By Andrew M. Seaman
NEW YORK (Reuters Health) - Older women shouldn't take vitamin D and calcium supplements to prevent broken bones, and there's not enough evidence to say whether it would help anyone else either, says a U.S. government-backed panel.
Based on two reviews of past research, the U.S. Preventive Services Task Force waded into the debate over the two vitamins that are thought to strengthen bones to prevent against breaks.
"Calcium and vitamin D are important in general health and bone health. For this recommendation, we review data on whether supplements of vitamin D and calcium can prevent fractures in addition to dietary intake," said Dr. Jessica Herzstein, a member of the Task Force.
Approximately 1.5 million Americans suffer from breaks that are tied to brittle bones each year. And about half of all women over 50 years old will end up with a break that's linked to the bone-weakening disease osteoporosis.
That's a major concern, according to the Task Force, because broken bones are linked to chronic pain, disability and increased risk of sickness and early death.
Based on the reviews, the panel found there were no benefits but some risk for post-menopausal women taking low-dose vitamin D and calcium supplements - below 400 international units and 1,000 milligrams, respectively.
Specifically, taking low-dose supplements didn't change the older women's risk for broken bones, but was tied to a small increase in the risk of kidney stones (see Reuters Health article of June 12, 2012 here: http://reut.rs/W760bF
They also found that there is not enough evidence to suggest higher doses of the vitamins would be effective or safer in older women, or that taking any dose of the supplements would help men or younger women.
For men and younger women, "We're not saying don't take it, we're just saying we don't know enough right now," said Herzstein, who is in charge of employee health at Air Products in Allentown, Pennsylvania.
She added that these recommendations do not apply to people who already have a diagnosis of osteoporosis, a history of fractures or are living in an assisted-living community.
TALK WITH YOUR DOCTOR
Herzstein said it's important for people to talk with their doctors about the supplements.
Cara Welch, senior vice president of scientific and regulatory affairs for the Natural Product Association in Washington, D.C., told Reuters Health she agreed that people should talk to their doctors, but said the group disagrees with the new recommendation.
"We believe this recommendation is out of step with current research, and it really should not affect consumers who are trying to supplement their calcium and vitamin D intake with supplements," Welch said.
According to the most recent data from a national survey of Americans, 56 percent of women over 60 years old take vitamin D supplements, and 60 percent take calcium supplements.
The two vitamins are often sold together and are relatively inexpensive.
The Task Force already recommends women older than 65 years old be screened for the bone-weakening disease osteoporosis, and younger women who have a higher risk of broken bones.
The panel also recommends senior citizens with a history of falls and vitamin D deficiency take supplements to help strengthen muscles and help with balance (see Reuters Health article of May 30, 2012 here: http://reut.rs/V1ARom
Vitamin D has also been researched as a preventive measure against dementia, heart disease and cancer, but with mixed results. Herzstein said the panel will soon be issuing recommendations about the vitamin for some of those diseases.
Marion Nestle, a nutrition researcher from New York University who coauthored a commentary published alongside the recommendations in the Annals of Internal Medicine, said that good studies on vitamin D are hard to do, and any end to the debate over whether to take supplements or not is a long way off.
"These studies are so difficult to do and to interpret that scientific consensus seems impossible to achieve, especially in situations where entire organizations are devoted to convincing people to take high-dose vitamin D," she wrote in an email to Reuters Health.
SOURCE: http://bit.ly/Ms1ZbQ Annals of Internal Medicine, online February 25, 2013.