Calcium and Vitamin D do not mix

The FDA (US Food and Drug Administration) on Friday Jan. 5th announced its proposal to allow new health claims on foods and dietary supplements containing calcium and vitamin D to indicate that these nutrients have the potential to help reduce risk of osteoporosis.

The proposed rule allows food and beverage manufacturers to include new information on the label and in the meantime eliminate some other information which is no longer justified.
The claim on calcium for its preventative role in osteoporosis was authorized in 1993, according to the FDA. The new rule amends the existing health claim by allowing claims on both calcium and vitamin D for their potential preventative effect against osteoporosis.

This is a disastrous development. Getting enough vitamin D and calcium is vital to good health, but taking supplements that combine vitamin D and calcium has been shown to weaken bones and increase the risk of osteoporosis.

The FDA proposal is a response to a health claim petition submitted by the Beverage Institute for Health and Wellness, the Coca-Cola Company. The FDA bases its decision on its review of the publicly available scientific evidence including the 2004 Surgeon General's report on Bone Health and Osteoporosis and the 2000 NIH Consensus Statement on Osteoporosis, Prevention, Diagnosis and Therapy.

While calcium and vitamin D play an important role in maintaining bone health in adults, a few issues need to be addressed, said a scientist affiliated with foodconsumer.org. For instance, supplementation of calcium and vitamin D may not be as important in children as in adults. Healthy children who eat a healthy diet and follow a healthy lifestyle rarely need supplements of vitamin D and calcium although supplementation and fortification of calcium and vitamin D may help certain children, according to a review article.

Calcium and vitamin D supplements do not benefit all adults whether taken separately or formulated together. A study published in 2005 in the Lancet finds that supplementation of vitamin D, calcium, or both, does not lower the risk of secondary bone fracture from osteoporosis in the elderly who have had one incident of bone fracture.

Elderly people who are frail and at risk for bone fractures may be helped somewhat by giving them both vitamin D and calcium. But the benefits may be marginal and appear only to help those who live in nursing homes or other institutions, according to Alison Avenell, M.D., of the University of Aberdeen, Scotland, and her colleagues who published their review of 38 randomized or quasi-randomized trials in the July 2005 issue of issue of The Cochrane Library.

Potential problems exist for uncontrolled intake of calcium and vitamin D. Too much calcium in the blood (hypercalcemia) has been associated with use of calcium supplementation. Mild hypercalcemia may not result in any symptom, or cause loss of appetite, nausea, vomiting, constipation and dry mouth, thirst and frequent urination. A severe condition could cause confusion, delirium, coma, and if not treated, death, according to the Linus Pauling Institute.

High levels of vitamin D in the blood (hypervitaminosis D) are also toxic as it induces abnormally high serum calcium levels (hypercalcemia). Virtually all research is showing that vitamin D supplementation in moderation is good for health provided it is not combined with calcium supplementation.

When vitamin D and calcium supplementation are taken together, this increases bone turnover, the rate at which calcium is pumped in and out of bone tissue. This in turn depletes the body’s finite reservoir of bone-making cells.

Every time calcium is processed into new bone a few bone-making cells die. When this happens on a regular basis, the erosion of bone-making cells reduces the body’s capacity to make new bone to replace old bone that is always melting away. The result is osteoporosis.

To protect bones it is best to get enough calcium from a healthy varied diet, and take vitamin D in moderation on its own, i.e. not combinecd with calcium. For the same reason, it is best to avoid dairy milk on days when vitamin D supplements are taken. Dairy milk, which is highly acidic, is also high in calcium and when combined with vitamin D supplementation it has the effect of eroding bone-making cells and increasing the risk of osteoporosis.

For the supporting evidence and latest research on this subject see the book The Milk Imperative.