Prevention of fractures in older people with calcium and vitamin D.
Study Goal
The researchers aimed to evaluate the effectiveness of calcium and vitamin D supplementation, including dairy-based sources, in reducing fracture risk in older people.
Results Summary
The study found that calcium supplementation alone has a modest effect in reducing total fracture risk, while combined calcium and vitamin D supplementation is more effective, particularly in individuals with low vitamin D status. Dairy-based foods and fortified options can help meet dietary calcium needs, but additional vitamin D supplements may be necessary for older people with limited mobility or sunlight exposure.
Population
Older people at risk of osteoporosis and fractures.
Effective Dosage
Adequate dietary calcium (>1100 mg/day) and vitamin D status (>60 nmol/L 25(OH)D).
Duration
Not specified.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
vitamin D supplementation alone | no change | fracture risk | older people | - | unlikely to reduce | #1 |
calcium supplementation alone | decrease | total fracture risk | older people | - | has a modest effect in reducing | #2 |
combination of calcium supplementation with vitamin D supplementation | decrease | total fractures, including hip fractures | those at risk of marginal and low vitamin D status | - | reduces | #3 |
adequate dietary calcium (>1100 mg/day) together with maintaining adequate vitamin D status (>60 nmol/L 25(OH)D) | decrease | fracture | older people | - | to reduce risk of | #4 |
increasing range of calcium fortified foods | increase | dietary calcium intake | older people | - | could assist in increasing | #5 |
vitamin D supplements | neutral | - | older people with reduced mobility and access to sunlight | - | are likely to be required | #6 |
The greatest cause of fracture in older people is osteoporosis which contributes to increased morbidity and mortality in older people. A number of meta-analyses have been performed assessing the effectiveness of calcium supplementation alone, vitamin D supplementation alone and the combined therapy on bone loss and fracture reduction in older people. The results of these meta-analyses indicate that vitamin D supplementation alone is unlikely to reduce fracture risk, calcium supplementation alone has a modest effect in reducing total fracture risk, but compliance with calcium supplements is poor in the long term. The combination of calcium supplementation with vitamin D supplementation, particularly in those at risk of marginal and low vitamin D status reduces total fractures, including hip fractures. Therefore older people would be recommended to consume adequate dietary calcium (>1100 mg/day) together with maintaining adequate vitamin D status (>60 nmol/L 25(OH)D) to reduce risk of fracture. It is a challenge to consume sufficient dietary calcium from dietary sources, but the increasing range of calcium fortified foods could assist in increasing the dietary calcium intake of older people. In addition to the usual dairy based food sources, vitamin D supplements are likely to be required for older people with reduced mobility and access to sunlight.