Calcium and Vitamin D Do Not Protect Older Adults From Fractures

When I was still practicing it was strongly suggested that everyone who was chronically ill or not take calcium and vitamin D supplements to protect against bone fracture. However, a recent study examining 33 randomized trials involving 51,145 people found there was no benefit to calcium supplements at all when it came to hip or spine fractures.

According to the study released in the December 26, 2017, issue of the Journal of the American Medical Association, it didn’t matter if the calcium still life with milksupplements contained Vitamin D or not. The number of hip and spine fractures was statistically similar for people on calcium pills and those who did not take the supplement.

Researchers looked at randomized clinical trials comparing calcium,  vitamin D, or combined calcium and vitamin D supplements with a placebo or no treatment for fractures. The study covered community-dwelling adults older than 50 years. They did not look at people in nursing homes, hospitals, and other facilities. The results were the same regardless of gender, dietary calcium, or a previous history of fractures.

Institute of Medicine Report

The main issue is how to obtain sufficient calcium to keep bones strong and prevent osteoporosis. In 2010, the Institute of Medicine (IOM) published recommendations for dietary calcium and vitamin D following a rigorous examination of the studies on potential
health outcomes. The IOM found that the evidence supported a role for these nutrients
in bone health but not in other health conditions. Further, the IOM noted there is emerging
evidence that too much of these nutrients may be harmful. The recommendations recognized conflicting messages about other benefits of these nutrients—especially vitamin D—and also about how much calcium and vitamin D people need to be healthy.

As North Americans take more supplements and eat more of foods that have been fortified with vitamin D and calcium, it becomes more likely that people consume high amounts of these nutrients. Kidney stones have been associated with taking too much calcium from dietary supplements. Very high levels of vitamin D (above 10,000 IUs per day) are known to cause kidney and tissue damage (Source).

Not enough calcium in diets

Most Americans do not get enough calcium and vitamin D in their diets. Consequently, many foods are fortified with calcium and/or vitamin D. Dietary calcium can be obtained in dairy products and leafy greens. Small amounts of vitamin D are found in fatty fish, but most of our vitamin D comes from sunlight. Combining calcium-fortified foods with supplements that can contain upwards of 1,000 mg may lead to kidney damage from excess calcium. The upper limit for calcium in men and women older than 50 is 2,000 mg/day. Vitamin D upper limits for the same group is 4,000 units/day (Source).

Vitamin D is not really a vitamin but instead is a hormone produced by a reaction to sunlight.  It has many different roles in the body related to bones, cancer, heart disease, diabetes, immune function and reproductive health (Source).

People with concerns about this study, especially those who have been diagnosed with osteoporosis, should not stop taking their calcium supplements before speaking with their healthcare provider.

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