**6.1 Calcium changes made to this section are indicated in blue**

The Women's Health Initiative failed to show a significant relationship between calcium supplementation and the risk of developing CRC among postmenopausal women [59], while a meta-analysis of cohort studies reported a significant inverse relationship for colon and CRC when comparing the highest to lowest levels of calcium supplementation [60]. As there is evidence of plausible mechanisms in humans, the Continuous Update Project (CUP) panel concluded that taking calcium supplements probably protect against CRC, based on evidence derived from a dosage of more than 200 mg per day [8]. The evidence was generally consistent and showed inverse associations across a range of intakes (200–1000 mg). RCTs reported a nonsignificant inverse association for calcium and vitamin D supplementation compared to placebo, after excluding women using calcium or vitamin D supplements at baseline. Although no dose-response meta-analysis could be conducted, six of the eight cohort studies reported inverse associations [8]. Predominant evidence indicates an increased CRC risk among individuals with a calcium intake lower than 700–1000 mg/day. It would therefore be reasonable to encourage individuals to increase their calcium intake to a level above this range, while recognizing that available data yielded inconsistent results [4].
