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Use of calcium or calcuim in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis

Tang, Benjamin M.P., Eslick, Guy D., Nowson, Caryl, Smith, Caroline and Bensoussan, Alan 2007, Use of calcium or calcuim in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis, Lancet, vol. 370, no. 9588, pp. 657-666.


Title Use of calcium or calcuim in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis
Author(s) Tang, Benjamin M.P.
Eslick, Guy D.
Nowson, Caryl
Smith, Caroline
Bensoussan, Alan
Journal name Lancet
Volume number 370
Issue number 9588
Start page 657
End page 666
Publisher Elsevier Ltd
Place of publication London, England
Publication date 2007-08
ISSN 0140-6736
Summary Background:  Whether calcium supplementation can reduce osteoporotic fractures is uncertain. We did a meta-analysis to include all the randomised trials in which calcium, or calcium in combination with vitamin D, was used to prevent fracture and osteoporotic bone loss.

Methods:  We identified 29 randomised trials (n=63 897) using electronic databases, supplemented by a hand-search of reference lists, review articles, and conference abstracts. All randomised trials that recruited people aged 50 years or older were eligible. The main outcomes were fractures of all types and percentage change of bone-mineral density from baseline. Data were pooled by use of a random-effect model.

Findings:  In trials that reported fracture as an outcome (17 trials, n=52 625), treatment was associated with a 12% risk reduction in fractures of all types (risk ratio 0·88, 95% CI 0·83–0·95; p=0·0004). In trials that reported bone-mineral density as an outcome (23 trials, n=41 419), the treatment was associated with a reduced rate of bone loss of 0·54% (0·35–0·73; p<0·0001) at the hip and 1·19% (0·76–1·61%; p<0·0001) in the spine. The fracture risk reduction was significantly greater (24%) in trials in which the compliance rate was high (p<0·0001). The treatment effect was better with calcium doses of 1200 mg or more than with doses less than 1200 mg (0·80 vs 0·94; p=0·006), and with vitamin D doses of 800 IU or more than with doses less than 800 IU (0·84 vs 0·87; p=0·03).

Interpretation:  Evidence supports the use of calcium, or calcium in combination with vitamin D supplementation, in the preventive treatment of osteoporosis in people aged 50 years or older. For best therapeutic effect, we recommend minimum doses of 1200 mg of calcium, and 800 IU of vitamin D (for combined calcium plus vitamin D supplementation).
Language eng
Field of Research 111199 Nutrition and Dietetics not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2007, Elsevier Ltd
Persistent URL http://hdl.handle.net/10536/DRO/DU:30007602

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Created: Mon, 29 Sep 2008, 08:54:00 EST