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Calcium not shown to help seniors ward off broken bones
By ANDRÉ PICARD
Taking supplements of vitamin D and calcium to prevent broken bones, a popular practice among sufferers of osteoporosis, is ineffective, according to new research.
Two studies, conducted independently, have come to the same conclusion, dealing a blow to seniors struggling to stave off the devastating side effects of the crippling condition.
People with osteoporosis have a high risk of fracture, particularly if they've already broken a bone, and supplements have been considered one of the best forms of protection -- until now.
"Routine supplementation with calcium and vitamin D, either alone or in combination, is not effective in the prevention of further fractures," said Dr. Adrian Grant of the health-services research unit at the University of Aberdeen in Scotland.
One of the studies, to be published in tomorrow's edition of The Lancet, involved 5,292 people with osteoporosis who had previously broken their wrist, arm or hip. All participants were older than 70. Each person in the study was prescribed vitamin D, calcium, a combination of the two, or a sugar pill, and they were followed for up to five years. Overall, 698 participants suffered a new fracture, but those taking supplements fared no better than those taking a placebo.
Osteoporosis is a disease characterized by low bone mass and deterioration of bone tissue, which increases the risk of fracture. More than 1.4 million Canadians have osteoporosis, including one in four women and one in eight men over age 50.
Dr. Grant said while he is confident in the findings, compliance was low. (Fewer than half of those in the study took their supplements routinely.)
Dr. Philip Sambrook, of the Institute of Bone & Joint Research at Royal North Shore Hospital in Sydney, Australia, said another shortcoming of the research is that the vitamin D levels of very few participants were actually measured.
He said the evidence is still quite strong that vitamin D deficiency is a major contributor to falls and fractures in older people, and they can benefit greatly from vitamin D.
What the new study suggests, Dr. Sambrook said, is that people with adequate vitamin D in their diet don't benefit from supplements, but that is hardly a surprise.
A second study, published in today's edition of the British Medical Journal, also concluded that taking calcium and vitamin D supplements does not prevent fractures in older women. The research, which involved 3,314 participants, focused on women considered at high risk of hip fracture, namely those who suffered previous fractures, had a low body weight (under 58 kilograms/128 pounds), were smokers or in poor overall health.
All participants were counselled about fall prevention, and half were provided with supplements. They were followed for just over two years on average. In this study, compliance was much better, with two-thirds of participants taking the supplements regularly.
"We found no evidence that supplementation with calcium and vitamin D affects fracture rates over two years in women aged 70 and over, with one or more risk factors for fracture of the hip," said Dr. David Torgerson, of the health-services department at the University of York in Britain. "We found no evidence that vitamin D supplementation reduced the incidence of falls, as previously hypothesized."
Neither study addressed whether taking supplements of Vitamin D and calcium is beneficial for younger people -- particularly premenopausal women. Once a woman reaches menopause, bone mass can decrease substantially. Some experts believe the risk of osteoporosis can be reduced by maintaining bone mass before the advent of menopause.
The medical director of the osteoporosis program at Toronto's Sunnybrook and Women's College Health Sciences Centre said the studies don't prove there is no role for the supplements, but rather that vitamin D and calcium aren't sufficient to treat older people who are starting to suffer bone fractures.
"These studies don't say that there's no benefit to calcium and vitamin D," Dr. Gillian Hawker said, insisting there is still a role for the supplements in conjunction with drugs such as bisphosphonates, which are used to combat bone loss caused by osteoporosis. "What they say is that in people who are at very high risk of another fracture and are unlikely to have vitamin D or calcium deficiency . . . it's not enough to just give calcium and vitamin D."
Source: Canadian Press
Senior Citizen Aticles | Calcium
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