Calcium and vitamin D produce modest bone benefit for healthy postmenopausal women

[Guest guest]

Calcium and vitamin D produce modest bone benefit for healthy

postmenopausal women



Feb 16, 2006



Janis



Dr D [source: Ohio State University Medical Center]



Columbus, OH - The largest study ever done of calcium and vitamin-D

supplementation in healthy postmenopausal women found rather small

improvements in bone-mineral density (BMD) and in hip-fracture risk,

but lead investigator Dr D (Ohio State University,

Columbus) tells rheumawire that the supplements are a worthwhile

strategy for many women [1].

" This study shows that healthy postmenopausal women, especially those

over 60, can gain modest benefit in preventing hip fractures and

preserving bone density from taking calcium and vitamin D. Women over

60 had a significant 21% reduction in hip fractures (six fewer

fractures per 10 000 women). Women [of all ages] who took the full

dose experienced a significant 29% decrease in hip fractures (four

fewer fractures per 10 000 women), " said.

Calcium, vitamin D not enough to protect bone health





Healthy postmenopausal women gain modest benefit in preventing hip

fracture.





The data are from the Women's Health Initiative (WHI), a series of

studies sponsored by the US National Heart, Lung, and Blood Institute

to examine causes and prevention of diseases affecting older women.

Previous WHI studies have involved hormone therapy, low-fat diets,

and heart disease.

The 36 282 healthy postmenopausal women (age 50 to 79) recruited for

the WHI were randomized to daily 1000 mg of elemental calcium as

calcium carbonate with 400 IU of vitamin D3 or to daily placebo.

Subjects were followed for 7.0 years.

The study's major findings were:

Women taking calcium/vitamin D had a statistically nonsignificant 12%

reduction in hip-fracture risk. Rates of vertebral and lower arm/

wrist fractures did not change.

Women who took at least 80% of the planned dose of calcium/vitamin D

had a 29% reduction in risk of hip fracture.

Calcium/vitamin-D supplementation increased the risk of kidney stones

by 17%.

The calcium/vitamin-D subjects had significantly greater preservation

of total hip BMD at years three (+0.59% vs placebo), six (+0.86%),

and nine (+1.06%).

According to the investigators, " The trial demonstrated that calcium

with vitamin-D supplementation diminishes bone loss at the hip, but

the observed 12% reduction in the incidence of hip fracture (the

primary outcome) was not statistically significant. There were no

significant reductions in the incidence of clinical vertebral

fractures, fractures of the lower arm or wrist, or total fractures. "

points out several factors that should be considered in

putting the data from this study into context. The first is that,

perhaps reflecting increasing awareness of the importance of

osteoporosis risk over the years of the study, actual fracture rates

in both the treatment and control group were much lower than had been

expected. That change reduced the power of the study to 48% for

detecting a greater reduction in hip-fracture risk with calcium/

vitamin D.

Other possibly confounding factors are use of a 400-IU vitamin D dose

rather than the 600 IU used in some other studies, the higher-than-

anticipated body-mass index of the study subjects (who were thus

likely to have stronger than expected bones), and recruitment of

fewer women over age 70 than had been expected.



Many women believe that they are completely protected against the

development of osteoporosis if they are taking these supplements.



" The most important take-home point for rheumawire readers would be

that women, particularly those over 60, should consider taking

calcium and vitamin-D supplements for bone health. To guard against

bone loss or hip fracture, it is recommended that women consume 1200-

mg calcium and 400 to 600 units of vitamin D through diet and

supplements combined. For women over 65 or at high risk for

osteoporosis or fracture, further assessment with bone-mass testing

and consideration of a bone-active agent for additional fracture

reduction might be appropriate, " said

In an accompanying editorial, Dr S Finkelstein (Massachusetts

General Hospital, Boston) writes, " With the widespread marketing of

calcium and vitamin D, many women believe that they are completely

protected against the development of osteoporosis if they are taking

these supplements. This study should help correct this important

misconception and allow more women to receive optimal therapy for

bone health. [2] "

http://www.jointandbone.org/viewArticle.do?primaryKey=649623

[Guest guest]

