Diet and nutrition: the folly of the reductionist approach

B E Christopher Nordin
Med J Aust 2013; 199 (6): . || doi: 10.5694/mja13.10501
Published online: 16 September 2013

To the Editor: The otherwise admirable MJA editorial on diet and nutrition1 did not perhaps give the right impression about the risks and benefits of calcium supplementation. In particular, the author did not make it clear that the important study from the National Institutes of Health found a cardiovascular risk from calcium supplements in men but not in women;2 and it is for women over 50 years (not for men) that extra calcium is recommended by the National Health and Medical Research Council.3 Nor was it made clear that the evidence of fracture prevention from supplementary calcium and vitamin D is overwhelming,4 or that two very convincing studies5,6 show that calcium supplementation is associated with reduced mortality. These reports surely make it very unlikely that there is any substance to the suggestion that such treatment increases the risk of cardiovascular disease.

  • 1 Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, SA.
  • 2 University of Adelaide, Adelaide, SA.

Competing interests:

No relevant disclosures.

  • 1. Stanton RA. Diet and nutrition: the folly of the reductionist approach. Med J Aust 2013; 198: 350-351. <MJA full text>
  • 2. Xiao Q, Murphy RA, Houston DK, et al. Dietary and supplemental calcium intake and cardiovascular disease mortality: the National Institutes of Health-AARP Diet and Health Study. JAMA Intern Med 2013: 173; 639-646.
  • 3. National Health and Medical Research Council and New Zealand Ministry of Health. Nutrient reference values for Australia and New Zealand. Calcium. (accessed Aug 2013).
  • 4. DIPART (Vitamin D Individual Patient Analysis of Randomized Trials) Group. Patient level pooled analysis of 68,500 patients from seven major vitamin D fracture trials in US and Europe. BMJ 2010; 340: b5463.
  • 5. Mursu J, Robien K, Harnack LJ, et al. Dietary supplements and mortality rate in older women: The Iowa Women’s Health Study. Arch Intern Med 2011; 171: 1625-1633.
  • 6. Rejnmark L, Avenell A, Masud T, et al. Vitamin D with calcium reduces mortality: patient level pooled analysis of 70,528 patients from eight major vitamin D trials. J Clin Endocrinol Metab 2012; 97: 2670-2681.


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