Diet and nutrition: the folly of the reductionist approach

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.