-1.22; P=0.21), or stroke (OR, 1.01; 95% CI: 0.91-1.13; P=0.80) when compared to the effect with a placebo. Subgroup analysis indicated that calcium supplementation alone might play an important role in increasing the risk of major cardiovascular events, myocardial infarction, and stroke, but this difference could not be identified as statistically significant. Furthermore, males seem to experience more harmful effects with supplements of calcium or vitamin D than the effects experienced by females. CONCLUSIONS Calcium supplementation might increase the risk of major cardiovascular events, myocardial infarction, and stroke compared to the risk with a placebo.
Collapse
Affiliation(s)
- Pei-Juan Mao
- Department of VIP Special Clinic, Shanghai Seventh People's Hospital, Shanghai, China
| | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Langsetmo L, Berger C, Kreiger N, Kovacs CS, Hanley DA, Jamal SA, Whiting SJ, Genest J, Morin SN, Hodsman A, Prior JC, Lentle B, Patel MS, Brown JP, Anastasiades T, Towheed T, Josse RG, Papaioannou A, Adachi JD, Leslie WD, Davison KS, Goltzman D. Calcium and vitamin D intake and mortality: results from the Canadian Multicentre Osteoporosis Study (CaMos). J Clin Endocrinol Metab 2013; 98:3010-8. [PMID: 23703722 PMCID: PMC5096927 DOI: 10.1210/jc.2013-1516] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
CONTEXT Calcium and vitamin D are recommended for bone health, but there are concerns about adverse risks. Some clinical studies suggest that calcium intake may be cardioprotective, whereas others report increased risk associated with calcium supplements. Both low and high serum levels of 25-hydroxyvitamin D have been associated with increased mortality. OBJECTIVE The purpose of this study was to determine the association between total calcium and vitamin D intake and mortality and heterogeneity by source of intake. DESIGN The Canadian Multicentre Osteoporosis Study cohort is a population-based longitudinal cohort with a 10-year follow-up (1995-2007). SETTING This study included randomly selected community-dwelling men and women. PARTICIPANTS A total of 9033 participants with nonmissing calcium and vitamin D intake data and follow-up were studied. EXPOSURE Total calcium intake (dairy, nondairy food, and supplements) and total vitamin D intake (milk, yogurt, and supplements) were recorded. OUTCOME The outcome variable was all-cause mortality. RESULTS There were 1160 deaths during the 10-year period. For women only, we found a possible benefit of higher total calcium intake, with a hazard ratio of 0.95 (95% confidence interval, 0.89-1.01) per 500-mg increase in daily calcium intake and no evidence of heterogeneity by source; use of calcium supplements was also associated with reduced mortality, with hazard ratio of 0.78 (95% confidence interval, 0.66-0.92) for users vs nonusers with statistically significant reductions remaining among those with doses up to 1000 mg/d. These associations were not modified by levels of concurrent vitamin D intake. No definitive associations were found among men. CONCLUSIONS Calcium supplements, up to 1000 mg/d, and increased dietary intake of calcium may be associated with reduced risk of mortality in women. We found no evidence of mortality benefit or harm associated with vitamin D intake.
Collapse
|
46
|
Uusi-Rasi K, Kärkkäinen MUM, Lamberg-Allardt CJE. Calcium intake in health maintenance - a systematic review. Food Nutr Res 2013; 57:21082. [PMID: 23687486 PMCID: PMC3657072 DOI: 10.3402/fnr.v57i0.21082] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 03/21/2013] [Accepted: 04/10/2013] [Indexed: 11/25/2022] Open
Abstract
Background Calcium (Ca) is an essential nutrient for the human body. Despite lively research, there is uncertainty about Ca requirements in terms of desirable health outcomes including an upper intake level above which the potential for harm increases. Objectives The aim was to conduct a review to update requirements and desirable or harmful health effects of Ca on the current scientific evidence. Methods We searched Medline and Swemed from January 2000 to December 2011 and included all systematic reviews that reported Ca supplementation or usual Ca intake on health outcomes. Meta-analyses, randomized clinical trials and cohort studies were included in the second search between May 2009 and March 2011 and an additional search covering studies till the end of 2011. This review concentrated on studies reporting independent effects of Ca, although a few recent trials report sole effects of Ca on health outcomes, most trials use Ca in combination with vitamin D vs. placebo. Results In total, we reviewed 38 studies addressing the effects of Ca on bone, pregnancy-related outcomes, cancers, cardiovascular outcomes, obesity, and mortality. There was a lot of heterogeneity in the study protocols, which made it difficult to draw any strong conclusions. According to the literature, high Ca intake seems to have a small positive effect on bone mineral content (BMC) or bone mineral density (BMD) in children and postmenopausal women. We did not find any consistent evidence on the effects of Ca on bone health in premenopausal women or men. Also, the evidence that Ca supplementation reduces fracture incidence is scarce and inconsistent. Maternal diet may influence the peak bone mass of offspring but more studies are required. There was no overall effect of Ca intake on cancers. Ca was associated with a decreased risk of breast cancer and a slightly increased risk of prostate cancer in two of the three studies. No associations were found with other cancers. We found no consistent association between cardiovascular outcomes and Ca intake except for blood pressure. A small decrease of 2–4 mmHg in systolic blood pressure was found in pregnant and in hypertensive subjects with Ca supplementation. Reviewed studies did not show consistent evidence relating Ca intake to either mortality or obesity. Conclusion Based on this evidence, there is no need to change the Nordic recommendations for Ca intake. However, due to heterogeneity in the studies it is difficult to interpret the results and provide single summary statement.
