Despite what doctors have long recommended, regularly
taking calcium and vitamin D does not prevent fractures
in older people who have broken a bone or who have
osteoporosis, according to two large studies released.
People with osteoporosis are often encouraged to
consume as much calcium and vitamin D as possible
to strengthen their bones and to lower the likelihood
of injuries.
But the new studies, involving thousands of elderly
people in Britain who had symptoms of the disease,
found that those who took calcium and vitamin D tablets
were just as likely to break a bone as those who took
neither.
The authors of the reports, published in The Lancet
and the British medical journal BMJ, said their findings
suggested that for people with brittle bones, relying
solely on the supplements might not be enough.
"Our trial indicates that routine supplementation
with calcium and vitamin D3, either alone or in combination,
is not effective in the prevention of further fractures
in people who have had a recent low-trauma fracture,"
the authors of the Lancet study wrote.
Other experts called the findings important but cautioned
that they did not apply to most people.
Just people older than 70, a majority of them women
with previous bone injuries, were included in the
studies.
Because vitamin D and calcium are widely considered
early preventive measures, it is no surprise that
the studies failed to find them effective in people
who already had osteoporosis or signs of it, said
Dr. Steven R. Goldstein, a professor of obstetrics
and gynecology at the New York University medical
center.
"This is something we've known for a long time, that
calcium and vitamin D alone are not enough to treat
osteoporosis," Dr. Goldstein said. "Once you've developed
frank osteoporosis and a bone fracture, you're going
to need medication, not simply vitamin D and calcium
to prevent fractures."
Osteoporosis causes bones to become thinner and occurs
primarily in the elderly.
About 10 million Americans older than 50 develop
the disease each year, and 1.5 million break bones
because of it. Osteoporosis can be treated with drugs
like biphosphonates that prevent the bones from deteriorating,
but doctors often recommend taking supplements or
eating foods rich in calcium and vitamin D to build
up bone mass.
The largest of the two studies, in The Lancet, followed
more than 5,o00 Scots who had broken bones in the
last decade. Separated in four groups, the subjects
received large doses of calcium, vitamin D, a combination
of the two or a placebo. After several years, the
researchers found that all four groups had roughly
the same number of fractures, mostly to the hip.
Dr. Joan McGowan, an expert on osteoporosis at the
National Institutes of Health, said it was surprising
that there were not fewer fractures among the people
who took the calcium and vitamin D, but that neither
was seen a replacement for medication." Nobody thinks
calcium and vitamin D are as potent as some of the
other bone-active drugs that we have available," Dr.
McGowan said.