Posted on 02/15/2006 6:52:24 PM PST by Pharmboy
The biggest study ever of calcium and vitamin D supplements for older women showed they offered only limited protection against broken bones, raising questions over what has been an article of faith among doctors and nutritionists.
The supplements seemed to reduce the risk of broken hips in women over 60 and also helped those who took the supplements most regularly. But as to preventing bone fractures overall, vitamin D and calcium flunked in these healthy women.
One of the researchers, Dr. Norman Lasser at New Jersey Medical School, said the study is "not as ringing an endorsement of calcium as one might like."
Even so, many experts said they would stand behind federal guidelines recommending the supplements, if needed, to meet standard intake of calcium and vitamin D.
"There's probably a small benefit," said Dr. Joel Finkelstein, of Massachusetts General Hospital, who wrote an editorial in the New England Journal of Medicine where the study appeared Thursday. "It's a good start, but women at higher risk need to know it's not enough."
The findings were an offshoot of the big national study of diet and hormone therapy known as the Women's Health Initiative.
Osteoporosis touches an estimated 10 million Americans, making their bones prone to break. One of two women will suffer such a fracture in her lifetime.
For women over age 50, federal guidelines recommend 1,200 milligrams of bone-building calcium and 400-600 international units of vitamin D daily from diet and, if needed, supplements.
The seven-year study of 36,282 women ages 50 to 79 gave half the participants 1,000 milligrams of calcium and 400 units of vitamin D, while the other half took dummy pills.
However, many were also taking their own supplements before the research began, and they were allowed to keep doing so, whether they were assigned to the test group or the comparison group. These extra supplements may have helped the women stay healthy but ironically diluted the findings, since any benefit is harder to show against a backdrop of fewer fractures. Also, women in the study were taking hormone pills, likely further cutting the number of fractures.
The study showed better hip bone density in the group given supplements, but they ranked no better statistically in avoiding fractures of all kinds. However, women over age 60 reduced their chances of hip fracture by 21 percent with the supplements.
Many women sometimes missed their daily dose — a common phenomenon in real-world testing — but those who took their supplements most faithfully lowered their risk by 29 percent.
"We still do believe ... that maintaining an adequate calcium intake will lay the foundation for bone health," said lead author Dr. Rebecca Jackson at Ohio State University.
Dr. Bess Dawson-Hughes, a Tufts University vitamin expert who helped shape the dietary guidelines, said they should remain unchanged for now. She largely dismissed the overall negative finding.
"You put people who don't need it together with people who aren't taking it, and you find nothing — and that really isn't all that surprising," she said.
Some researchers said the effect would have been clearer with higher doses of vitamin D, perhaps up to 1,000 units daily. The vitamin helps the body absorb calcium and promotes muscle health, reducing falls.
"We don't want to send the message to people to throw away their calcium pills, which was my wife's first reaction," said Lasser, one of the study authors.
The study did show a significant side effect with the diet supplements: a 17 percent increase in the risk of kidney stones. But several doctors downplayed that risk, saying hip fractures are typically much worse than kidney stones.
Doctors said the study suggests that women at higher risk of fracture — whose tests show lost bone density — likely need more than diet supplements. They may require osteoporosis drugs.
The study also checked whether the supplements might help prevent colon cancer, and the results indicated there was no benefit. That wasn't a big surprise partly because past studies had not signaled much benefit.
Still, the researchers plan to check participants in future years, because colorectal cancer can take 10 to 20 years to develop.
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On the Net:
New England Journal of Medicine: http://nejm.org
federal dietary guidelines:
http://www.health.gov/dietaryguidelines/dga2005/document/html/chapter2.htm
Osteoporosis facts:
http://www.osteo.org/newfile.asp?docfast&doctitleFast+Facts+on+Osteoporosi
&doctypeHTML
Yes. Weight-bearing activities increase bone density. I don't know how much it helps at the age when you're most likely to develop osteoporosis (since you most likely will have cut back by then), but I don't see how it can hurt.
There is evidence that one course of Fosamax (or drugs in its class--the bisphosphonates) does it for a long long time.
First the study that reducing fatty foods not lower a woman's cancer risk and now this:
I didn't know this was Truth In Health Sciences Month.
