Supplements of calcium and vitamin D improve women’s cholesterol balance

- and you also need magnesium for your bones

It has been discussed whether it is calcium or vitamin D that improves women’s cholesterol balance. Earlier studies of women who use combined supplements have not been able to determine whether the positive effect is due to calcium or vitamin D. However, a study from Women’s Health Initiative (WHI) reveals that the effect is down to vitamin D. If you want strong bones and a healthy cardiovascular system, it is a good idea to combine both calcium and vitamin D with magnesium.

The study, headed by Peter F. Schnatz, Professor of Obstetrics and Gynecology and of Internal Medicine at the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, set out to clarify if supplements of calcium or vitamin D affected blood levels of cholesterol and vitamin D in postmenopausal women. As part of the WHI study, around 600 women took daily supplements of calcium (1,000 mg) and vitamin D (10 micrograms) or matching placebo (dummy pills.) The researchers then analyzed the relation between the supplements and blood levels of vitamin D and blood levels of the two cholesterol types, HDL and LDL.
Cholesterol is an essential lipid that is important for all cells, the nervous system, and the body’s production of steroid hormones, vitamin D, and Q10. The body produce most of its cholesterol from carbohydrate. It is important to have the proper balance between HDL (also known as “healthy cholesterol”) and LDL (often referred to as “bad cholesterol”.)
People with insulin resistance, type-2 diabetes, and metabolic syndrome (or pre-diabetes) often have elevated cholesterol, an imbalance between the two types of cholesterol, and elevated levels of triglycerides. This combination of imbalances harms the cardiovascular system.

The more vitamin D in the blood, the better the cholesterol balance

The women who took supplements of calcium and vitamin D generally had higher blood levels of vitamin D than the women who did not take the supplements. Those women who took the supplements also had lower levels of LDL cholesterol than the non-supplemented women had.
The researchers even noticed that the women with the highest blood levels of vitamin D had the highest levels of HDL cholesterol (the good cholesterol) and lower levels of potentially harmful triglycerides.

The effect of supplements depends on age, the time of year, and lifestyle

Supplements of calcium and vitamin D had a particularly good effect on older women, on women with low dietary intake of these nutrients, and (as expected by the scientists) on women who took supplements of vitamin D during the winter, as the summer sun is the primary source of this vitamin. Still, lifestyle also played a role in the study. Women who did not smoke and drank little or no alcohol had a better effect of the supplements.
The researchers warrant further studies, however, before making conclusions about the long-term effect on cardiovascular disease in postmenopausal women. Based on their findings, the researchers advise women to consider taking supplements of calcium and vitamin D in particular after menopause as a way of controlling their cholesterol balance. It is important to balance calcium properly with magnesium to maintain strong bones and a healthy cardiovascular system.

Surplus calcium accumulates in the vessel walls with the risk of blood clots

Our teeth and bones contain about 99 percent of the body’s calcium reserve. Cells in our soft tissues are nearly completely devoid of calcium thanks to magnesium that functions as a doorman and guards the calcium channel of the cell membrane. It is magnesium that allows calcium into bones and teeth and makes sure that calcium is kept out cells in other tissues (we do need a little calcium in muscle cells, though)
If we lack magnesium, our calcium channels are left open with the risk that too much calcium enters the cells in our soft tissues. This increases the risk of atherosclerosis. A study from Johns Hopkins University School of Medicine in Baltimore, Maryland, shows that people who take large amounts of calcium increase their risk of atherosclerosis and heart problems. These findings support earlier research, which is why calcium supplements must always be combined with magnesium.

The relation between calcium and magnesium

Researchers cannot agree on the optimal intake of calcium and magnesium. In Denmark, the reference intake (RI) for calcium is 800 mg and for magnesium it is 375 mg. In other words, the two nutrients are recommended in a 2:1 ratio. In countries like Japan, the natural dietary intake of the two nutrients is closer to a 1:1 ratio, which is because the Japanese do not consume dairy products and only get around 400-500 mg of calcium daily. In return, they get more magnesium from vegetables. The Japanese diet and lifestyle explain why people in Japan are generally less prone to osteoporosis.

References:

Peter F. Schnatz et al. Calcium/vitamin D supplementation, serum 25 hydroxy-vitamin D concentrations, and cholesterol profiles in Women’s Health Initiative calcium/vitamin D randomized trial Menopause 2014

The North American Menopause Society (NAMS). Calcium, vitamin D improve cholesterol in postmenopausal women. ScienceDaily 2014

Johns Hopkins Medicine. Calcium supplements may damage the heart. ScienceDaily. 2016
https://www.sciencedaily.com/releases/2016/10/161011182621.htm

Andrea Rosanoff et al. Essential Nutrient Interactions: Does Low or Suboptimal Magnesium Interact with Vitamin D and/or Calcium status. Advances in Nutrition 2016
http://advances.nutrition.org/content/7/1/25.full

Mark J Bolland et al. Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial. BMJ 2008
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2222999/