My husband, a heart transplant patient on big doses of immuno-suppressants and

other meds had a great deal of bone loss. For the past two years, he has been on

Fosamax and his bone density is back to normal for someone his age.

a <a54@...> wrote:

Calcium and vitamin D produce modest bone benefit for healthy

postmenopausal women



Feb 16, 2006



Janis



Dr D [source: Ohio State University Medical Center]



Columbus, OH - The largest study ever done of calcium and vitamin-D

supplementation in healthy postmenopausal women found rather small

improvements in bone-mineral density (BMD) and in hip-fracture risk,

but lead investigator Dr D (Ohio State University,

Columbus) tells rheumawire that the supplements are a worthwhile

strategy for many women [1].

" This study shows that healthy postmenopausal women, especially those

over 60, can gain modest benefit in preventing hip fractures and

preserving bone density from taking calcium and vitamin D. Women over

60 had a significant 21% reduction in hip fractures (six fewer

fractures per 10 000 women). Women [of all ages] who took the full

dose experienced a significant 29% decrease in hip fractures (four

fewer fractures per 10 000 women), " said.

Calcium, vitamin D not enough to protect bone health





Healthy postmenopausal women gain modest benefit in preventing hip

fracture.





The data are from the Women's Health Initiative (WHI), a series of

studies sponsored by the US National Heart, Lung, and Blood Institute

to examine causes and prevention of diseases affecting older women.

Previous WHI studies have involved hormone therapy, low-fat diets,

and heart disease.

The 36 282 healthy postmenopausal women (age 50 to 79) recruited for

the WHI were randomized to daily 1000 mg of elemental calcium as

calcium carbonate with 400 IU of vitamin D3 or to daily placebo.

Subjects were followed for 7.0 years.

The study's major findings were:

Women taking calcium/vitamin D had a statistically nonsignificant 12%

reduction in hip-fracture risk. Rates of vertebral and lower arm/

wrist fractures did not change.

Women who took at least 80% of the planned dose of calcium/vitamin D

had a 29% reduction in risk of hip fracture.

Calcium/vitamin-D supplementation increased the risk of kidney stones

by 17%.

The calcium/vitamin-D subjects had significantly greater preservation

of total hip BMD at years three (+0.59% vs placebo), six (+0.86%),

and nine (+1.06%).

According to the investigators, " The trial demonstrated that calcium

with vitamin-D supplementation diminishes bone loss at the hip, but

the observed 12% reduction in the incidence of hip fracture (the

primary outcome) was not statistically significant. There were no

significant reductions in the incidence of clinical vertebral

fractures, fractures of the lower arm or wrist, or total fractures. "

points out several factors that should be considered in

putting the data from this study into context. The first is that,

perhaps reflecting increasing awareness of the importance of

osteoporosis risk over the years of the study, actual fracture rates

in both the treatment and control group were much lower than had been

expected. That change reduced the power of the study to 48% for

detecting a greater reduction in hip-fracture risk with calcium/

vitamin D.

Other possibly confounding factors are use of a 400-IU vitamin D dose

rather than the 600 IU used in some other studies, the higher-than-

anticipated body-mass index of the study subjects (who were thus

likely to have stronger than expected bones), and recruitment of

fewer women over age 70 than had been expected.



Many women believe that they are completely protected against the

development of osteoporosis if they are taking these supplements.



" The most important take-home point for rheumawire readers would be

that women, particularly those over 60, should consider taking

calcium and vitamin-D supplements for bone health. To guard against

bone loss or hip fracture, it is recommended that women consume 1200-

mg calcium and 400 to 600 units of vitamin D through diet and

supplements combined. For women over 65 or at high risk for

osteoporosis or fracture, further assessment with bone-mass testing

and consideration of a bone-active agent for additional fracture

reduction might be appropriate, " said

In an accompanying editorial, Dr S Finkelstein (Massachusetts

General Hospital, Boston) writes, " With the widespread marketing of

calcium and vitamin D, many women believe that they are completely

protected against the development of osteoporosis if they are taking

these supplements. This study should help correct this important

misconception and allow more women to receive optimal therapy for

bone health. [2] "

http://www.jointandbone.org/viewArticle.do?primaryKey=649623