Meta-analysis reaffirms benefit of calcium and vitamin D supplementation in fracture prevention

Tuesday, November 10, 2015

An updated meta-analysis from the National Osteoporosis Foundation that was published online on October 28, 2015 in the journal Osteoporosis International supports the use of calcium and vitamin D supplements to reduce the risk of fracture in middle-aged to older men and women.

Acting on the publication of new data concerning the effect of supplementation on fracture risk, T. C. Wallace of the National Osteoporosis Foundation and colleagues selected eight randomized trials that compared calcium and vitamin D supplementation to a placebo among a total of 30,970 community-dwelling and institutionalized participants. Calcium doses used in the trials ranged as high as 1200 milligrams per day, and vitamin D doses were most often 800 international units (IU).

Over follow-up periods ranging from one to seven years, 2,231 fractures, including 195 hip fractures occurred. Supplementing with calcium and vitamin D was associated with a 15% reduction in fracture risk and 30% reduction in hip fracture risk in comparison with a placebo.

In their discussion, the authors note that vitamin D promotes calcium absorption in the gut and helps maintain adequate serum calcium concentrations, which promotes bone mineralization. They add that the vitamin is necessary for bone growth and remodeling by osteoblasts and osteoclasts and remark that the 400 IU dose used in the Women's Health Initiative may not be high enough to influence fracture outcomes.

"Our analyses indicate that supplementation could decrease the risk of total and hip fractures by 15% and 30%, respectively, which could decrease the public health burden of osteoporotic fractures," the authors conclude. "Additional clinical randomized clinical trials that address personal use of supplements and adherence to allocated interventions may better facilitate our understanding of the role of supplemental calcium plus vitamin D and vitamin D alone on fracture prevention. The findings from this quantitative assessment support the use of calcium plus vitamin D supplements as an intervention for fracture risk reduction in both community-dwelling and institutionalized middle-aged to older adults."

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Tea, flavonoid intake associated with lower fracture risk
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An article published on August 12, 2015 in the American Journal of Clinical Nutrition adds more evidence to a protective effect for tea drinking against the development of osteoporotic fractures in women.

The study included 1,188 women over the age of 75 years enrolled in the Calcium Intake Fracture Outcome Study, which evaluated the effect of calcium supplementation in the prevention of osteoporosis. Tea intake was assessed at the beginning of the study and at two and five years. The subjects were followed for ten years, during which 288 women developed an osteoporotic fracture, including 212 major fractures and 129 hip fractures.

Among women whose intake of tea was three cups or higher per day, there was a 30% decrease in the risk of any osteoporotic fracture in comparison with those whose intake was a cup or less per week. Subjects whose flavonoid intake from tea and foods was among the highest one-third of subjects had risks of osteoporotic fracture, major osteoporotic fracture and hip fracture that were 35%, 34% and 42% lower than those whose intake was among the lowest third. When individual flavonoids were analyzed, higher consumption of flavonols, flavan-3-ols and flavones was significantly associated with a protective effect against osteoporotic fracture risk.

"The current study found that flavonoid intake was associated with a reduced risk of hip, major, and all osteoporotic fractures in elderly women," write authors Gael Myers and colleagues. "The major flavonoids found in tea, flavan-3-ols, and flavonols were also associated with a reduced fracture risk, providing evidence for the role of tea flavonoids in promoting bone health."

"If the 30–40% reduction in fracture risk with higher intake of black tea and specific classes of flavonoids were confirmed, this knowledge would provide a major addition to the dietary prevention of fracture," they conclude.

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Life Extension Magazine® November 2015 Issue

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On the cover

On the cover: AMPK and Aging, A technical review, by Raegan Linton


Boron reduces prostate cancer risk, by Michael Downey

How to obtain optimal benefits from selenium, by Alice Langstrom

The link between vitamin C and optimal immunity, by Chad Robertson

How to improve your odds of successful cataract surgery, by Kenneth J. Absher, DO, BCCN

Novel strategy to restore youthful facial contour, by Robert Goldfaden and Gary Goldfaden, MD

The Microbiome of Aging and Age-Related Disease conference, by Ben Best


As we see it: "To grow old without disease," by William Faloon

Wellness profile: Dr Valdimir Turovskiy, by Loretta Granham

In the news

Journal abstracts: Vitamin C, selenium, boron and AMPK

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Health Concern


Most of us assume that our bones are like pieces of rocks or hard shells. However, bone is a living tissue, constantly undergoing demolition and renewal as it responds to changing forces in the environment (Martin 2009, Body 2011). Bone is also the body's primary reservoir of the calcium needed for a wide variety of biological processes (de Baat 2005). Bone is now recognized as an endocrine organ, secreting compounds that function like hormones throughout the body (Kanazawa 2010).

Our bones are made of crystals of calcium salts in a protein matrix. Specific cells, called osteoblasts, produce the matrix and attract calcium compounds to form new bone, while a different set of cells, called osteoclasts, resorbs the bone tissue to allow new shapes and structures to form in response to gravity and the pull of muscles. This process of remodeling helps repair microdamage that occurs as a result of daily activity and prevents the accumulation of old fragile bone (Martin 2009, Mitchner 2009, Body 2011).

At the simplest level, osteoporosis occurs when more bone is resorbed than formed (Banfi 2010, Chang 2009). There are multiple causes for osteoporosis including suboptimal nutrition, age-related hormonal imbalance, and lack of weight-bearing exercise, to name a few (Body 2011).

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