Calcium, Vitamin D and Osteporosis

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Main Category: Bones/Orthopaedics News

Article 10 Mar 2006 - 0:00am (UK)

 

On February 16th, 2006 the New England Journal of Medicine published

new findings of the Women's Health Initiative Study looking at calcium

and vitamin D for hip fracture reduction (Jackson, R et al., NEJM

354,7:684-96,2006). Headlines around the country read, " Calcium and

Vitamin D Supplements Don't Cut Fracture " . But, we at the Osteoporosis

Education Project ask, " Is this true? "

 

Sure enough, a more careful look at the study suggests that the

headlines are misleading and that calcium and Vitamin D are indeed

helpful in preventing osteoporotic fractures.

 

In this study 36,282 postmenopausal US women were given the daily

treatment of either 1,000 mg of calcium plus 400 IU vitamin D or

" sugar pills " . After seven years there was no reported significant

reduction in hip fractures in the group as a whole--thus the headline,

" Calcium and Vitamin D Don't Cut Fracture " . However, when researchers

looked only at women over 60 years of age (those most likely to

experience a hip fracture) they found there was a 21% reduction in hip

fractures. Further, when researchers looked just at the women who

actually took the calcium and vitamin D supplements on a regular basis

(at least 80% of time) over the seven year study they found a 29%

decrease in hip fractures. Thus, just the simple addition of 1,000 mg

calcium and 400 IU vitamin D did help reduce hip fracture by almost

one-third among older women.

 

Most important of all, however, is the issue of supplement doses.

While the dose of calcium used in the study was appropriate (1,000

mgs), the dose of vitamin D (400 IU) used in the study was only half

of the amount known to be needed to reduce hip fractures. Several good

studies in the U.S. and Europe have recently shown that

supplementation with 700 to 800 IU vitamin D (not 400 IU as used in

this study) along with calcium reduced osteoporotic fractures by some

30 to 50% and more at times (Chapuy MC, et al., NEJM 1992,

327(23);1637-42; Chapuy MC et al., BMJ 1994; 308:1081-1082;

Dawson-Hughes, B et al., NEJM 1997; Sept. 4; 337(10):670-6; SatoY et

al., Stroke 2001;32: 1673-1677).

 

So the byline of this important segment of a $725 million study should

be that an adequate amount of calcium (1,000 mg) plus half of the

vitamin D necessary to reduce fractures was able to decrease hip

fractures by 29% in those women using the supplements at least 80% of

the time. Preventing nearly one in three hip fractures with calcium

and low dose vitamin D is not bad. Further, we surely would have seen

a much greater fracture reduction if the appropriate amount of vitamin

D had been used in this study and had all the subjects really taken

the supplemental nutrients.

 

Susan E. Brown, Ph.D., CNS, Director

 

The Osteoporosis Education Project

605 Franklin Park Drive

East Syracuse, NY 13057

http://www.betterbones.com

http://www.susanbrownphd.com