The problem I have with an announcement like this is that it is generally recognized that most folks are actually deficient in calcium.
We used to drimk well water and water flowing in streams, in most places in the country, positively loaded with calcium.
Now, in a lot of areas, we are drinking water that has far less than it used to.
Remember, if you fractionalize the body into elements, besides for carbon and water, calcium is by far the most prevalent element.
I wonder who funded the study and what form of vitamin D they were using.
Yep--moving around as much as you can even if you're 90 years old is the best thing for every system you have. I have a 91 year old uncle (I'm going to visit him in a few weeks with my son) and he still moves pretty good when he mixes up a batch of martinis for the three of us. No foolin'...
There's an old saying, "For every child, a tooth" - a tooth lost that is. I got so many cavities during or right after my pregnancies it wasn't funny.
Mrs VS
Methods We recruited 36,282 postmenopausal women, 50 to 79 years of age, who were already enrolled in a Women's Health Initiative (WHI) clinical trial. We randomly assigned participants to receive 1000 mg of elemental calcium as calcium carbonate with 400 IU of vitamin D3 daily or placebo. Fractures were ascertained for an average follow-up period of 7.0 years. Bone density was measured at three WHI centers.
The lack of calcium and minerals in our diet is to blame, due to petroleum based fertilizers. You cannot escape this conclusion, if you know anything about soil. Even if you make meals from scratch, you still are working with mineral depleted vegetables and meats.
Ubiquitous corn syrup is also a health danger, and subsidies of US cane sugar growers must stop, so we can once again have affordable cane sugar in food and drinks and stop the obesity epidemic.
I know, I'm probably going to be labeled as a crazy. I scoff at Global Warming, but think the soil issue is serious, and so is the fructose issue.
Well, I agree with you that fructose is slow poison...no question about that.
Old women often don't fall and "break a hip"....what happens is a bone BREAKS, causing them to fall....and yes, ACTIVITY does help.
Uhhh...calcium is not "burned" when it is used in muscle contractions. It is eliminated in the urine and absorbed through the gut. And you have forgotten to mention the very potent parathyroid hormone in calcium and phosphorus metabolism.
This pertained to the upregulation of whatever enzymatic pathway builds or removes bone structure... Put another way, the skeleton represents a large reserve of calcium, and keeping blood concentration precisely balanced is a strong priority over how much the bones get to keep for themselves.
My doc recently told me to substantially increase my Vitamin D intake....that it was MORE important than Calcium...so, I'm up to about 2000mg/iu? a day. (Something in a blood test said I was losing bone at a faster rate than I should.) People in the northern states should probably ALL be taking more. And, Calcium IS overrated....I always hated milk, but I probably have stronger bones than 80% of women in my age group (nearly 55).
Yep....I tell my ladies strength training class that all the time. The youngest participant is 51...the oldest 76. You should see them do what they never thought they'd be able to do when they started. I never have them on any machines. They use all free weights, stability balls and bodyweight.
I have a nextdoor neighbor, who has osteo arthritis. She has lost 3 vertebraes in her back. She will be in a wheelchair shortly, and has Macular Degeneration. The Back problem has caused her to shrink more than 3".
It is sad to see her wither away to nothing.
Getting old is never pretty. she is 78 years old this year, and cared for her husband when he came down sick and died, mourned for years, now she has lost her sight and her bones are giving out on her.
I want to be like a dear friend of mine who passed away last october.
She was 93. Drove until Friday, died Saturday, and buried the following Wednesday. Had pain, from arthritis, but she was capable of getting around til she just was not there any more
I'm taking My Calcium, Magnesium, and D. FOREVER.
Perhaps 'burned', being a lay term, wasn't a good choice of words. Calciuim ions in the sarcoplasmic reticulum are used to initiate muscle contraction. There, is that better? And I did mention the parathyroid glands.
bump
Could you explain this, please.
Good Q and also, what form of calcium was used for the study. Many common forms used in supplements is anot al that easily assimilated, and thats what counts, by the body. Cal carbonate is most common - and is very hard for the body to assimilate. D helps with its use by the body, but still only a small % is actually going into the bloodstream.
Calcium citrate is probably the best form for humans. It should be accompanied by Vit D, and some Zinc for best use by the human system...;-)!
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