October 14, 2015
Research Recommends Against Calcium Increase Through Supplements or Dietary Changes

Auckland, New Zealand—How pharmacists answer questions about calcium supplementation might be affected by a pair of studies published recently by the British Medical Journal (BMJ).

The reports suggest that increasing calcium intake through dietary sources or supplements is unlikely to improve bone health or prevent fractures in older people. In fact, study authors led by researchers from the University of Auckland suggest that the results argue against recommending increased calcium intakes—through supplements or dietary sources—to prevent fractures.

Some current guidelines advise older people to take at least 1,000 to 1,200 mg/day of calcium to improve bone density and prevent fractures. Because of recent concerns about the safety of calcium supplements, users have been urged to increase their intake of the mineral through food sources rather than supplements, according to background information in the reports.

For the studies, the researchers analyzed evidence from randomized controlled trials and observational studies of extra dietary or supplemental calcium in women and men aged older than 50. In the first study, the researchers found that increasing calcium intake from dietary sources or by taking supplements produces only small (1-2%) increases in bone mineral density and that is “unlikely to lead to a clinically meaningful reduction in risk of fracture.” In the second study, the team found that dietary calcium intake is not associated with risk of fracture, and no clinical trial evidence suggests that increasing calcium intake from dietary sources prevents fractures.

In an accompanying editorial, Professor Karl Michaƫlsson from Uppsala University in Sweden argues that recommendations on calcium supplementation need to be reconsidered.

Guidelines on use of calcium and vitamin D supplementation define nearly the entire over 50 population as at risk, he points out, yet, most of the users will accrue no benefits and instead are exposing themselves to risks, such as an increase in hip fractures linked to calcium supplementation. Michaƫlsson also notes that a meta-analysis by the United States Preventive Services Task Force two years ago found similar results as these studies, although many organizations still recommend calcium supplements.

“The weight of evidence against such mass medication of older people is now compelling,” he writes, “and it is surely time to reconsider these controversial recommendations.”
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