Vitamin D bone benefits need added calcium, study

By Stephen Daniells

- Last updated on GMT

Related tags: Calcium, Osteoporosis

Taking vitamin D supplements to reduce the risk of
fractures is only effective if accompanied by additional
calcium, Belgian researchers have reported.

"To optimize clinical efficacy, vitamin D 700-800 International Units per day (IU/d) should be complemented with calcium, using a dose of 1000-1200 mg/d of elemental calcium,"​ wrote lead author Steven Boonen in the Journal of Clinical Endocrinology & Metabolism.​ The combination of vitamin D and calcium has long been recommended to reduce the risk of bone fracture for older people, particularly those at risk of or suffering from osteoporosis, which is estimated to affect about 75m people in Europe, USA and Japan. Use of these supplements is widely accepted by the general public, with calcium reported to be the biggest seller in the US supplements industry. Annual sales were about $993m (€836m) in 2004, according to the Nutrition Business Journal. The action of the nutrients is complimentary, with calcium supporting bone formation and repair, while vitamin D helps the body absorb calcium. The researchers, from Katholieke Universiteit Leuven, sought to extend a previous meta-analysis from 2005 that reported vitamin D 700-800 IU/d reduced hip-fracture risk in elderly individuals by 25 per cent (JAMA​ 2005, Vol. 293, Pages 2257-2264). They reviewed randomised controlled trials (RCTs) of supplementing postmenopausal women and/or elderly men over the age of 50 with oral vitamin D with or without calcium supplementation vs.​ placebo/no treatment. Boonen and co-workers report that when vitamin D alone was supplemented, no significant reduction of hip fracture risk was observed. On the other hand, when the vitamin was supplemented in combination with calcium, the risk of hip fracture was reduced by 18 per cent. When the results of the new meta-analysis were combined with those of the JAMA meta-analysis, the risk of hip fracture was reduced by 25 per cent, compared to vitamin D only. "Universal supplementation in the elderly is unnecessary. Further research should identify those individuals who benefit most from vitamin D and calcium supplementation,"​ concluded the researchers. Source: The Journal of Clinical Endocrinology & Metabolism​ Volume 92, Pages 1415-1423; doi:10.1210/jc.2006-1404 "Need for Additional Calcium to Reduce the Risk of Hip Fracture with Vitamin D Supplementation: Evidence from a Comparative Metaanalysis of Randomized Controlled Trials"​ Authors: S.Boonen, P. Lips, R. Bouillon, H.A. Bischoff-Ferrari, D. Vanderschueren, and P. Haentjens

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