[PHNUTR-L] Calcium supplements may prevent fractures in elderly women who take them regularly

[Kathrynne Holden, MS, RD]

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Public release date: 24-Apr-2006
http://www.eurekalert.org/pub_releases/2006-04/jaaj-csm042106.php

Contact: Richard L. Prince, M.D.
rlprince at cyllene.uwa.edu.au
JAMA and Archives Journals

Calcium supplements may prevent fractures in elderly women who take them 
regularly

Calcium supplements may be an ineffective way of preventing bone 
fractures among the population of elderly women because of poor 
long-term compliance with the therapy, but appear to be effective for 
women who take the supplements regularly, according to a study in the 
April 24 issue of Archives of Internal Medicine, one of the 
JAMA/Archives journals.

Menopause reduces women's levels of the hormone estrogen, and these 
lowered levels can contribute to calcium deficiencies, according to 
background information in the article. Calcium supplements can be used 
to correct this imbalance, but it is not known if these supplements can 
prevent fractures in bones weakened by the loss of calcium, a condition 
known as osteoporosis.

Richard L. Prince, M.D., University of Western Australia, Western 
Australian Institute of Medical Research and Sir Charles Gairdner 
Hospital, Devine, and colleagues studied the effect of calcium 
supplementation on 1,460 women older than age 70 years. Half of the 
patients were randomly assigned to take 600-milligram calcium carbonate 
tablets twice per day and the other half took identical placebo tablets. 
X-rays, bone ultrasounds and bone scans were performed at the beginning 
of the study and after five years, and adverse events that required a 
visit to a health care provider were recorded at four-month intervals. 
Participants returned their unused pills at the end of each year-long 
period and those who took fewer than 80 percent were classified as 
noncompliant.

After five years, 236 (16.2 percent) participants sustained one or more 
osteoporotic fractures. Overall, women who were assigned to the calcium 
group had the same risk of fracture as those in the placebo group, 
indicating that calcium supplementation did not reduce the risk of 
fracture in the entire study population. However, among the 830 women 
(56.8 percent of the entire study group)--310 in the calcium group and 
320 in the placebo group--who took 80 percent or more of their pills and 
were classified as compliant, those in the calcium group were less 
likely to develop fractures than those in the placebo group (10.2 
percent vs. 15.4 percent). Calcium treatment also improved results on 
several of the bone tests. Constipation was the only adverse effect that 
was more common in women taking calcium than in those taking placebo, 
but there was no difference in the percentage of women who stopped 
taking pills because of constipation.

Calcium supplements appeared to be ineffective at reducing fractures 
because so many patients were noncompliant, the authors write. In 
patients who were compliant, there was no difference in the amount of 
calcium they consumed through their regular diet, suggesting that 1.2 
grams of calcium per day is enough to help protect women's bones. "In 
conclusion, the calcium supplementation regimen tested currently cannot 
be recommended as a public health approach to fracture prevention 
because of the lack of long-term compliance," the authors write. 
"However, these data supported the continued use of calcium supplements 
by women who are able to remain compliant with their use. In these 
individuals, especially if they are under the care of a clinician, 
calcium supplementation is a safe and effective therapy for reducing the 
risk of osteoporitic fracture."

###

(Arch Intern Med. 2006; 166: 869-875. Available pre-embargo to media at 
www.jamamedia.org.)

Editor's Note: This study was supported by a grant from the Healthway 
Health Promotion Foundation of Western Australia and by a project grant 
from the National Health and Medical Research Council of Australia.
-- 
Kathrynne Holden, MS, RD < fivestar at nutritionucanlivewith.com >
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