Collapse
|
47
|
Kim J, Hwang JY, Kim KN, Choi YJ, Chang N, Huh KB. Relationship between milk and calcium intake and lipid metabolism in female patients with type 2 diabetes. Yonsei Med J 2013; 54:626-36. [PMID: 23549807 PMCID: PMC3635625 DOI: 10.3349/ymj.2013.54.3.626] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study was conducted to determine the association between intake of milk and dairy products as well as calcium and biomarkers related to lipid metabolism in Korean female patients with type 2 diabetes. MATERIALS AND METHODS A cohort of 509 female subjects (mean age: 59.0 years; range: 35-80 years) was recruited from Huh's Diabetes Clinic in Seoul between 2005 and 2010. Dietary intake was assessed using a validated food-frequency questionnaire. Subjects were divided into three groups on the basis of their daily intake of milk and dairy products [<50 g/day (0<50 g/day), 50-200 g/day, and >200 g/day (>200-1201 g/day)] and then further divided into two groups according to their daily calcium intake: below and above the estimated average requirement (EAR). RESULTS After adjustment for age, body mass index, energy intake, exercise, use of nutritional supplements and cholesterol medication, the level of serum high-density lipoprotein (HDL)-cholesterol was significantly higher in subjects with milk and dairy products consumption of >200 g/day than in subjects in the other two groups. Those subjects with a milk and dairy products consumption of >200 g/day had significantly higher levels of apolipoprotein A-1 and a significantly lower atherogenic index than the other two groups. Patients with a calcium intake above the EAR exhibited a significantly greater serum HDL-cholesterol level than those with a calcium intake below the EAR. CONCLUSION Milk and dairy products, good sources of calcium, play a positive role in lipid profiles in female patients with type 2 diabetes.
Collapse
Affiliation(s)
- JaeHee Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Korea
| | - Ji-Yun Hwang
- The Graduate School of Education, Sangmyung University, Seoul, Korea
| | - Ki Nam Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Korea
| | - Young-Ju Choi
- The Huh's Diabetes Clinic & The 21C Diabetes and Vascular Research Institute, Seoul, Korea
| | - Namsoo Chang
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Korea
| | - Kap-Bum Huh
- The Huh's Diabetes Clinic & The 21C Diabetes and Vascular Research Institute, Seoul, Korea
| |
Collapse
|
48
|
[Calcium supplementation and the possible increase in cardiovascular risk]. Rev Esp Geriatr Gerontol 2013; 48:130-8. [PMID: 23523304 DOI: 10.1016/j.regg.2012.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 11/28/2012] [Accepted: 11/28/2012] [Indexed: 11/22/2022]
Abstract
The primary goal of osteoporosis treatment is to prevent the occurrence of fragility fractures, and thereby reduce morbidity and mortality. Among the various approaches to the treatment of this disease include ensuring proper calcium intake and to obtain adequate levels of vitamin D. Virtually all clinical trials with drugs used to treat osteoporosis systematically include calcium and vitamin D supplements. In light of the recent publication of clinical trials and meta-analyses, a possible increase in cardiovascular risk, particularly in the form of a myocrdial infarction, is hypothesised in patients taking calcium supplements. However, data published to date are inconclusive. Until the development of new scientific evidence, it seems reasonable to recommend, whenever practicable and individualized for each patient, increasing calcium intake with food and reserve supplements for patients with very low calcium intake in the diet. It would also be advisable for the administration of total daily dose to be fractionated throughout the day and with meals, and to obtain appropriate levels of vitamin D (25-hydroxycholecalciferol or calcidiol), along with the basic treatment for osteoporosis that is decided to be prescribed to patients.
