Calcium, vitamin D and involutional osteoporosis.

Area of Science:

• Gerontology
• Nutritional Science
• Bone Health

Background:

• Previous research indicated combined calcium and vitamin D supplementation may reduce fracture risk in older adults, especially those in care homes.
• Trials on vitamin D alone for fracture prevention have yielded inconsistent findings.
• Adequate dietary calcium intake and vitamin D sufficiency levels in adults remain debated.

Purpose of the Study:

• To review the physiological roles of calcium and vitamin D.
• To examine differing perspectives on adequate calcium and vitamin D intake.
• To highlight findings from recent large-scale calcium and vitamin D supplementation studies.

Main Methods:

• Review of recent large-scale studies on calcium and vitamin D supplementation.
• Analysis of physiological functions of calcium and vitamin D.
• Examination of contrasting views on dietary calcium and vitamin D sufficiency.

Main Results:

• The RECORD study found calcium (1000 mg/day) and vitamin D (800 IU/day) ineffective for secondary fracture prevention in community-dwelling older adults.
• The Northern and Yorkshire Study indicated no benefit of calcium and vitamin D for primary fracture prevention in community-dwelling older women.
• The Wessex study showed no fracture reduction in community-dwelling older adults receiving annual vitamin D injections (300,000 IU).

Conclusions:

• Recent studies suggest vitamin D, with or without calcium, is ineffective for primary or secondary fracture prevention in community-dwelling older adults.
• Calcium and vitamin D supplementation effectively prevents fractures in institutionalized elderly individuals.
• Institutionalized elderly often experience vitamin D deficiency and secondary hyperparathyroidism, benefiting from supplementation.