Healthy Women Advised Taking Low Dose Calcium & Vitamin D Will Not Help Prevent Fractures But These Supplements Still Have Other Health Benefits
The United States Preventive Services Task Force, a panel of experts in health prevention, recently concluded that low doses of calcium (1000mg or less) with vitamin D (400 IU or less) do not help to prevent fractures in healthy postmenopausal women, and, thus, recommended against these women taking a low dose of calcium and vitamin D. This recommendation applied only to healthy post-menopausal women not at increased risk for low bone density, osteoporosis, or a history of fractures. The National Osteoporosis Foundation recommends that people with the bone disease consume at least 1,200mg of calcium and 800-1,000 IUs of vitamin D daily through food or supplements.
The task force’s new recommendations add more fervor to the ongoing debate about the benefits associated with these popular supplements. In response to the task force’s statements, numerous experts expressed concerns that the recommendations were misleading and potentially dangerous. Dr. Susan Ott, a bone specialist noted that “they ignored a lot of people who are getting very little calcium in their ordinary diet." She said that she fears "for the millions of women who feel perfectly healthy yet are in fact deficient in calcium or vitamin D, and who erroneously think as a result of the task force recommendations that they are in the clear." The Institute of Medicine estimates that 75% of American women do not get the recommended 1,000-1,200 mg of calcium from their food every day. Certainly, adequate intake of calcium from food sources is rare unless a person consumes a lot of dairy. For example, to get the recommend amount one would have to drink 3-4 cups of milk or eat 16-20 cups of cooked broccoli daily.
Also, while the task force concluded that supplementing with 400 IU of vitamin D does not prevent fractures, a growing body of evidence suggests that higher levels of supplementation in fact do improve fracture rates. Indeed, the same task force recently advised that, to prevent falls in older adults, there is significant evidence that supplementing with 800 IU of vitamin D, and participating in physical therapy and/or regular activity can reduce the risk of falls by 13-17%. And, in a recent Swiss study, researchers found that taking more than 800 IU of vitamin D daily could reduce the risk of hip fractures in older women by 30%. Similarly, a recent study that followed more than 3,000 people between the ages of 70 and 79 for six years, found that those with the lowest vitamin D levels at the start of the study, had nearly a 30% increased risk of a mobility limitation and almost twice the risk of a mobility disability compared to those with the highest levels of vitamin D.
Also, in addition to vitamin D and calcium’s role in bone health, they have many other important roles in the body. The heart, muscles, and nerves cannot work properly without calcium. Vitamin D is crucial in part because it helps the body absorb calcium from food but it also appears to be important for proper functioning of the endocrine and immune systems. These two nutrients have even been implicated in controlling appetite. Persons that are low in calcium and/or vitamin D appear to be more likely to overeat. In a recent study Dr. Erin LeBlanc and her team found that women over 65 with higher blood vitamin D levels gained less weight over time than women with lower vitamin D levels. And, a recent review of multiple clinical trials concluded that older adults who take vitamin D and calcium supplements may live a bit longer than their peers. Researchers found that older adults who were given vitamin D and calcium supplements were 9% less likely to die over three years than those given placebo pills.
What to do: Certainly, it is always best to get necessary nutrients from food. To get adequate calcium be sure to consume plenty of lowfat/nonfat dairy, foods that contain bones such as sardines, and/or foods fortified with calcium. The body makes vitamin D when exposed to sunlight but it is difficult and possibly puts one at risk for skin cancer to get adequate sun exposure. Vitamin D is not widespread in the food supply. Only fatty fish liver oil and foods containing bones are very good natural sources though now many foods are supplemented with vitamin D including milk and cereals. Vitamin D levels can be reliably tested with routine bloodwork. Supplementation is still advised for those with bone disease or at high risk for bone disease. And, for others who do not get adequate calcium and vitamin D from their diet, a supplement of 500mg of calcium and 500 IU of vitamin D taken 2-3 times daily is likely to have some health benefits, but to determine if you should be taking a supplement, talk to your primary care physician or dietitian about what level of supplementation best suits your health needs.
Adapted from articles at:
http://www.nlm.nih.gov/medlineplus/news/fullstory_126935.html
http://www.nlm.nih.gov/medlineplus/news/fullstory_125688.html
http://www.nlm.nih.gov/medlineplus/news/fullstory_125812.html
Research sources include:
http://bit.ly/LaoDDQ Journal of Clinical Endocrinology & Metabolism, online May 17, 2012. http://bit.ly/K7kSAx Annals of Internal Medicine, online June 12, 2012.
http://bit.ly/L9cPi0 Annals of Internal Medicine, May 28, 2012
Kaiser Permanente, news release, June 26, 2012
Heike Bischoff-Ferrari, M.D., Dr.P.H., the Center on Aging and Mobility at the University of Zurich and Wald City Hospital, Zurich; Anna Lasak, M.D., clinical director of the department of rehabilitation, and the women's physical medicine and rehabilitation program, Montefiore Medical Center, New York City; July 5, 2012, New England Journal of Medicine.
U.S. Preventive Services Task Force. Vitamin D and Calcium Supplementation to Prevent Cancer and Osteoporotic Fractures in Adults: Draft Recommendation Statement. AHRQ Publication No. 12-05163-EF-2. http://www.uspreventiveservicestaskforce.org/draftrec3.htm.
Denise Houston, Ph.D., R.D., nutrition epidemiologist and assistant professor, Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, N.C.; Jessica Shapiro, M.S., R.D., C.D.N., associate wellness dietician, Montefiore Medical Center, New York City; May 2012, Journal of Gerontology: Medical Sciences, online
No comments:
Post a Comment