Vitamin D and Calcium Supplementation to Prevent Fractures in Adults
Tuesday, April 29, 2014
U.S. Preventive Services Task Force Recommendation Statement
The U.S. Preventive Services Task Force (USPSTF) makes recommendations about the effectiveness of specific clinical preventive services for patients without related signs or symptoms.
It bases its recommendations on the evidence of both the benefits and harms of the service and an assessment of the balance. The USPSTF does not consider the costs of providing a service in this assessment.
The USPSTF recognizes that clinical decisions involve more considerations than evidence alone. Clinicians should understand the evidence but individualize decision making to the specific patient or situation. Similarly, the USPSTF notes that policy and coverage decisions involve considerations in addition to the evidence of clinical benefits and harms.
Summary of Recommendations and Evidence
The USPSTF concludes that the current evidence is insufficient to assess the balance of the benefits and harms of combined vitamin D and calcium supplementation for the primary prevention of fractures in premenopausal women or in men (I statement).
The USPSTF concludes that the current evidence is insufficient to assess the balance of the benefits and harms of daily supplementation with greater than 400 IU of vitamin D3 and greater than 1,000 mg of calcium for the primary prevention of fractures in noninstitutionalized postmenopausal women (I statement).
The USPSTF recommends against daily supplementation with 400 IU or less of vitamin D3 and 1,000 mg or less of calcium for the primary prevention of fractures in noninstitutionalized postmenopausal women (D recommendation).
The USPSTF has previously concluded in a separate recommendation that vitamin D supplementation is effective in preventing falls in community-dwelling adults aged 65 years or older who are at increased risk for falls (B recommendation).
Rationale
Importance
Fractures, particularly hip fractures, are associated with chronic pain and disability, loss of independence, decreased quality of life, and increased mortality (1). One half of all postmenopausal women will have an osteoporosis-related fracture during their lifetime.
Appropriate intake of vitamin D and calcium are essential to overall health. The Institute of Medicine has published recommended dietary allowances (Table). However, the benefits and harms of daily supplementation with greater than 400 IU of vitamin D3 and greater than 1,000 mg of calcium to prevent fractures are not clearly understood.
Benefits of Preventive Medication
In premenopausal women and in men, there is inadequate evidence to determine the effect of combined vitamin D3 and calcium supplementation on the incidence of fractures. In postmenopausal women, there is adequate evidence that daily supplementation with 400 IU of vitamin D3 combined with 1,000 mg of calcium has no effect on the incidence of fractures. However, there is inadequate evidence regarding the effect of higher doses of combined vitamin D and calcium supplementation on fracture incidence in noninstitutionalized postmenopausal women.
Harms of Preventive Medication
Adequate evidence indicates that supplementation with 400 IU or less of vitamin D3 and 1,000 mg or less of calcium increases the incidence of renal stones. The USPSTF assessed the magnitude of this harm as small.
USPSTF Assessment
Noninstitutionalized, community-dwelling postmenopausal women. The USPSTF concludes that evidence is lacking about the benefit of daily supplementation with greater than 400 IU of vitamin D3 and greater than 1,000 mg of calcium for the primary prevention of fractures, and the balance of benefits and harms cannot be determined.
The USPSTF concludes with moderate certainty that daily supplementation with 400 IU or less of vitamin D3 and 1,000 mg or less of calcium has no net benefit for the primary prevention of fractures.
Men and premenopausal women. The USPSTF concludes that evidence is lacking about the benefit of vitamin D supplementation with or without calcium for the primary prevention of fractures, and the balance of benefits and harms cannot be determined.
Recognize the signs of calcium deficiency body!
Friday, March 14, 2014
Common signs of calcium deficiency body
- Back pain or low back
- Susceptible to bone fractures
- Brittle nails
- Frequent toothache or tooth decay
- Frequent cramps in the legs
- Headache
- Heartbeat became faster
- High blood pressure
- Insomnia
- Joint pain
- Nervous, anxious, irritable
- While for women, menstrual period longer
Foods rich in calcium
Although dairy products are often erred to as the best source of calcium, unfortunately not everyone can eat. If you, too, there are several options calcium-rich foods other than milk, the almonds, broccoli, carrots, green leafy vegetables, kale, tofu, and soy milk.
Calcium supplements
Other sources of calcium can be obtained from supplements. But be sure the supplements are free dyes and harmful chemicals.
Similarly, a variety of information about the body signs of calcium deficiency which can be obtained in addition to the calcium in dairy products.
