By Joseph E. Scherger, MD, MPH
Core Faculty, Eisenhower Health Family Medicine Residency Program, Eisenhower Health Center, La Quinta, CA; Clinical Professor, Keck School of Medicine, University of Southern California, Los Angeles
SYNOPSIS: A large population study of calcium intake at dinner vs. breakfast showed an increased risk of heart disease.
SOURCE: Zhang T, Zhuang S, Yu Y, et al. Association of dietary calcium intake at dinner vs. breakfast with cardiovascular disease in U.S. adults: The national health and nutrition examination survey, 2003-2018. BMC Public Health 2024;24:1086.
Calcium is a vital nutrient, but its intake has been associated with cardiovascular disease. This study looked at the national health and nutrition examination survey (NHANES) for 2003-2018 and showed that populations with more calcium intake at dinner compared with breakfast had a higher risk of cardiovascular disease. The population consisted of 36,164 adults completing the NHANES 2003-2018 study, and calcium intake was divided into five groups. Adjustments were made for confounding factors.
The results showed a linear regression based on calcium intake. The group with dietary calcium intake at breakfast was associated with a 6% lower risk of cardiovascular disease.
Commentary
Calcium is no longer recommended as a dietary supplement because of its small but significant risk of causing heart disease.1,2 Vitamins D3 and K2 are useful supplements able to direct dietary calcium into bones rather than into coronary arteries.3,4 This is the first study I have seen discussing the risks of dietary calcium and the timing during the day. While the differences are small, this study suggests that dietary calcium at breakfast has benefits over at dinner with respect to cardiovascular disease risk.
References
- Margolis KL, Manson JE. Calcium supplements and cardiovascular disease risk: What do clinicians and patients need to know? Ann Internal Med 2016;165:884-885.
- Michaelsson K, Melhus H, Warensjo Lemming E, et al. Long term calcium intake and rates of all cause and cardiovascular mortality: Community based prospective longitudinal cohort study. BMJ 2013;346:f228.
- Clover Internal Medicine. Why everyone needs to take vitamin D3 with K2. https://www.cloverinternalmedicine.com/blog/why-everyone-needs-to-take-vitamin-d3-with-K2
- Van Ballegooijen AJ, Pilz S, Tomaschitz A, et al. The synergistic interplay between vitamins D and K for bone and cardiovascular health: A narrative review. Int J Endocrinol 2017;2017.7454376.
A large population study of calcium intake at dinner vs. breakfast showed an increased risk of heart disease.
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