The story examines the potential risks and benefits associated with the use of calcium supplements, and discusses two recent studies (found in the Journal of the American Heart Association and the Annals of Internal Medicine) that address the issue.
On the whole, the story is strong: It offers guidance to readers about the state of research regarding calcium supplements, providing balanced information they can use to make informed decisions about their health. Yet, the story would have been stronger if it also had discussed the evidence around taking calcium to prevent osteoporosis-related bone fractures in older women.
Failure to consume an adequate amount of calcium can be a contributing factor to osteoporosis, a condition in which a patient’s bones become weak and brittle — making osteoporosis patients more likely to suffer broken bones. However, there is concern among some healthcare providers that taking calcium supplements increases heart disease risk. In a 2012 report, the National Institutes of Health reported that heart disease was the leading cause of death in the U.S. So, given the dueling concerns over heart disease risk and osteoporosis risk, where does this leave patients? This story attempts to answer that question, and it overall does a good job.
Cost is not mentioned. While calcium supplements are not prohibitively expensive for most patients (prices vary, but tend to cost less than $10 for several months’ worth of pills), they are not free — and expense can be an important consideration for many patients. Also, given that most people can get enough calcium through foods and beverages, and yet more than one-third of Americans take calcium in supplement form, it would be informative for the reader to understand how much is spent annually on supplements that may not provide additional benefit.
This story does several things well here, but it does not give us any sense of the measured benefits of taking calcium supplements–a systematic review determined the evidence was “weak and inconsistent.” That lack of quantification is why this earns a “not satisfactory” rating.
That said, let’s look at the things the story does well. First, the story makes clear that many people do not need calcium supplements, discussing what constitutes the recommended level of calcium intake per day, and that fact that many people meet that mark through their daily diet. Second, the story also makes clear that some people can benefit from calcium supplements, pointing specifically to older adults who have been diagnosed with osteoporosis and teen girls, whose diets may not include the recommended 1,300 milligrams of calcium per day.
While we discussed benefits above, the focus of the story is primarily on potential harms. Namely, the story looks at potential risks to heart health associated with the use of calcium supplements. And the story does a fine job here, particularly given the fact that, as one source in the story notes, “The public has been receiving very confusing and alarming messages about calcium supplements.” Specifically, the story explains that there is some concern that the use of calcium supplements may lead to a build-up of calcium in the arteries, which may contribute to risk of heart attack or stroke. The story then fleshes out the arguments of both sides in this debate, without making any sweeping judgments about which side of that argument is correct. In other words, the story gives readers information without telling readers what conclusions they should draw. In a case like this one, we think that’s the responsible position to take.
Given the scope of this piece, involving two studies and a slew of background information, the story does a good job of offering readers adequate insight into the evidence. First, the story includes links to both of the relevant studies. That’s always a good thing. Second, the story describes the scope of both studies (3,000 adults for the observational study in JAHA, 31 studies in the meta-analysis in AIM). Third, the story addresses the shortcomings of the relevant studies. For example, the story notes that the JAHA study “was not designed in a way that could prove the supplements caused the artery changes.” Similarly, the story notes that some critics feel the AIM meta-analysis “did not include all potentially relevant studies.” In both cases, those are points worth making.
No disease mongering here. If anything, this is quite the opposite: giving readers more information in order to help them make informed decisions.
This is a strong point. The story not only incorporates input from multiple sources, but clearly identifies any affiliation that could be perceived as influencing their perspective (e.g., noting that one source wrote an editorial that was published in conjunction with the JAHA paper). In addition, the story clearly notes that the meta-analysis was done with support from a pharmaceutical company that manufactures calcium supplements.
On its face, the story deals with two options: taking calcium supplements or not taking them. Both options are addressed here, so it earns a “satisfactory” rating. But this story also goes a step further, highlighting other factors in supporting bone health, including vitamin D consumption and exercise.
The story does not address calcium supplement availability. However, given that these supplements are not new, and are widely available, we’ll rate this as not applicable.
The story does note that “Over the past decade, some studies have raised the possibility that calcium…might raise heart risks.” That is enough — barely — to earn it a “satisfactory” rating, in part because one of the two studies being discussed is a meta-analysis of 31 previous studies. However, a brief dive into the history of calcium supplementation and the public’s perceptions on the issue would add weight to the impact of these newer studies.
The story does not appear to rely on a news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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