USPSTF Recommends Against Calcium, Vitamin D

WASHINGTON, D.C.The U.S. Preventive Services Task Force (USPSTF) released its final recommendations on calcium and vitamin D in preventing fractures on Feb. 25. In the recommendations, USPSTF said the current evidence is insufficient to assess the benefits and harms of combined vitamin D and calcium supplementation for the primary prevention of fractures in premenopausal women and men. USPSTF also advised against daily supplementation with 400 IU or less of vitamin D and 1,000 mg or less of calcium for preventing fractures in postmenopausal women. The recommendations are published in the Annals of Internal Medicine.  

Dietary supplement industry organizations such as Council for Responsible Nutrition (CRN) and The Natural Products Association (NPA) said these guidelines only highlight a limited amount of literature on calcium and vitamin Dleading to a questionable conclusion that may mislead consumers.

 These recommendations fail to recognize the well-established role of calcium and vitamin D in maintaining bone health," said Taylor Wallace, Ph.D., senior director, scientific and regulatory affairs, CRN. "If these recommendations are taken to heart, or misconstrued as general recommendations against calcium and vitamin D, consumers could be compromising their bone health and missing out on important other benefits from these nutrients. The bottom line: calcium and vitamin D are vital to staying healthy."

Wallace explained the USPSTF decision came from a meta-analysis that relied largely on the Womens Health Initiative (WHI). The huge study found negligible effect on fracture rates in 35,000 postmenopausal women; however, Wallace said it is now known the participants did not adhere to their calcium routine, creating widely known limitations. However, WHI investigators recently reanalyzed the data, honing in on women who followed protocol strictly (Osteoporos Int. 2013 Feb;24(2):567-80.). Though researchers found a 38-percent reduction in hip fracture, Wallace said these findings were not included in the USPSTF meta-analysis.

Cara Welch, Ph.D., vice president of scientific and regulatory affairs, NPA, agreed, noting the current recommendation is contradicted by credible research and other established calcium and vitamin D recommendations.

"This conflicts with the recommendation of the Institute of Medicine, which took into account nearly 1,000 published studies that confirm the role of calcium and vitamin D supplements in promoting bone health," Welch said.

Vitamin D and calcium have been in the scientific spotlight increasingly in recent months. In Februrary, two studies linked supplemental calcium to higher risk of cardiovascular death (CVD) in men and women. However, industry experts have responded to negative concerns with study flaws and use of inappropriately designed cohort trials.

Overall, consumers must evaluate their individual needs and intake to ensure they receive enough of these critical nutrients.

Keep a food diary, so you know what nutrients youre getting from your food, then consider adding calcium supplements to get what you need, based on your life stage and lifestyle," said CRNs Duffy MacKay, N.D., vice president, scientific and regulatory affairs. But consumers also shouldnt be looking for magic bullets to prevent bone fractures.  Instead, they should practice a combination of healthy habits, which include a role for supplements along with strength conditioning and good diet."