What's the difference between a heart attack and cardiac arrest?

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Vitamins and minerals are essential nutrients that your body needs in small amounts to work properly. Many people choose to take supplements but you should get all the nutritional benefits you need from eating a healthy, balanced diet. What’s more, certain supplements may do more harm than good.

That’s the assessment of a decades-long analysis conducted by researchers at Johns Hopkins Medicine.

The supplement that raised alarm bells was calcium.

After analysing 10 years of medical tests on more than 2,700 people in a federally funded heart disease study, researchers at Johns Hopkins Medicine and elsewhere concluded that taking calcium in the form of supplements may raise the risk of plaque buildup in arteries and heart damage, although a diet high in calcium-rich foods appeared be protective.

“When it comes to using vitamin and mineral supplements, particularly calcium supplements being taken for bone health, many Americans think that more is always better,” said Erin Michos, M.D., M.H.S., associate director of preventive cardiology and associate professor of medicine at the Ciccarone Center for the Prevention of Heart Disease at the Johns Hopkins University School of Medicine.

“But our study adds to the body of evidence that excess calcium in the form of supplements may harm the heart and vascular system.”

The researchers were building on previous research, which showed that “ingested calcium supplements — particularly in older people — don’t make it to the skeleton or get completely excreted in the urine, so they must be accumulating in the body’s soft tissues,” said nutritionist John Anderson, Ph.D., professor emeritus of nutrition at the University of North Carolina at Chapel Hill’s Gillings School of Global Public Health and a co-author of the report.

Scientists also knew that as a person ages, calcium-based plaque builds up in the body’s main blood vessel, the aorta and other arteries, impeding blood flow and increasing the risk of heart attack.

The investigators looked at detailed information from the Multi-Ethnic Study of Atherosclerosis, a long-running research project funded by the National Heart, Lung, and Blood Institute, which included more than 6,000 people seen at six research universities, including Johns Hopkins.

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Their study focused on 2,742 of these participants who completed dietary questionnaires and two CT scans spanning 10 years apart.

The participants chosen for this study ranged in age from 45 to 84, and 51 percent were female. Forty-one percent were white, 26 percent were African-American, 22 percent were Hispanic and 12 percent were Chinese.

At the study’s onset in 2000, all participants answered a 120-part questionnaire about their dietary habits to determine how much calcium they took in by eating dairy products; leafy greens; calcium-enriched foods, like cereals; and other calcium-rich foods.

Separately, the researchers inventoried what drugs and supplements each participant took on a daily basis. The investigators used cardiac CT scans to measure participants’ coronary artery calcium scores, a measure of calcification in the heart’s arteries and a marker of heart disease risk when the score is above zero. Initially, 1,175 participants showed plaque in their heart arteries.

The coronary artery calcium tests were repeated 10 years later to assess newly developing or worsening coronary heart disease.

High dietary intake of calcium did not increase heart disease risk, but the researchers found that supplement users showed a 22 percent increased likelihood of having their coronary artery calcium scores rise higher than zero over the decade, indicating development of heart disease.

The finding was consistent after accounting for demographic and lifestyle factors that could influence heart disease risk.

“Based on this evidence, we can tell our patients that there doesn’t seem to be any harm in eating a heart-healthy diet that includes calcium-rich foods, and it may even be beneficial for the heart,” said Ms Michos.

“But patients should really discuss any plan to take calcium supplements with their doctor to sort out a proper dosage or whether they even need them.”

What the Department of Health and Social Care (DHSC) says

According to the DHSC, you should be able to get all the calcium you need by eating a varied and balanced diet.

“If you take calcium supplements, do not take too much as this could be harmful.”

The health body adds: “Taking 1,500mg or less a day is unlikely to cause any harm.”

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