Calcium, Vitamin D, and Osteoporosis: Futility or Prevention?

Food Centered Solutions

Nutrition Counseling

Calcium, Vitamin D, and Osteoporosis: Futility or Prevention?

Many peri, menopausal, and post-menopausal women routinely take either calcium supplements or a combined calcium/vitamin D supplement in hopes of slowing bone loss and staving off osteoporosis.

Furthermore, the medical community routinely advises patients to consume the RDA of calcium and vitamin D. For women aged 19-50 years the RDA for calcium and vitamin D is 1000 mg/day and 600 IU/day respectively. For women aged 51-70 years, the RDA for calcium increases to 1200 mg/day while the recommendation for vitamin D remains the same.1

To meet these calcium needs, a woman needs to consume about 4 8-ounce glasses of milk per day. This amount of milk would supply close to 450 IUs of vitamin D as well. Due to dietary constraints such as lactose intolerance, dairy allergy, dietary preference (such as following a vegan diet) and the relative dietary availability of these nutrients, most people choose to take calcium and vitamin D supplements to meet their needs.1

So how effective are these supplements in reducing the incidence of fractures?

A recent meta-analysis that reviewed 33 randomized trails with at total of 51,145 participants found that neither calcium, vitamin D, or a combined supplement reduced the incidence of hip fractures in healthy older adults aged 50 years or older.2

Furthermore, the recommendation statement from the US Preventive Task Force concluded that “Daily supplementation with 400 IU or less of vitamin D and 1000 mg or less of Calcium had no benefit for the primary prevention of fractures in community dwelling post-menopausal women.” Dosages of these nutrients at greater amounts also failed to show any benefits and may even increase the risk of kidney stones.3,4 They went on to say that "These findings do not support the routine use of these supplements in community-dwelling older adults."3,4 Additionally, these recommendations do not apply to individuals diagnosed with osteopenia, osteoporosis, increased risk of falls, fractures, or a vitamin D deficiency.

With calcium and vitamin D supplements now considered ineffective in preventing fractures, what are some of the preventative steps that women can take to decrease their risk of bone fractures and osteoporosis?

Frances Siver, the dietitian at Food Centered Solutions has the following recommendations:

1. Reduce dietary sodium intake to less than 2,300 mg/day. That’s less than one teaspoon of salt per day. High levels of sodium promote calcium loss.
2. Reduce dietary phosphorus. Drink water or naturally flavored water instead of sodas. High levels of phosphoric acid promote calcium loss.
3. Eliminate or restrict caffeine intake to one 8-ounce cup per day. Caffeine promotes calcium loss.
4. Increase fruits and vegetables. This will promote an alkaline environment and conserve calcium.
5. Avoid refined sugar. Sugar feeds acid producing bacteria and may promote calcium loss.
6. Incorporate regular weight bearing exercise and resistance training into your daily routine.
7. With diagnosed osteopenia, osteoporosis, vitamin D deficiency, fractures or falls, calcium and vitamin D supplementation may be necessary. Consult your physician.
8. If appropriate, consider bio-identical hormone replacement therapy. The bottom line is that many post-menopausal women can suffer from bone loss due to low levels of estrogen, progesterone, and testosterone.
9. Make an appointment with a dietitian to review your nutrient status to ensure proper digestion, absorption, and intakes of all your bone strengthening and maintaining nutrients (vitamin D, vitamin K, calcium and others).

Schedule your free 15-minute consultation today with Food Centered Solutions at fcsiver.com.

1. National Institutes of Health, Office of Dietary Supplements. Calcium, fact sheet for health professionals. National Institutes for Health. Updated March 2, 2017. Accessed May 14, 2018.
2. Zhao J-G, Zeng X-T, Wang J, Liu L. Association between calcium or vitamin D supplementation and fracture incidence in community-dwelling older adults; A systemic review and meta-analysis. JAMA. 2017;318(24):2466-2482.
3. US Preventative Task Force. Vitamin D, calcium or combined supplementation for the primary prevention of fractures in community-dwelling adults, US Preventative Task Force recommendation statement. JAMA. 2018;319(15):1592-1599.
4. Bischoff-Ferrari HA, Bhasin S, Manson JE. Preventing fractures and falls; A limited role for calcium and vitamin D supplements? JAMA. 2018;319(15):1552-1553.