Who Should Receive Calcium and Vitamin D Supplementation?
Who Should Receive Calcium and Vitamin D Supplementation?
Numerous trials have convincingly shown that an inadequate intake of calcium and vitamin D is an important risk factor for the development of osteoporosis and osteoporotic fractures. Vitamin D deficiency is common in older people, and together with a poor dietary calcium intake leads to negative calcium balance, which in turn contributes to age-associated secondary hyperparathyroidism. As this is key in the pathogenesis of osteoporosis, calcium and vitamin D supplementation is generally recommended as the baseline therapy, as this has been shown to enhance bone mineral density and reduce fracture risk in both men and women, although the benefit may be reduced by poor compliance. Vitamin D supplementation may also reduce the risk of falling, but only in a dose of at least 700 IU per day. Trials that assessed the effect of calcium or vitamin D alone have failed to show a reduction in fracture risk. This is not surprising because the negative calcium balance in older people is often the result of low calcium intake and vitamin D deficiency. Supplementation therefore typically consists of combined supplementation with 1,000–1,200 mg calcium and 800 IU vitamin D.
Importantly, the inhibitory effects of calcium and vitamin D on bone resorption are short–lived and cease when supplementation is discontinued. Therefore, continued compliance and persistence with supplementation are essential to obtain therapeutic benefit.
Calcium and Vitamin D Supplements in the Prevention of Osteoporosis and Osteoporotic Fractures
Numerous trials have convincingly shown that an inadequate intake of calcium and vitamin D is an important risk factor for the development of osteoporosis and osteoporotic fractures. Vitamin D deficiency is common in older people, and together with a poor dietary calcium intake leads to negative calcium balance, which in turn contributes to age-associated secondary hyperparathyroidism. As this is key in the pathogenesis of osteoporosis, calcium and vitamin D supplementation is generally recommended as the baseline therapy, as this has been shown to enhance bone mineral density and reduce fracture risk in both men and women, although the benefit may be reduced by poor compliance. Vitamin D supplementation may also reduce the risk of falling, but only in a dose of at least 700 IU per day. Trials that assessed the effect of calcium or vitamin D alone have failed to show a reduction in fracture risk. This is not surprising because the negative calcium balance in older people is often the result of low calcium intake and vitamin D deficiency. Supplementation therefore typically consists of combined supplementation with 1,000–1,200 mg calcium and 800 IU vitamin D.
Importantly, the inhibitory effects of calcium and vitamin D on bone resorption are short–lived and cease when supplementation is discontinued. Therefore, continued compliance and persistence with supplementation are essential to obtain therapeutic benefit.
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