Meta-analysisindependent cross-checkabstract only checked★ key study I-SUP-06 in-depth review
Calcium and heart disease – updated review
Calcium Intake and Cardiovascular Disease Risk: An Updated Systematic Review and Meta-analysis.
Overview
Chung M et al.. Ann Intern Med 2016 · PMID 27776363 · DOI 10.7326/M16-1165
No link between calcium intake within upper limits and heart disease.
Does the study support the specific claim? No · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Calcium and CVD.
- How was the study done?
SR/MA.
- How many people, animals or samples were studied?
4 RCTs, 27 cohorts.
- What was actually found?
No association.
- What do the results mean in everyday life?
Calcium pills probably not a heart risk.
- What are the study's limitations?
COI; secondary outcomes.
- What does it say about Elawady's specific claim?
Contradicts C-SUP-04.
- Do the results apply to Germany and Europe?
Applicable.
- What can explicitly not be concluded from this study?
Very high intakes.
Scientific in-depth review
1. Full reference
- Authors
- Chung M et al.
- Journal
- Ann Intern Med
- Year
- 2016
- Identifier
- PMID 27776363 DOI 10.7326/M16-1165
- Verification
- verified – PubMed efetch 2026-10-25
- Retracted
- no
- Corrections
ErratumIn: Ann Intern Med. 2017 May 2;166(9):687. doi: 10.7326/L16-0570.
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract | Funding (abstract): National Osteoporosis Foundation
2. Research question
Calcium intake and CVD risk in generally healthy adults
3. Study design and population
- Study design
- Meta-analysis – Updated systematic review and meta-analysis (RCTs and cohorts)
- Population
Generally healthy adults
- Country
Multinational
- Period
1966–July 2016
- Sample size
4 RCTs (10 publications) + 27 observational studies
- Inclusion and exclusion criteria
Dietary or supplemental calcium ± vitamin D
4. Methods and endpoints
- Exposure / intervention
Calcium/CaD
- Comparator
Placebo/lower intake
- Endpoints
CVD events, mortality
- Statistical methods
Meta-analysis; dose-response
5. Actual results
- Results
Trials: no statistically significant differences in CVD events or mortality with calcium or calcium + vitamin D vs placebo; cohorts: no consistent dose–response with CV mortality; inconsistent for stroke.
- Absolute risks
not reported in abstract
- Authors' conclusion
Calcium intake within tolerable upper levels (2000–2500 mg/d) is not associated with CVD risk.
6. Strengths
- Includes low-risk-of-bias RCTs
7. Weaknesses
- CVD secondary outcomes
- Funded by National Osteoporosis Foundation (potential interest)
- Erratum
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Funding by an osteoporosis foundation.
9. Assessment of the statistical interpretation
10. Relevance to the specific claim
11. Independent contrary findings
12. Transferability to Germany and Europe
High.
13. Overall methodological judgement
Counter-analysis to Bolland.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | inconsistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
15. Linked fact checks
- Calcium supplements without vitamin D raise the risk of myocardial infarction by about 31%, and adding vitamin D does not remove this harm. – Studies contradicting or limiting the claim