Study spanned 19 years for less calcium supplement

Good study shows too much calcium can increase risk but the right amount will help. This is impt for some who believe supplements are the answer to all bone problems.

The study that was just published in the British Medical Journal looked at the relationship between calcium intake and risk for fractures and overall bone health. This was a very large study: more than 61,000 women, followed for 19 years overall, had a total of more than 14,000 incident fractures and more than 3800 incident hip fractures. Specifically, the fractures were identified through a registry, so concern about reporting bias or recall bias was minimal. This study suggests that it's only the women who had the lowest intake of calcium, below about 750 mg a day, who had an increased risk for fracture, and then with increasing intake of calcium, evidence of further benefit for bone health and fracture reduction was very limited. A threshold factor or plateauing of benefit was suggested.

The women who had the highest intake of calcium (above 1100 mg a day) actually had a hint of increased risk for hip fracture. The bottom line of this study was that more moderate levels of calcium intake were best for bone health and that more was not better. We should be recommending more moderate intakes of calcium for our patients and not above the RDA of 1000-1200 mg a day total. Assuming that many women will get about 700 mg a day from dietary sources alone, many women may require no more than an additional 500-600 mg a day from calcium supplements. In contrast, many women are taking a very high dose of calcium, often 1200-1500 mg a day just from the supplements alone, and this could lead to very high total intake.

On the basis of the recent study in the British Medical Journal, as well as the overall totality of evidence, it seems that even for bone health, calcium in moderation is probably best. We may want to recommend that women try to get as much of their calcium as possible from dietary sources. Some of the best dietary sources are low-fat dairy products and leafy greens, fortified foods such as fortified fruit juices and cereals, and types of fish that have bones in them, such as sardines and canned salmon. It's probably best, wherever possible, to read the food labels that will help you understand the amount of calcium that's in the different food products and to recommend reading labels to our patients.

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Thanks Chalk, I found this helpful.

When I was taking prescription Ca-D3 as instructed by my doctor, I found that my total Ca intake was sometimes over 2000 mg per day, so I started cutting down on the tablets and aiming for about 1200 mg of Ca, without knowing whether this was a wise thing to do or not. After reading this article, this level appears to be OK. The only thing is, does OP treatment increase bone turnover (I am on strontium ranelate) if so, would a higher intake would be more appropriate? I also take D3, Mg and K2 to try to safely optimise Ca uptake.

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It appears here to be the case for those eating ordinary diets that lower levels of Calcium are good and can be especially so if Vitamin D3 levels are high as suggested by some clinics. This finding is already practiced in some clinics that accept a lower intake of calcium, under 1000 mg or even lower, with 60 ng/ml to 80 ng/ml blood levels of Vitamin D. The problem here is that these research results are only marginally instructive to those with bone loss and the big story is how research disproves the common existing medical advice of giving large calcium doses alone to counteract bone loss.

Since there are multiple nutritional factors that affect bone loss and good science seeks accuracy by controlling all the factors affecting the results, I look with wonder at research tests that try to measure just calcium intake and pretend to arrive at a conclusion. These results are valid if you take only a calcium supplement, but if you start to take generous extra Vitamin D or magnsium, this research is not reporting on that outcome since they didn't control for and measure those supplements.

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61000 women over 19 year period-- seems the study tried to do some of what you require in examining fractures. This is quite a study but ofcourse everyone knows someone who ate gobs of calcium and never fractured. We can only generalize information and then apply it how we wish. I think if you read the whole study, you might draw different conclusions. Too much calcium has had other detrimental effects on other organs as well. Again, some people smoke cigarettes until they die at age 99. It doesnt mean cigarettes arent harmful. some people are lucky.

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The fly in the ointment is always the "luck" factor. My bigger concern with the calcium supplements is the plaque buildup in arteries and soft tissue. Are we substituting heart problems and stroke in exchange for possible bone building? It seems like medical studies are like political statements. The facts and figures can be skewed to provide whatever message the giver wants to convey. Sound cynical? Yes, I am.
I've read so many stories here of people who've done it ALL right their whole lives and end up with serious OP and fractures. I'm wondering if heredity isn't the most important factor in all of this. And, the results cited for SOME with drugs, SOME with their self tailored combos of vitamins and supplements, and the controversial DEXA scans as the indicator of brittle bones, are so varied and individual.
Then there are the hidden agendas in some studies to promote certain drugs, etc..
And, as noted, each study concentrates on one aspect of a picture. Like looking at one piece of a jigsaw puzzle and trying to see the finished work.
Of the people responding so far, which of you has had a significantly improved bone density test after a year or two of whatever regimen you are on? Even that doesn't guarantee it will work for another. But, I understand the need to TRY to do something or anything to stop the process. We all like to feel we have some control over our health. And, obviously, eating better diets, exercising, avoiding stress, good sleep habits, etc., are not likely to have adverse effects. So, better to try than not to do anything.
Personally, I'm beginning to feel that various disorders in our bodies are all connected and may be the reason why we each vary so much. We don't all have the same set of ancillary problems going on.
I guess I fear the plaque more than I have confidence in the calcium supplements. I try to get enough calcium from my eating. Not always so easy to do. I have a poor appetite and trying to get enough food in me to maintain weight is hard in itself.
Oh, and then there are those of us who take Proton Pump Inhibitors, that supposedly destroy bones too. The alternative, to be sick at the stomach and vomiting if we don't take it.

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