Comment & Response |

Dietary and Supplemental Calcium Intake and Mortality

Ruth Chan, PhD1; Jason Leung, MSc2; Jean Woo, MD1
[+] Author Affiliations
1Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
2Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
JAMA Intern Med. 2013;173(19):1840. doi:10.1001/jamainternmed.2013.9276.
Text Size: A A A
Published online


To the Editor Several recent articles documented increased cardiovascular mortality associated with high calcium intake, in particular supplemental calcium.1 Most epidemiological studies of calcium intake and cardiovascular health have been conducted in white individuals with moderate to high calcium intake. Only a few specifically focused on cardiovascular mortality. Xiao et al2 reported that supplemental calcium was associated with elevated cardiovascular disease (CVD) mortality in men but not in women, whereas dietary calcium intake was unrelated to CVD death in either sex.2 In contrast, another female cohort study showed that dietary calcium intake above 1400 mg/d was associated with higher all-cause and CVD mortality compared with lower intakes. Interestingly, among women with dietary calcium intake exceeding 1400 mg/d, the addition of calcium supplements further increased risk of death in a dose-dependent manner.3 Results of both studies reveal that increasing calcium intake increases mortality, in particular CVD mortality, but the relationship is possibly dependent on habitual calcium intake.4,5 In a Chinese population with comparatively low habitual calcium intake, high calcium intake has a protective effect.


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





October 28, 2013
Qian Xiao, PhD; Yikyung Park, ScD
1Division of Cancer Epidemiology and Genetics, Nutritional Epidemiology Branch, National Cancer Institute, Rockville, Maryland
JAMA Intern Med. 2013;173(19):1841-1842. doi:10.1001/jamainternmed.2013.9232.
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...