The Evidence and Controversy Between Dietary Calcium Intake and Calcium Supplementation and the Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Cohort Studies and Randomized Controlled Trials

source extracted confidence: high 2026-04-09
#calcium-dietary #cardiovascular-diseases #coronary-disease #diet #dietary-supplements

The Evidence and Controversy Between Dietary Calcium Intake and Calcium Supplementation and the Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Cohort Studies and Randomized Controlled Trials

Yang et al., 2020 | J Am Coll Nutr | Meta Analysis

Citation

Yang Chao, Shi Xiangling, ... Sun Guiju. The Evidence and Controversy Between Dietary Calcium Intake and Calcium Supplementation and the Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Cohort Studies and Randomized Controlled Trials. J Am Coll Nutr. 2020;39(4):352-370. doi:10.1080/07315724.2019.1649219

Abstract

Objective: Our objective was to synthesize both trial and observational studies and undertake a meta-analysis to explore the associations between calcium from dietary and supplemental intakes and cardiovascular disease (CVD) risks.Methods: Data sources were from PubMed, Cochrane Central, Scopus, and Web of Science, published from the inception dates up to March 2019. Randomized controlled trials (RCTs) and prospective cohort studies with data on dietary or supplemental intake of calcium, with or without vitamin D, and cardiovascular outcomes, were included.Results: Of the 1,212 identified studies, 26 prospective cohort studies and 16 RCTs were included. Results of cohort studies reveled that dietary calcium intakes (DCIs) ranging from 200 to 1500 mg/d did not affect the risk of CVD, coronary heart disease (CHD), and stroke (relative risk (RR) RR for CVD = 0.96, 95% CI, 0.87-1.05; RR for CHD = 0.98, 95% CI, 0.88-1.08; RR for stroke = 0.94, 95% CI, 0.85-1.04). Pooled RR of RCTs showed that the risk of CHD due to calcium supplements (CSs) increased 8% (RR = 1.08, 95% CI, 1.02-1.22; I2 = 0.0%) and increased 20% allocated to CSs alone (RR = 1.20, 95% CI, 1.08-1.33; I2 = 0.0%). CSs increased the risk of myocardial infarction (MI) by 14% (RR = 1.14, 95% CI, 1.05-1.25; I2 = 0.0%), and CSs alone increased the MI risk 21% (RR = 1.21, 95% CI, 1.08-1.35; I2 = 0.0%).Conclusions: We concluded that calcium intake from dietary sources do not adequately increase the risk of CVD including CHD and stroke, while calcium supplements might raise CHD risk, especially MI.

Key Findings

Of the 1,212 identified studies, 26 prospective cohort studies and 16 RCTs were included. Results of cohort studies reveled that dietary calcium intakes (DCIs) ranging from 200 to 1500 mg/d did not affect the risk of CVD, coronary heart disease (CHD), and stroke (relative risk (RR) RR for CVD = 0.96, 95% CI, 0.87-1.05; RR for CHD = 0.98, 95% CI, 0.88-1.08; RR for stroke = 0.94, 95% CI, 0.85-1.04). Pooled RR of RCTs showed that the risk of CHD due to calcium supplements (CSs) increased 8% (RR = 1

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 16
Age Range See abstract
Condition See abstract

MeSH Terms

  • Calcium, Dietary
  • Cardiovascular Diseases
  • Coronary Disease
  • Diet
  • Dietary Supplements
  • Heart Disease Risk Factors
  • Humans
  • Myocardial Infarction
  • Observational Studies as Topic
  • Prospective Studies
  • Randomized Controlled Trials as Topic
  • Stroke
  • Vitamin D

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Systematic Review
  • Vertical: calcium-cardiovascular

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09