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Prevention of Fracture Risk with Supplementation Combination

Prevention of Fracture Risk with Supplementation Combination

DAILY supplementation with vitamin D and calcium showed great potential for reducing risk of fracture in a recent study. Osteoporotic fractures are experienced by one in two women and one in five men aged 50 years or older, with the incidence of hip fracture increasing exponentially as both women and men age.

To reduce fracture risk and occurrence in individuals living in extra-care housing and with vitamin D deficiency, combined supplementation with vitamin D and calcium is recommended at 800 IU and 1200 mg, respectively. Optimal dosage and recommended practice for taking the supplements differs in the literature, and the effectiveness of supplementation also causes certain apprehension. This recent study assessed different concentrations of 25-hydroxyvitamin D and the associated fracture risk. Additionally, fracture risk with supplementation with vitamin D alone or in combination with calcium was also measured.

A meta-analysis of 11 randomised controlled trials involving 34,243 participants taking vitamin D supplementation alone found that increased increments of 25-hydroxyvitamin D concentration corresponded to a 7% decreased risk of any fracture, and a 20% decreased risk of hip fracture. Meanwhile, a randomised controlled trial with 34,243 participants administered with daily or intermittent doses of vitamin D supplementation alone found no benefits regarding reduced fracture risk. Limitations to these studies included infrequent intermittent dosing, low daily doses of vitamin D, and an inadequate number of participants.

In a meta-analysis of six randomised controlled trials, the authors, from the University of Oxford, Oxford, UK, reported: “Daily supplementation with both vitamin D and calcium was associated with a 16% reduced risk of hip fracture,” but, “these randomised controlled trials had a high risk of bias.”

The authors call for further studies in combined treatment with vitamin D and calcium “…before advocating vitamin D and calcium supplements or fortified foods with vitamin D and calcium for prevention of hip fracture”.