0 Making sense of conflicting advice on calcium intake

In recent years, studies have reported inconsistent findings regarding whether calcium supplements used to prevent fractures increase the risk of heart attack.

Now, in an assessment of the scientific literature, reported as a perspective piece in the October 17, 2013 issue of the New England Journal of Medicine, a UC San Francisco researcher says patients and health care practitioners should focus on getting calcium from the diet, rather than supplements, when possible.

"Osteoporosis may result from inadequate calcium intake and its quite common for certain segments of our population, such as the elderly, to consume less than the recommend amount," said Douglas C. Bauer, MD, UCSF professor of Medicine, Epidemiology and Biostatistics. "But a high calcium diet should be the perred method to receive adequate amounts of the nutrient. The Institute of Medicines recommended dosage for post-menopausal women over the age of 50 and men over 70 is 1,200 mg per day.

"If it is not possible to consume enough calcium from the diet, the use of calcium supplements is most likely safe and not associated with cardiovascular outcomes," he said.

Calcium supplements are known to have several side effects, the most common being indigestion and minor constipation, and kidney stones are a rare complication. However, several recent studies have suggested that calcium supplements can also lead to an increase risk of heart attacks.

A 2010 British Medical Journal study, which pooled nearly a dozen randomized trials, concluded that calcium supplements "are associated with an increased risk of myocardial infarction [heart attacks]" and went on to say, " As calcium supplements are widely used, these modest increases in risk of cardiovascular disease might translate into a large burden of disease in the population."

A 2013 JAMA Internal Medicine non-randomized study examined 11,778 cardiovascular-related deaths and found an increased risk with calcium supplement use. The authors concluded, "high intake of supplemental calcium is associated with an excess risk of CVD (cardiovascular disease) death in men but not in women."

However, several other studies have shown no relationship between the use of calcium supplements and cardiovascular events.

For example, a 2010 meta-analysis that included all of the Womens Health Initiative (WHI) trial participants showed "no significant relationship between supplementation and cardiovascular events" in three trials of calcium supplements alone.

Bauer recommends consuming dairy products to increase ones dietary intake of calcium as well as food products that are fortified with extra calcium, such as kale, broccoli and Bok Choy.

Dr. Bauer has received research support from Amgen and Novartis in the past for his work on independent adjudication of endpoints in clinical trials unrelated to calcium, which ended two years ago.

0 Moderate alcohol intake and cancer the role of under reporting

A large US cohort study in 129,987 persons suggests that the apparent increased risk of cancer among light-moderate drinkers is substantially due to underreporting of intake.

Although experts agree that heavy consumption of alcohol is related to increased risk of several cancer types, the role of light-to-moderate drinking is less clear, said Dr Arthur Klatsky of Kaiser Permanente Medical Care Program, Oakland, CA, USA. Some studies have suggested there is a connection, while others have found no link.

The results of the new analysis suggest that any apparent relationship between cancer risk and light-to-moderate drinking, meaning up to 2 standard sized drinks per day for men and one for women, may be largely an artifact of under-reporting—that is, lying about drinking amount.

"If some heavy drinkers answer surveys saying that they only drink lightly, the effects of heavy drinking then appear to be related to light-to-moderate intake," Dr Klatsky explained. "Our analysis inferentially supports this factor in our study population and it is probably applicable to most studies, as under-reporting of alcohol consumption is surely prevalent."

"There are plenty of reasons why people need to avoid heavy drinking, but these do not generally apply to light drinking," Dr Klatsky said. "All concerns about the risks of light drinking need to be balanced by the evidence that persons at risk of heart disease benefit from lighter alcohol drinking. This --with plenty of exceptions-- means most persons over 50."

0 felicitous chuck Health Vitamin Intake

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The food health vitamin intake amounts of certain foods are included spell the nutritional labelling. This labelling is important now a man to count on and helps ensure that they are receiving the deserved food health vitamin intake from the foods that they eat. The nutritional information is usually represented for a percentage of the recommended frequent remembrance of each vitamin and mineral besides can help assess the value of the foods in the quest for tailor-made food health vitamin intake.

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