6 best food sources of calcium
Tuesday, February 18, 2014
But you rarely know is what are the foods that can be the best source of calcium. Here are the 6 best sources of calcium as reported from magforwomen.com
1. Milk
The main food of course the biggest producer of calcium is milk. Besides milk also contains all sorts of goodness of vitamins and minerals. Consumption of a glass of milk in the morning or you can also put it in a bowl of cereal.
2. Spinach
Spinach is one of the types of vegetables that contain a lot of calcium. Include spinach in your diet for stronger bones.
3. Fish
Fish like sardines, tuna, and salmon is one animal products rich in calcium. In addition to calcium, fish is also the best source of vitamin D.
4. Yoghurt
Yogurt is one of the dairy products. All dairy products are good sources of calcium and is easily digested by the body. In addition, dairy products also contain magnesium and phosphorus.
5. Cabbage
Especially green leafy vegetables are included in the cabbage family such as broccoli, cauliflower, and radishes in addition to containing calcium also contain vitamin K.
6. Nuts
Nuts and seeds are a decent one to put calcium into your diet program.
The food in the main nutrients namely calcium . Combine these foods to your diet to be healthy and balanced.
Calcium Supplements May Raise Odds of Heart Death in Women
Wednesday, February 12, 2014
Women eating a high-calcium diet and taking calcium supplements adding up to more than 1,400 milligrams a day may be running nearly twice the risk of dying from heart disease, a large Swedish study suggests.
Both men and women take calcium supplements to prevent bone loss. The new findings come on the heels of another recent study that found a similar increased risk of death related to calcium intake among men.
"Many older adults increase dietary intake of calcium or take calcium supplements to prevent bone loss and there had been speculation that increased calcium intake with or without vitamin D could improve cardiovascular health," said Dr. Gregg Fonarow, an American Heart Association spokesman who wasnt involved in the study.
However, a number of recent studies have suggested that higher dietary intake or calcium supplementation may not only not improve cardiovascular health -- they may be associated with increased risk for cardiovascular events and mortality, said Fonarow, a professor of cardiology at University of California, Los Angeles.
The new report was published in the Feb. 12 online edition of the BMJ.
To see if calcium supplements raised the risk of dying from heart disease, a team led by Dr. Karl Michaelsson, a clinical professor in the department of orthopedic surgical sciences at Uppsala University in Sweden, analyzed data collected on more than 61,000 women enrolled in a study on mammograms.
Over 19 years of follow-up, nearly 12,000 women died -- almost 4,000 dying from cardiovascular disease, about 1,900 from heart disease and 1,100 from stroke, the researchers found.
The highest rates of death were seen among women whose calcium intake was higher than 1,400 milligrams a day, the researchers noted. On the other hand, women who took less than 600 milligrams of calcium a day were also at an increased risk of death.
Moreover, women taking 1,400 milligrams of calcium a day and also using a supplement had even a higher risk of dying than women not using supplements, Michaelssons group found.
All in all, women getting more than 1,400 milligrams of calcium a day were more than twice as likely to die than women getting 600 to 999 milligrams a day, the researchers said.
The U.S. Office of Dietary Supplements recommends 1,000 to 1,200 milligrams of calcium a day for most adults.
According to the study authors, diets very low or very high in calcium can override normal control by the body, causing changes in blood levels of calcium.
Rather than worry about increasing calcium intake of those getting enough through their diet, emphasis should be placed on people with a low intake of calcium, the authors suggest.
Taylor Wallace, a representative of the supplement industry, faults this study because, he said, it was not specifically meant to address calcium supplements and heart disease.
"We are comparing apples and oranges," said Wallace, who is senior director for Scientific & Regulatory Affairs at the Council for Responsible Nutrition. He noted that in the new study, the data that researchers used to draw their conclusions looked at diet and cancer, not whether calcium supplements were bad for the heart.
"Still, there is not a single human cause-and-effect study that demonstrates a hazard for calcium either from the diet or supplements and cardiovascular disease," he said.
Although the new study tied total calcium intake to increased risk of death from heart disease in women, it didnt establish a cause-and-effect relationship.
Wallace did say its important to know how much calcium a person is getting from diet and supplements. "It is important to talk with your doctor to make sure you are getting the right amount for you," he said.
For his part, heart association spokesman Fonarow said: "While further studies are needed, calcium supplements should be used only after caul consideration of whether the potential benefits in terms of bone health outweigh the potential cardiovascular risks."
