Posted on 04/28/2005 10:48:03 AM PDT by neverdem
Despite what doctors have long recommended, regularly taking calcium and vitamin D does not prevent fractures in older people who have broken a bone or who have osteoporosis, according to two large studies released yesterday.
People with osteoporosis are often encouraged to consume as much calcium and vitamin D as possible to strengthen their bones and to lower the likelihood of injuries.
But the new studies, involving thousands of elderly people in Britain who had symptoms of the disease, found that those who took calcium and vitamin D tablets were just as likely to break a bone as those who took neither.
The authors of the reports, published in The Lancet and the British medical journal BMJ, said their findings suggested that for people with brittle bones, relying solely on the supplements might not be enough.
"Our trial indicates that routine supplementation with calcium and vitamin D3, either alone or in combination, is not effective in the prevention of further fractures in people who have had a recent low-trauma fracture," the authors of the Lancet study wrote.
Other experts called the findings important but cautioned that they did not apply to most people.
Just people older than 70, a majority of them women with previous bone injuries, were included in the studies.
Because vitamin D and calcium are widely considered early preventive measures, it is no surprise that the studies failed to find them effective in people who already had osteoporosis or signs of it, said Dr. Steven R. Goldstein, a professor of obstetrics and gynecology at the New York University medical center.
"This is something we've known for a long time, that calcium and vitamin D alone are not enough to treat osteoporosis," Dr. Goldstein said. "Once you've developed frank osteoporosis and a bone fracture, you're going to need medication, not simply vitamin D and calcium to prevent fractures."
Osteoporosis causes bones to become thinner and occurs primarily in the elderly.
About 10 million Americans older than 50 develop the disease each year, and 1.5 million break bones because of it. Osteoporosis can be treated with drugs like biphosphonates that prevent the bones from deteriorating, but doctors often recommend taking supplements or eating foods rich in calcium and vitamin D to build up bone mass.
The largest of the two studies, in The Lancet, followed more than 5,o00 Scots who had broken bones in the last decade. Separated in four groups, the subjects received large doses of calcium, vitamin D, a combination of the two or a placebo. After several years, the researchers found that all four groups had roughly the same number of fractures, mostly to the hip.
Dr. Joan McGowan, an expert on osteoporosis at the National Institutes of Health, said it was surprising that there were not fewer fractures among the people who took the calcium and vitamin D, but that neither was seen a replacement for medication." Nobody thinks calcium and vitamin D are as potent as some of the other bone-active drugs that we have available," Dr. McGowan said.
The Lancet article is not available for free. Regardless, if you google, you'll find that between one in four or five has died in the year after a hip fracture.
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It's important to drink milk everyday.
Calcium is just the tip of the iceberg, and it's questionable as to which type of calcium people take. Some is groun up oyster shells pressed into tablets. I wonder if the body can actually assimilate it.
I also read the article closely looking for what kind of calcium, and they never indicated. Many kinds of calcium simply aren't absorbed by the body. Calcium citrate taken with vitamin D is most likely to be helpful. I wish they had been a bit more specific.
Three years isn't all that long a study. How much of the supplements did they take? Why didn't they study bone density instead of the incidence of fractures? Did these women ever get out into the sun, which would affect how much vitamin D their bodies created? I wonder who sponsored this study.
"I wonder who sponsored this study". Always an interesting observation. At the University of Illinois in the 90's the company I was with was trying to get research done on milk proteins but the researchers were all tied up with soy research funded by a big soybean producer.
Careful of oyster shells. They could contain heavy metals, depending on the source, and they don't absorb well.
It also doesn't mention one of the most important aspects - exercise.
I am totally sold on Calcium and have been for a while. It helps my moods. It prevents muscle pain.
It seems to be widely accepted that most folks are calcium deficient. A quick blurb I saw on the tube said the worst deficiencies in America were: Vit C, Vit E, Vit D, Calcium, Potassium, and Magnesium.
What happened to Vitamin K?
They took Calcichew® -D3 Forte (500mg calcium as calcium carbonate and 10 micrograms vitamin D3 as colecalciferol) twice a day according to the BMJ article that I linked in comment# 1. 10 micrograms vitamin D3 as cholecalciferol equals 400 IU.
Why didn't they study bone density instead of the incidence of fractures?
I don't know, but I guess they didn't have the funds to do the radiology. Subsequent fractures seem like a good indicator to me. They didn't think of doing bone densities until after they started taking note of all the osteoporotic hip fractures that come along with aging populations. The other previous studies that showed a benefit from supplementation used fractures as endpoints except a relatively small study in the U.S. that used bone density.
Did these women ever get out into the sun, which would affect how much vitamin D their bodies created?
The BMJ article doesn't say except that they were women over 70 who lived in the community, not like two of the previous studies whose populations lived in French nursing homes. I wouldn't expect these English women to be bronzed sun worshippers in the first place, especially now, not all with the studies relating skin cancers to sun exposure.
I wonder who sponsored this study.
There were two studies. The following is from the BMJ article. "Grants from the Northern and Yorkshire NHS resarch and development, healthy ageing programme....Shire and Nycomed. Shire supplied the calcium and vitamin D supplements. None of the funders were involved in the design, analysis or writing up of this study."
The point of the Times' and the BMJ article was that routine calcium and vitamin D3 supplementation showed no benefit in reducing the risk of fractures in community living older women.
The calcium and other supplements made no difference.
It was published in a book in the '90s along with other pro-exercise information.
I've read that load-bearing exercise (weight lifting) does more for bone density than calcium/D. Makes sense to me!
And since I haven't read the whole thread, I expect to see this info pre-echoed at least 3 times before my post here. :)
These studies are worthless if they can't assure that at least one group of individuals in the test group were not in a negative calcium balance.
I'd like to see a comparison between those who obtained adequate calcium from food sources vs supplements.
Someone I know extremely well found that he had low bone density a few years ago. Testing (DEXA scan) showed that the problem worsened the following year. Taking calcium and vitamin D supplements was effective in raising this person's bone density and preventing the need for special drugs. In addition some bothersome symptoms of osteoarthritis disappeared, although two doctors claimed that this could not be related.
Anecdotal reports about individuals don't advance arguments about specific populations backed by studies too much, IMHO.
Calcium carbonate is processed from rocks. How well does the body assimilate?
But no one would be interested in sponsoring such a study of calcium in food vs. supplements/pharmaceuticals; unless the dairy producers would. Not a bad idea.
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