Collapse
|
49
|
Zhu W, Cai D, Wang Y, Lin N, Hu Q, Qi Y, Ma S, Amarasekara S. Calcium plus vitamin D3 supplementation facilitated fat loss in overweight and obese college students with very-low calcium consumption: a randomized controlled trial. Nutr J 2013; 12:8. [PMID: 23297844 PMCID: PMC3599592 DOI: 10.1186/1475-2891-12-8] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2012] [Accepted: 12/20/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recent evidence suggests that higher calcium and/or vitamin D intake may be associated with lower body weight and better metabolic health. Due to contradictory findings from intervention trials, we investigated the effect of calcium plus vitamin D3 (calcium+D) supplementation on anthropometric and metabolic profiles during energy restriction in healthy, overweight and obese adults with very-low calcium consumption. METHODS Fifty-three subjects were randomly assigned in an open-label, randomized controlled trial to receive either an energy-restricted diet (-500 kcal/d) supplemented with 600 mg elemental calcium and 125 IU vitamin D3 or energy restriction alone for 12 weeks. Repeated measurements of variance were performed to evaluate the differences between groups for changes in body weight, BMI, body composition, waist circumference, and blood pressures, as well as in plasma TG, TC, HDL, LDL, glucose and insulin concentrations. RESULTS Eighty-one percent of participants completed the trial (85% from the calcium + D group; 78% from the control group). A significantly greater decrease in fat mass loss was observed in the calcium + D group (-2.8±1.3 vs.-1.8±1.3 kg; P=0.02) than in the control group, although there was no significant difference in body weight change (P>0.05) between groups. The calcium + D group also exhibited greater decrease in visceral fat mass and visceral fat area (P<0.05 for both). No significant difference was detected for changes in metabolic variables (P>0.05). CONCLUSION Calcium plus vitamin D3 supplementation for 12 weeks augmented body fat and visceral fat loss in very-low calcium consumers during energy restriction. TRIAL REGISTRATION ClinicalTrials.gov (NCT01447433, http://clinicaltrials.gov/).
Collapse
Affiliation(s)
- Wei Zhu
- Department of Nutrition, Shanghai Institute of Health Sciences, Shanghai 201318, China
| | | | | | | | | | | | | | | |
Collapse
|
50
|
Kim YH, Jung KI, Song CH. Effects of serum calcium and magnesium on heart rate variability in adult women. Biol Trace Elem Res 2012; 150:116-22. [PMID: 23054869 DOI: 10.1007/s12011-012-9518-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 10/01/2012] [Indexed: 02/05/2023]
Abstract
The present study was designed to evaluate the association of serum calcium (Ca) and magnesium (Mg) levels with heart rate variability (HRV). One hundred and sixteen adult women were recruited in this cross-sectional study. Serum Ca and Mg levels were measured, and HRV in each time and frequency domain was recorded for 5 min. Mean heart rate and standard deviation of the normal to normal interval (SDNN) and root mean square of differences of successive RR interval (RMSSD) in time domain and total power (TP), low-frequency power (LF), high-frequency power (HF), and LF/HF ratio in frequency domain were compared according to the tertiles of serum Ca and Mg levels and Ca/Mg ratio. The associations between serum Ca and Mg levels and Ca/Mg ratio with HRV were evaluated using regression analyses. Mean heart rate tended to increase from the lowest to the highest tertile of Ca levels (p = 0.081), whereas it decreased significantly with higher Mg levels (p = 0.026). Increasing SDNN value was observed from the lowest to the highest tertile of Mg levels (p = 0.009). SDNN value decreased significantly from the lowest to the highest tertile of Ca/Mg ratio (p = 0.030). Participants in the lowest tertile of Ca/Mg ratio had significantly higher TP and LF values compared to those in the middle and highest tertiles (p < 0.05). Decreasing SDNN, TP, and LF values were significantly associated with higher Ca/Mg ratios (p < 0.05). Associations of serum Mg level and Ca/Mg ratio with HRV could be one of the mechanisms involved in cardiovascular diseases.
Collapse
Affiliation(s)
- Yeong-Hoon Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | | | | |
Collapse
|