Older Women Should Not Take Calcium, Vitamin D: Task Force

TUESDAY, June 12 (HealthDay News) — A leading U.S. government
advisory panel has proposed that postmenopausal women not take
low-dose calcium and vitamin D supplements daily to ward off bone
fractures.

But the jury is still out on higher doses of these supplements, stated
the U.S. Preventive Services Task Force (USPSTF), which issued the draft
recommendations Tuesday. Public comment on the draft recommendations is
invited until July 10.

The news was a bit of a bombshell, given that women have been told for
so long to take calcium and vitamin D, said Dr. Suzanne Steinbaum,
director of women and heart disease at Lenox Hill Hospital in New York
City and a spokeswoman for the American Heart Association. “What we’re
really seeing is no role for calcium for the prevention of osteoporotic
fractures. At this point, there’s no reason to be taking calcium,” she
noted.

But, the issue of which women should take which supplements is a
complicated one and these preliminary recommendations are unlikely to
change practice immediately, said Dr. Shiri Levy, service chief of
endocrinology at West Bloomfield Henry Ford Hospital in Michigan, who
already tells her patients to get calcium from food sources as much as
possible.

“Taking calcium naturally in the diet is probably the best way for
patients who don’t have lactose intolerance and can drink milk and eat
dairy products,” she said. “For those not able to take dairy products
regularly, then we would supplement to the degree that we can. I would
individualize it for patients.”

And, Levy pointed out, data from the landmark Women’s Health Initiative
study did indicate that women on supplements showed a decreased risk for
fractures.

As Steinbaum noted, millions of women take vitamin D supplements with
or without calcium in the hopes of diminishing the risk of fractures as
they age.

According to previous research, half of postmenopausal women will
suffer such a fracture in their postmenopausal years.

The USPSTF said there was no evidence to support using the low-dose
supplements — defined as 400 IU of vitamin D with 1,000 milligrams of
calcium carbonate — as protection against fractures.

There was “inadequate evidence” as to how higher doses — meaning more
than 400 IU of vitamin D paired with 1,000 milligrams of calcium — might
affect bone fracture risk, the task force noted.

And it’s not clear at this point if vitamin D/calcium supplementation
could help fight cancer and fractures in men and younger women, the
recommendations added.

There can be a downside to taking such daily supplements, given that
there may be a slightly heightened risk of kidney stones, the USPSTF
stated.

Both supplements have garnered plenty of evidence for and against their
use.

For instance, vitamin D might lower the risk of colorectal and other
forms of cancer, according to some studies, while calcium recently has
been linked to an increased risk of heart attacks.

The USPSTF recommendations say that vitamin D could still be useful in
preventing falls in people aged 65 or older who are already at increased
risk for falling.

Women at average risk for osteoporosis should have a baseline bone
density scan at age 65, Levy said.

Women who have risk factors for the condition such as celiac disease, a
family history of osteoporosis or premature menopause should have a
baseline bone density test taken earlier, when they go through menopause,
she added.

“If there is an increased risk, we do recommend a healthy lifestyle,
appropriate diet including foods rich in calcium and vitamin D and
weight-bearing exercise,” Levy said.

In addition to natural food sources, many foods are now fortified with
vitamin D and calcium.

More information

The draft recommendations can be viewed at the USPSTF website.

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