Best calcium and vitamin d supplement
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Best Calcium and Vitamin D Supplement: A Comprehensive Review
Introduction to Calcium and Vitamin D Supplementation
Calcium and vitamin D are essential nutrients for maintaining bone health and preventing osteoporosis. Supplementation with these nutrients is often recommended, especially for older adults, to reduce the risk of fractures and bone loss. This article synthesizes findings from multiple studies to determine the best calcium and vitamin D supplement regimen.
Calcium and Vitamin D for Fracture Prevention
Efficacy in Reducing Fracture Risk
Several studies have demonstrated that calcium and vitamin D supplementation can significantly reduce the risk of fractures. A meta-analysis involving 63,897 participants found that calcium, or calcium combined with vitamin D, reduced the risk of fractures by 12% and slowed bone loss at the hip and spine1. Another study with 36,282 postmenopausal women showed a hazard ratio of 0.88 for hip fractures with calcium and vitamin D supplementation, although the reduction was not statistically significant2. An updated meta-analysis from the National Osteoporosis Foundation also supported these findings, showing a 15% reduced risk of total fractures and a 30% reduced risk of hip fractures8.
Optimal Dosage
The optimal dosage for calcium and vitamin D supplementation appears to be at least 1200 mg of calcium and 800 IU of vitamin D daily. Higher doses of calcium (1200 mg or more) and vitamin D (800 IU or more) were associated with better outcomes in terms of fracture risk reduction1.
Impact on Bone Mineral Density
Calcium and vitamin D supplementation has been shown to improve bone mineral density (BMD). In a study involving postmenopausal women, those who received calcium and vitamin D had a 1.06% higher hip bone density compared to the placebo group2. This improvement in BMD is crucial for reducing the risk of fractures and maintaining overall bone health.
Cardiovascular and Other Health Effects
Cardiovascular Risks
The cardiovascular safety of calcium and vitamin D supplementation has been a topic of debate. Some meta-analyses suggest a potential increase in cardiovascular risks with calcium supplements, whether or not combined with vitamin D7. However, other large studies have not found a significant increase in cardiovascular events with these supplements9. Therefore, while the cardiovascular risks cannot be entirely dismissed, they should be interpreted with caution.
Effects on Glucose Metabolism and Cancer Risk
Calcium and vitamin D supplementation may also have beneficial effects beyond bone health. For instance, a study on overweight and obese women with polycystic ovary syndrome (PCOS) found that co-supplementation improved insulin sensitivity and reduced serum insulin levels6. Additionally, another randomized trial indicated that calcium and vitamin D supplementation could reduce the risk of all types of cancer in postmenopausal women5.
Conclusion
Based on the current evidence, the best calcium and vitamin D supplement regimen for preventing fractures and maintaining bone health in older adults includes at least 1200 mg of calcium and 800 IU of vitamin D daily. While there are some concerns about cardiovascular risks, the benefits in terms of fracture prevention and potential improvements in other health outcomes make this supplementation strategy worthwhile. Further research is needed to clarify the cardiovascular safety and to optimize dosing schedules for different populations.
Sources and full results
Most relevant research papers on this topic
Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis
Calcium supplementation, or calcium combined with vitamin D, can effectively prevent osteoporosis in people aged 50 years and older, with optimal effects achieved at minimum doses of 1200 mg calcium and 800 IU vitamin D.
Meta-Analysis
Rigorous Journal
Highly CitedCalcium plus vitamin D supplementation and the risk of fractures.
Calcium with vitamin D supplementation improved hip bone density in healthy postmenopausal women, but did not significantly reduce hip fracture risk and increased the risk of kidney stones.
RCT
Large Human TrialHighly CitedSystematic Review: Vitamin D and Calcium Supplementation in Prevention of Cardiovascular Events
Vitamin D supplements at moderate to high doses may reduce cardiovascular disease risk, while calcium supplements show minimal cardiovascular effects.
Systematic ReviewHighly CitedEffects of vitamin D and calcium supplementation on pancreatic β cell function, insulin sensitivity, and glycemia in adults at high risk of diabetes: the Calcium and Vitamin D for Diabetes Mellitus (CaDDM) randomized controlled trial.
Short-term cholecalciferol supplementation improved pancreatic cell function and had a marginal effect on attenuating Hb A(1c) rise in adults at risk of type 2 diabetes.
RCT
Very Rigorous JournalHighly CitedVitamin D and calcium supplementation reduces cancer risk: results of a randomized trial.
Improving calcium and vitamin D nutritional status significantly reduces all-cancer risk in postmenopausal women.
RCTLarge Human TrialVery Rigorous JournalHighly CitedCalcium plus vitamin D supplementation affects glucose metabolism and lipid concentrations in overweight and obese vitamin D deficient women with polycystic ovary syndrome.
Calcium plus vitamin D supplementation for eight weeks in overweight and obese vitamin D deficient women with PCOS improved glucose metabolism and lipid levels, but did not affect FPG or other lipid profiles.
RCTVery Rigorous JournalHighly CitedWho should receive calcium and vitamin D supplementation?
Combined calcium and vitamin D supplementation is recommended for osteoporosis prevention and treatment, with a daily dose of 1,000-1,200 mg calcium and 800 IU vitamin D recommended for elderly, institutionalized individuals, patients with established osteoporosis, and individuals on glucocorticoids.
Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation
Calcium plus vitamin D supplementation significantly reduces the risk of total fractures and hip fractures in middle-aged to older adults.
Meta-AnalysisRigorous JournalHighly CitedThe calcium and vitamin D controversy
Increasing vitamin D intake may reduce fracture risk and deaths, but the cardiovascular safety of calcium and vitamin D supplements remains unclear, and current research on their use is insufficient for evidence-based recommendations.
Rigorous JournalCalcium plus vitamin D supplementation and the risk of colorectal cancer.
Daily calcium and vitamin D supplementation for seven years did not significantly reduce the incidence of colorectal cancer in postmenopausal women.
RCTLarge Human TrialHighly Cited