Calcium plus vitamin D may slash hip fracture rates: WHI data

06-Feb-2013 - Last updated on 06-Feb-2013 at 18:24 GMT

$Calcium plus vitamin D may slash hip fracture rates: WHI data$

Supplements of calcium and vitamin D may reduce the rate of hip fracture by almost 40%, says a new analysis of data from the Women's Health Initiative (WHI).

The WHI was the largest randomized, double-blind, placebo-controlled clinical trial of these nutrients, and involved 36,282 postmenopausal women in the US. The women were randomly assigned to receive 1,000 mg elemental calcium carbonate plus 400 IU of vitamin D3 daily, or placebo, for an average if seven years.

The initial analysis of the data, published in 2006 in the New England Journal of Medicine (Vol. 354, pp. 669-683), concluded: “Among healthy postmenopausal women, calcium with vitamin D supplementation resulted in a small but significant improvement in hip bone density, and did not significantly reduce hip fracture.”

However, in the 59% of the participants who actually adhered to the supplementation program (assuming 80% or more compliance with taking the supplements) the number of fractures was 29% lower, leading this publication to run with the headline: Calcium/ vitamin D supplements good for bones – if you take them (NutraIngredients-USA, Feb 16, 2006).

Hip fracture benefits

The new analysis, published in Osteoporosis International, reports that, among women not taking calcium or vitamin D supplements at the start of the study, the risk of hip fracture occurrence was 38% lower, compared to the placebo group.

In addition, when data from the WHI clinical trial and the WHI prospective observational study were combined, the risk was 35% lower.

“Though based primarily on a subset analysis, long-term use of calcium and vitamin D appears to confer a reduction that may be substantial in the risk of hip fracture among postmenopausal women,” wrote the researchers, led by Dr Ross Prentice from the Fred Hutchinson Cancer Research Center in Seattle.

The researchers also cautiously reported that there was a suggestion of a lower risk of breast cancer and total cancer among supplement users.

Concerns? No concerns…

In addition, there was no link observed between vitamin D and calcium supplementation and cardiovascular outcomes, which challenges concerns raised by other studies, most recently .

Earlier this week, researchers from the National Cancer Institute, Bethesda reported in JAMA Internal Medicine that high intakes of calcium from supplements may increase the risk of cardiovascular disease for men, but not women.

Source: Osteoporosis International
February 2013, Volume 24, Issue 2, pp 567-580,
“Health risks and benefits from calcium and vitamin D supplementation: Women's Health Initiative clinical trial and cohort study”
Authors: R. L. Prentice, M. B. Pettinger, R. D. Jackson, et al.

1 comment

Are calcium and other mineral supplements really necessary on a healthy diet?

Posted by chris aylmer, 08 February 2013 - 20:18 GMT

I eat a wholefood diet with the minimum of refined, processed and salted foods. It includes fish(but no other meat), dairy, legumes, vegetables, fruit, whole grains, nuts and seeds. Out of interest, I checked my mineral intake over two days by weighing and recording everything I ate and drank and checking against USDA nutrition tables. Here are the intakes averaged per day(+ or - RDA):
Magnesium: 694mg(+319mg)
Calcium: 957mg(+157mg)
Zinc: 15.9mg(+5.9mg)
Iron: 20.2mg(+6.2mg)
Potassium: 4493mg(+2493mg)
Phosphorus: 2571mg(+1871mg)
Selenium: 158mcg(+103mcg)
Copper: 3.7mg(+2.7mg)
Manganese: 15.6mg(+13.6mg)
Sodium: 433mg(-1967mg maximum 2400mg).
There is nothing in deficit. The high manganese is interesting and mainly due to wholegrains like wheat and rice, plus tea, which is my favourite beverage.
However, without dairy, I would be well short of calcium. Meat does not supply a great deal of calcium, and calcium in leafy veg is not very well absorbed, so those who choose to avoid dairy products may need to supplement with calcium. Most of the magnesium in my diet comes from wholegrains, so those who avoid grains may be lacking this mineral. Those who avoid both dairy and wholegrains may lack both of these minerals and need to supplement or take care to check their intake.

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