According to August 25 issue of The Lancet, people over age 50 can prevent osteoporosis with or without calcium combined with Vitamin D. Benjamin M.P. Tang, MD, from the University of Western Sydney in New South Wales, Australia, and colleagues performed an analysis of study trials to determine if calcium with or without Vitamin D prevents fractures and osteoporosis.
Searching databases, and handpicking studies, Dr. Tang’s team identified 29 eligible studies that included 63,897 people treated with either Calcium, or Calcium combined with Vitamin D for an average of 3 ½ years. Eligibility requirements included those over age 50. Fractures of all type and percentage of bone mineral density change were used as primary outcomes.
In 17 trials involving 52,625 people taking either Vitamin D with Calcium or just Calcium, fractures were noted, but the risk was reduced by 12%. Decreased bone loss was seen in 23 trials, involving 41,419 subjects. Greater compliance with Calcium intake yielded a 24% risks reduction. The effect was greater when Calcium intake was greater than 1200mg/ day and with Vitamin D intake of 800 IU/day.
The authors conclude, "Evidence supports the use of calcium, or calcium in combination with vitamin D supplementation, in the preventive treatment of osteoporosis in people aged 50 years or older. For best therapeutic effect, we recommend minimum doses of 1200 mg of calcium, and 800 IU of vitamin D (for combined calcium plus vitamin D supplementation)."
The message is, Calcium really is important to prevent bone loss, and it doesn’t seem to matter whether you supplement with Calcium or Calcium with Vitamin D. The current study does not address dietary intake, or take into account activity levels of the participants. In addition, low levels of Vitamin D can adversely affect health, especially over a lifespan. (2)
Recommendations from past observations show that calcium is also important for proper heart function. Health care practitioners often recommend calcium supplements because it can be difficult to obtain from dietary products. However, pills can be hard to swallow, and absorption is often questionable.
Calcium citrate and calcium carbonate tablets are absorbed well. You can take calcium citrate either with or without food – calcium carbonate should be taken with a meal, and might be especially useful for elderly persons and is less expensive.
For those who can’t tolerate pills, or experience gastrointestinal upset with calcium supplements, a common problem, alternatives include fortified foods such as milk, flavored water, and chocolate wafers with calcium added, such as Adora, made from all natural milk or dark chocolate. Adora has 500 mg. of calcium carbonate in each wafer, and only 30 calories. Though juice provides calcium, you’ll get a lot more calories – 110 for an eight out glass on average. If you prefer no chocolate, Viactiv is an excellent choice, and comes in many flavors, also providing 500 mg. of calcium carbonate and only 20 calories.
Calcium citrate may be more tolerable for some people. Look for “Creamy Bites” from Mission pharmaceuticals, containing 500 mg. of calcium citrate with 35 calories. Bayer makes a calcium fortified 81 mg. aspirin, providing 300 mg. of calcium carbonate. You can also look for fiber products that contain calcium, such as Metamucil plus calcium or Fiber Choice chewable tablets. You may need to take more, because fiber decreases Calcium absorption.
Manufacturers have developed many ways for consumers to get enough calcium. Over one-half of women and one- fourth of men over age 50 will break a bone from osteoporosis. You may not even know you have bone mineral loss until a fracture occurs. (1) Prevention is mandatory to maintain quality of life and prevent disability. Obtaining our daily requirement of calcium should be taken seriously. Given the plethora of products and fortified foods available, reducing our risk of broken bones is attainable. Speak with your doctor about your individual risk factors, get a bone mineral density test, and do your best to find a calcium supplement that works for you. Use a combination of good dietary habits, combined with weight bearing exercise to protect from fractures and prevent osteoporosis.
Lancet. 2007; 370:632-633, 657-666.
Journal for Nurse Practitioners. 2008; 4(1):36-39. ©2008 Elsevier Science, Inc.
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