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Prevention of fractures in older people with calcium and vitamin D.

Nutrients
September 1, 2010
Caryl A Nowson
Journal ArticleReviewHuman Study
Study Details

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.

Extracted Claims (6)
InterventionDirectionEndpointPopulationDosageImpactClaim #
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
Abstract

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.

Medical Subject Headings (MeSH)
Accidental FallsAgedAged, 80 and overAgingBone DensityCalcium, DietaryDietary SupplementsFemaleFood, FortifiedFractures, BoneHip FracturesHumansMaleMeta-Analysis as TopicMiddle AgedMuscle StrengthOsteoporosisVitamin D
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality85/10
Citation Metrics
Total Citations13
Citations/Year0.9
Relative Citation Ratio0.44
NIH Percentile23.7%
Research Impact Scores
APT Score0.50
Weight Score1.26
Normalized Score0.67
Related Supplements
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