Too much calcium a heart attack risk?

I think so, another comment for MedPageToday, and I will probably close my diatribe post as it was more sleep posting.

The comment was to this article Dairy Reportedly Bad for the Heart -- But Don't Lump Milk and Cheese Together | MedPage Today. The nutshell - a Food Frequency survey style research article found that total dairy intake seemed linked to worse cardiovascular outcomes than total cheese intake. Butter and milk intake were linked to worse risk for Acute Myocardial Infarction.

I had tackled the cheese/dairy/ill health risks topic in this post:

Spurious correlation or unidentified causal link?

The ratio of calcium to magnesium in a person’s average intake is the significant risk factor based on my years of interest in this topic. Magnesium has been my main research focus since 2010 when I started looking into why pumpkin seeds had helped so many of my prenatal clients with a history of hypertension or pre-eclampsia. I suspected magnesium was the reason, I also recommended a DASH style diet. I discovered pumpkin seeds in particular are also a very good source of zinc, phospholipids and over beneficial nutrients.

“Pumpkin seeds are an excellent source of vitamin B group (thiamin, riboflavin, niacin, pantothenic acid, vitamin B-6 and folates). 100 g of pumpkin seeds contains about 30 grams of protein. According to studies, pumpkin seeds prevent calcium oxalate kidney stone formation.”

13 Health Benefits of Pumpkin Seeds, (lispine.com)

The thing that physicians and others need to remember about nutrients, and minerals in particular, is that they are all team players. None of them work all alone. This study is confusingly showing that many of the patients with Acute Myocardial Infarction (AMI) who were examined had hypocalcemia, and low albumin. Correcting the low albumin helped improve the calcium level too. (Wiener, 1977)

I would say that supports my theory that AMI and/or cardiovascular disease involves the ratio of magnesium and calcium, rather than invalidating it.

We need adequate protein and phospholipids in order to have a backstock of magnesium. It has to be held in an electrically inactive form by mineral transport proteins. Mineral transport proteins are shared with other minerals, so an excess of one type can lead to a low level of another type. In the case of calcium, magnesium, and potassium though, as electrolytes the body will purposely cause a lower level of calcium and potassium if magnesium is deficient. The bone matrix is depleted of magnesium, which also releases more calcium, which escalates the problem.

Addition: in this article, it was noted that parathyroid hormone levels were elevated in the AMI patients. (Ljunghall et al, 1986) Hyperparathyroidism can be caused by low calcium levels and/or low vitamin D levels and low calcium levels can be secondary to having low magnesium levels. I have had hyperparathyroidism secondary to low calcium and low magnesium may have been involved. I needed a topical source of magnesium and I take a 250 mg calcium supplement daily. (I do not eat any dairy products due to inflammatory reactions to dairy and albumin.)

Epsom salt foot soaks need to be in every Emergency Department and nursing home STAT. They can help reduce pain and anxiety within twenty minutes. Many people sit around waiting for a while anyway.

Related posts: To have optimal Magnesium needs Protein and Phospholipids too, Magnesium – essential for eighty percent of our body’s chemistry., Magnesium- protects against vascular calcification, Good news – magnesium protects against cancer, EMFs and Intracellular Calcium – Magnesium is nature’s calcium channel blocker.

Photo by engin akyurt on Unsplash

Some people think a glass of milk is a 16 ounce water glass, others may only have a small 8 ounce which would be considered one serving. Some people have 2 pieces of pizza, others have the whole small/medium pizza. An estimated average based on a Food Frequency questionnaire may not get a really clear picture of a person’s typical intake.

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The comment was to a reply about calorie vs kcal and how could 2 grams of butter be unhealthy? - True, but per every 1000 kcal, means double that for a standard 2000 calorie intake. And it turned out to likely be a typo that should have said 5 grams - a teaspoon, which is still not much compared to a dish with Hollandaise sauce or most bakery treats.

My reply: Dietitians use kcal, it means kilocalorie. "The “calorie” of a food is actually a “kilocalorie.” One kilocalorie (kcal) is equal to one calorie. A kilocalorie is the amount of heat required to raise the temperature of 1 kilogram of water to one degree Celsius. The number of calories in a food item represents the potential amount of energy from that food." https://www.nal.usda.gov/legacy/fnic/what-difference-between-calories-and-kilocalories

And the 2g per 1000 kcal, may be a mistake. The research Abstract says 5g per 1000 kcal of butter. Which would be roughly a teaspoon. https://academic.oup.com/eurjpc/advance-article/doi/10.1093/eurjpc/zwac217/6711074?login=false

The increased risk was for Acute Myocardial Infarction, so saturated fat intake may be a factor. I would think total calcium load of total dairy intake is a factor.

The research team used a Food Frequency survey self-reporting method, so it is an estimate of total diet, a rough estimate of variance between the individuals.

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Food Frequency questionnaires are just an estimate. People don’t remember that well what or how much they ate yesterday or last week or month. People are more likely to remember their usual choices and the frequency checklists can give an estimate of how balanced or caloric their average choices might add up to. Under-estimates are likely on ‘bad’ choices (like butter and eggs became known as), and over-estimates are likely on ‘good’ choices (like milk is thought to be) - it is human nature to want to do the right thing. More accurate nutrition and diet studies have a controlled food situation where food is prepared for the participants and what was chosen by each participant is measured somehow.

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Addition from the Comments, Thanks!

Ep154: Stopping Heart Disease Progression with Dr Arthur Agatston Cardiologist Extraordinaire!

The discussion makes it clear that both magnesium and a low carbohydrate diet are essential to help prevent or reverse earlier stages of calcium plaque deposits within blood vessels. Cholesterol is more like a bandaid to cover up excess electrically active calcium.

Alkaloid phytonutrients might help in addition to increased magnesium as they stimulate bitter taste receptors within the kidneys which increase removal of calcium from the body.

Excerpt from an old post that I just added to my pomegranate paper: Why do we have bitter taste receptors in the kidneys? because when activated they increase the removal of calcium. Alkaloid plant phytonutrients (“phellodendrine and coptisine“) have been found to activate the renal taste receptors and increase uptake of calcium as a result. (Liang, et al, 2017) Caffeine is also an alkaloid phytonutrient. (Chen and Lin, 2020)

Pomegranate peel is heart smart and protects the kidneys, liver, and brain. Nice!

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

Reference List

1. Wiener K. Plasma calcium in acute myocardial infarction. Ann Clin Biochem. 1977 Jan;14(1):45-7. doi: 10.1177/000456327701400108. PMID: 843059. https://pubmed.ncbi.nlm.nih.gov/843059/

2. Ljunghall S, Lundin L, Hvarfner A, Joborn H, Wide L. Serum electrolytes and parathyroid hormone concentrations in acute myocardial infarction. Exp Clin Endocrinol. 1986 Nov;88(1):95-100. doi: 10.1055/s-0029-1210581. PMID: 3817007. https://pubmed.ncbi.nlm.nih.gov/3817007/