CALCIUM SUPPLEMENTS REMAIN A VALUABLE TOOL FOR MAINTAINING BONE HEALTH
Thursday, January 16, 2014
Individuals who do not obtain recommended intake levels of calcium through dietary sources can safely utilize calcium supplements to achieve optimal bone health, an expert panel concludes. These findings appear in the November online edition of Advances in Nutrition, a journal that highlights the significance of recent research in nutrition and illustrates the central role of nutrition in the promotion of health and prevention of disease.
Responding to questions raised last year about a possible link between calcium supplements and a potential increased risk of cardiovascular disease, an expert panel composed of academic and industry experts in the fields of nutrition, cardiology, epidemiology, bone health, and integrative medicine convened on Nov. 10 and 11, 2011 in Washington, D.C.
The panel collected and examined the available body of scientific literature, including randomized controlled trials (RCTs) and observational data, assessing whether long-term use of calcium supplements could promote the occurrence of strokes, coronary heart disease, heart attacks and other forms of cardiovascular disease, and cross-referenced these findings with four of the Bradford-Hill criteria for causal interference: strength, consistency, dose-response and biological plausibility. The panel concluded that the available science does not suggest an increased risk for cardiovascular disease from calcium supplement use.
“There is a strong body of evidence from a variety of rigorous scientific studies reinforcing the benefits of calcium in promoting bone growth and maintenance. After reviewing the entire scope of scientific literature for calcium, we are now more confident than ever in both its health benefits and safety,” said panelist Robert P. Heaney, M.D., Osteoporosis Research Center, Creighton University Medical Center. “Consumers can feel confident about the safety of their calcium supplements and should continue taking them with confidence. They should, however, be aware of how much calcium their diets provide, and then supplement accordingly.”
In addition to Dr. Heaney, panel experts included: Stephen Kopecky, M.D., Division of Cardiovascular Diseases, Mayo Clinic; Kevin Maki, Ph.D., Provident-Biofortis; John Hathcock, Ph.D., former senior vice president, scientific and international affairs, Council for Responsible Nutrition (CRN); Douglas MacKay, N.D., vice president, scientific and regulatory affairs, CRN; and Taylor Wallace, Ph.D., senior director, scientific and regulatory affairs, CRN.
The CRN Foundation, the educational non-profit affiliate for CRN, the dietary supplement industry’s leading trade association, commissioned the panel after results from a meta-analysis of RCTs, and reanalysis of the Women’s Health Initiative by researchers at a New Zealand laboratory, prompted concern about a potential association between calcium supplement use and a small increase in risk for adverse cardiovascular events. However, a number of issues with the meta-analysis and accompanying studies—such as exclusion of the majority of RCTs which indicate calcium has no effect on the cardiovascular system; large reliance on unpublished data; failure to appropriately ascertain cardiovascular events; and a lack of information on known cardiovascular risk determinants—warranted a complete examination of the scientific literature. The CRN Foundation assembled the expert panel to study the findings of this analysis in context with the larger body of scientific research on calcium.
“In light of our safety findings combined with the well-documented benefits of calcium, we urge physicians to continue recommending calcium supplements to their patients as appropriate, as our review of the scientific literature further reinforces the valuable role of calcium in helping consumers maintain bone health,” said the Mayo Clinic’s Dr. Kopecky. “Building and maintaining calcium is vital for all age groups—young children to adolescents to adults and the elderly must obtain adequate amounts of calcium, either through diet or supplementation. For those who are unsure if they need to supplement their diets with additional calcium, make sure to discuss your current nutritional picture with your physician.”
Supporting the expert panel’s conclusion is the recent “Framingham Study,” published online in the Nov. 7 American Journal of Clinical Nutrition by Elizabeth Samelson, Ph.D., et al., which also looked at the association of calcium and coronary artery calcification and found that “…calcium intake from diet and supplements appeared to neither increase nor decrease vascular calcification, which is a measure of cardiovascular risk…The use of calcium supplements is important for many older adults to ensure adequate intake for bone health.”1
The Institute of Medicine currently suggests women ages 19 through 50 and men up to 71 obtain a Recommended Dietary Allowance (RDA) of 1,000 milligrams calcium daily; women over 50 and men 71 and older should obtain 1,200 milligrams daily to ensure they are meeting their daily needs for strong, healthy bones. Calcium is popular among U.S. consumers, and according to CRN’s most recent survey of U.S. adults, 17 percent indicate they take a calcium supplement.
