Calcium plus vit D effective for bone density boost: Study

Combined supplements of vitamin D and calcium are effective for increasing the bone mineral density of post-menopausal women, even when calcium intakes are adequate, says a new study from Finland.

The bone mineral density (BMD) of post-menopausal women increased significantly more when they received daily doses of 800 International Units of vitamin D (cholocalciferol) and 1,000 milligrams of calcium for three years, compared with women who received no intervention.

Moreover, results from the Osteoporosis Risk Factor and Prevention-Fracture Prevention Study (OSTPRE-FPS) indicated that women who complied the best with the supplementation protocol, taking at least 80 percent of the supplements, experienced the greatest benefits.

Researchers from the University of Kuopio report their findings in the journal Osteoporosis International.

Study details

OSTPRE-FPS was a randomized population-based open trial involving 3,432 women aged between 66 and 71. A sub-set of 593 women were randomly selected for BMD measurements, with half of the women receiving the daily vitamin D plus calcium supplements, while the other group received nothing.

After three years of study, the researchers report that the total body BMD increased by 0.84 percent in the intervention group, compared with 0.19 percent increase in the control group.

However, no significant differences were observed in the BMD change at the lumbar spine, femoral neck, trochanter, and total proximal femur, said the Finnish researchers.

“Daily vitamin D and calcium supplementation have a positive effect on the skeleton in ambulatory postmenopausal women with adequate nutritional calcium intake,” concluded the researchers.

History of use

The combination of vitamin D and calcium has long been recommended to reduce the risk of bone fracture for older people, particularly those at risk of or suffering from osteoporosis, which is estimated to affect about 75m people in Europe, USA and Japan.

The action of the nutrients is complimentary, with calcium supporting bone formation and repair, while vitamin D helps the body absorb calcium.

Indeed, the European Food Safety Authority (EFSA) accepted a health claim linking calcium and vitamin D to bone health in older women in 2008 following a disease-reduction claim application, made under article 14 of the European Union’s nutrition and health claims regulation and submitted by Abtei Pharma Vertriebs, a GlaxoSmithKline company.

The dossier claimed that chewing tablets with calcium and vitamin D improves bone density in women over the age of 50, and may reduce the risk of osteoporotic fractures and hip fractures. The proposed dosages were 1000mg calcium and 800 IU vitamin D3.

Daily supplements which combine vitamin D and calcium may reduce the risk of fractures for everyone, regardless of age or gender, say the results of a huge study.

Indeed, a pooled analysis published in the British Medical Journal (2010; 340: b5463 Published online, doi:10.1136/bmj.b5463) with almost 70,000 people from the US and Europe found that the vitamin-mineral combination significantly reduced fractures by 8 per cent, and hip fractures by 16 per cent.

However, supplemental vitamin D on its own in daily doses equivalent to 10 to 20 micrograms had no effects on fracture prevention, said the study, led by researchers at Copenhagen University in Denmark.

Contradictory results

However, earlier results from OSTPRE-FPS do not back up the link with a lower risk of fractures, according to findings published in the Journal of Bone and Mineral Research (doi: 10.1002/jbmr.48), which found that the risk of all fractures, fractures to the forearm, and fracture to any upper extremity reductions were reduced by 17, 30, and 25 per cent, respectively. However, none of these were statistically significant, added the Finnish researchers.

Source: Osteoporosis International

2010, Volume 21, Issue 12, Pages 2047-2055

“Effect of calcium and vitamin D supplementation on bone mineral density in women aged 65-71 years: a 3-year randomized population-based trial (OSTPRE-FPS)”

Authors: M. Karkkainen, M. Tuppurainen, K. Salovaara, L. Sandini, T. Rikkonen, J. Sirola, R. Honkanen, J. Jurvelin, E. Alhava, H. Kroger