Calcium and/or Vitamin D Supplementation for the Prevention of Fragility Fractures: Who Needs It?

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dc.contributor.author Reid, Ian en
dc.contributor.author Bolland, Mark en
dc.date.accessioned 2020-06-12T04:23:28Z en
dc.date.issued 2020-04-07 en
dc.identifier.citation Nutrients 12(4) 07 Apr 2020 en
dc.identifier.issn 2072-6643 en
dc.identifier.uri http://hdl.handle.net/2292/51523 en
dc.description.abstract Vitamin D and calcium have different biological functions, so the need for supplementation, and its safety and efficacy, need to be evaluated for each separately. Vitamin D deficiency is usually the result of low sunlight exposure (e.g., in frail older people, those who are veiled, those with dark-skin living at higher latitudes) and is reversible with calciferol 400-800 IU/day. Calcium supplements produce a 1% increase in bone density in the first year of use, without further increases subsequently. Vitamin D supplements do not improve bone density in clinical trials except in analyses of subgroups with baseline levels of 25-hydroxyvitamin D <30 nmol/L. Supplementation with calcium, vitamin D, or their combination does not prevent fractures in community-dwelling adults, but a large study in vitamin D-deficient nursing home residents did demonstrate fracture prevention. When treating osteoporosis, co-administration of calcium with anti-resorptive drugs has not been shown to impact on treatment efficacy. Correction of severe vitamin D deficiency (<25 nmol/L) is necessary before use of potent anti-resorptive drugs to avoid hypocalcemia. Calcium supplements cause gastrointestinal side effects, particularly constipation, and increase the risk of kidney stones and, probably, heart attacks by about 20%. Low-dose vitamin D is safe, but doses >4000 IU/day have been associated with more falls and fractures. Current evidence does not support use of either calcium or vitamin D supplements in healthy community-dwelling adults. en
dc.format.medium Electronic en
dc.language eng en
dc.relation.ispartofseries Nutrients en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.title Calcium and/or Vitamin D Supplementation for the Prevention of Fragility Fractures: Who Needs It? en
dc.type Journal Article en
dc.identifier.doi 10.3390/nu12041011 en
pubs.issue 4 en
pubs.volume 12 en
dc.rights.holder Copyright: The authors en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/OpenAccess en
pubs.subtype review-article en
pubs.subtype Review en
pubs.subtype Journal Article en
pubs.elements-id 799073 en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Medicine Department en
pubs.org-id Science en
pubs.org-id Science Research en
pubs.org-id Maurice Wilkins Centre (2010-2014) en
dc.identifier.eissn 2072-6643 en
pubs.record-created-at-source-date 2020-04-11 en
pubs.dimensions-id 32272593 en


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