As part of my duties as a cardiologist, I read thousands of Cardioscans, CT scans that screen for calcified plaques in the arteries supplying the heart. While looking at the images, I often point out to the residents and cardiology fellows how some people with “hardening of the arteries” due to extensive amounts of coronary atherosclerosis have more calcium in their coronary arteries than in the bones of their spine. When you are young and healthy you have soft, supple arteries and sturdy, strong bones. The development of soft bones and hard arteries is an ominous sign.
About two out of three Americans do not meet the Recommended Daily Allowance for calcium, which partly explains why osteoporosis or osteopenia (inadequate bone density) affects the majority of post-menopausal women and is increasingly common in men. For that reason, next to multivitamins, calcium pills are the most commonly consumed daily over-the-counter supplement. Unfortunately, recent studies suggest that calcium supplements might increase risk of heart attack in women, probably by accelerating calcified plaque build-up in your coronary arteries. On the other hand, meeting your calcium requirement by getting it from your food and beverages appears to be perfectly safe, both for your bones and your heart.
Get Calcium from Dairy and Bones; Not Pills
The traditional focus in nutrition on supplementation of single isolated nutrients may be especially misguided in the case of calcium. A diet supplemented with calcium, as a mono-nutrient pill, is not ideal for promoting bone health and may instead accelerate arterial plaque calcification and increase cardiovascular risk.
A diet rich in plants such as leafy greens, colorful vegetables and fruits will make your system less acidic, which is conducive for strong bones. However, plants are relatively poor sources of calcium compared to animal sources. Non-fat or low-fat dairy products such as skim milk and Greek yogurt are excellent sources of calcium, but many adults do not tolerate dairy due to lactase deficiency or milk allergies.
Adult human hunter-gatherers for millennia acquired most of their calcium by consuming animal bones, where it is found in a matrix of bone-building nutrients including magnesium, phosphorus, protein, and osteocalcin. I know—eating bones during your meals is currently inconvenient and socially impolite, yet it may be a key to strong bones and soft supple arteries. Make stews using bones, letting them slow cook for hours. And if you like sardines, look for those with the skin and bones intact, packed in water with no added salt.
Consuming plenty of high-quality protein like egg whites, whey protein, lean red meat and fish, when combined with adequate calcium and magnesium intake and regular strength training (like weight lifting), is a sure-fire recipe for strong, sturdy bones that will hold up for a century.
In Good Health,
James O'Keefe, MD