Updated: November 25 2024

Update Authors: Dr. Adrian Lau, Dr. Rowena Ridout, Dr. Laetitia Michou, Dr. Claudia Gagnon, Dr. Vithika Sivabalasundaram, Dr. Emma Billington, Dr. Zahra Bardai

The National Osteoporosis Foundation and the American Society for Preventive Cardiology formed an expert panel and completed a detailed review of all published research evaluating the effects of calcium intake from food sources and or supplements with or without vitamin D on the risk of heart attacks, strokes and death.

The results of that review were published in the Annals of Internal Medicine (1) by Kopecky and colleagues on October 25, 2016. The review confirms that there does not appear to be any harmful or beneficial effects of calcium and or vitamin D on the risk of heart disease or stroke or on the likelihood of death in healthy adults. The expert panel recommended that calcium intake from food and or supplements be not greater than 2000 mg or 2500 mg on a daily basis.  A systematic review and meta-analysis of twelve randomized-controlled trials published in 2023 have shown that calcium supplementation was not associated with myocardial infarction, stroke, heart failure, and all-cause of cardiovascular mortality (2).

This position taken by the National Osteoporosis Foundation and the American Society for Preventive Cardiology supports the position of Osteoporosis Canada which advises Canadians to include 1000 mg to 1200 mg of calcium daily from all sources with preference for dietary sources.  If this is not possible then Osteoporosis Canada advises that calcium supplements may be used to meet the daily calcium requirements.  Osteoporosis Canada recommends evaluating the need for additional calcium or vitamin D supplements as both nutrients are essential for achieving and maintaining optimal bone health.

1. Kopecky SL, Bauer DC, Gulati M, Nieves JW, Singer AJ, Toth PP, Underberg JA, Wallace TC, Weaver CM. Lack of Evidence Linking Calcium With or Without Vitamin D Supplementation to Cardiovascular Disease in Generally Healthy Adults: A Clinical Guideline From the National Osteoporosis Foundation and the American Society for Preventive Cardiology. Ann Intern Med. 2016 Dec 20;165(12):867-868. doi: 10.7326/M16-1743. Epub 2016 Oct 25. PMID: 27776362.
2. Sim MG, Teo YN, Teo YH, Syn NL, Li TYW, Yeo LLL, Kong WKF, Tan BYQ, Yip JW, Wong RCC, Poh KK, Yeo TC, Sharma VK, Chai P, Chan MY, Sia CH. Association Between Calcium Supplementation and the Risk of Cardiovascular Disease and Stroke: A Systematic Review and Meta-Analysis. Heart Lung Circ. 2023 Oct;32(10):1230-1239. doi: 10.1016/j.hlc.2023.07.008. Epub 2023 Sep 23. PMID: 37743221.