A 2013 review by the U.S. Preventive Services Task Force (USPSTF) suggests that
routine use of vitamin D and calcium supplementation by postmenopausal women
is not of proven value for the primary prevention of fractures in non-institutionalized
postmenopausal women. The USPSTF did not address the value of higher
doses of calcium and vitamin D, nor did they discuss younger women or individuals
with osteoporosis.
A 2017 meta-analysis of 33 randomized trials reported in the JAMA included participants
receiving vitamin D, calcium, or both. Compared to those receiving a
placebo, there was no difference in the risk of fractures among these community-
dwelling (not institutionalized) adults age 50 or older. A 2018 analysis of data
from 81 randomized controlled trials found that regardless of the dose, vitamin D
supplements do not help prevent fractures or increase bone mineral density—even
among postmenopausal women with osteoporosis.52 A 2019 meta-analysis noted
the inconsistent findings of randomized controlled trials (RCTs) assessing the effects
of both vitamin D and calcium vs. placebo. The meta-analysis of RCTs
found no benefit for the risk of fracture from supplementation with vitamin D alone.
The meta-analysis of the RCTs of daily supplementation with vitamin D and calcium
demonstrated a marginally significant reduction in the risk of any fracture of 6%
and a hip fracture of 16%.
Studies of extra calcium intake are inconclusive. Some show a protective effect,
others show no benefit, and still, others show an increased risk of fractures. U.S.
surveys have found no link between bone density and calcium consumption. Long
term prospective studies from seven countries show no important reduction in fractures
with increasing consumption of calcium. In fact, rates of hip fracture tend
to be high in countries with a high intake of calcium and low in countries with low
intake. The bottom line on calcium is that with a healthy diet, it is usually not
necessary to worry about calcium consumption or take calcium supplements.
As is shown in the table below, the Recommended Dietary Allowances for calcium,
(covering requirements of at least 97.5% of the population), range from 700 to 1300
mg/d for life-stage groups at least one year of age.
The safe upper limit for calcium is:
• 1,000 mg/day for infants 0 to 6 months
• 1,500 mg/day for infants 6 to 12 months
• 2,500 mg/day for children 1 – 8 years
• 3,000 mg/day for children and teens 9-18 years including pregnant and
breastfeeding teens
• 2,500 mg/day for adults 19-50 years including pregnant and breastfeeding
women
• 2,000 mg/day for adults age 51 years and older
Recommended Calcium Intakes for persons age 4 and older is between 1000 and 1300 mg/day
This blog presents opinions and ideas and is intended to provide helpful general information. I am not engaged in rendering advice or services to the individual reader. The ideas, procedures and suggestions in that are presented are not in any way a substitute for the advice and care of the reader’s own physician or other medical professional based on the reader’s own individual conditions, symptoms or concerns. If the reader needs personal medical, health, dietary, exercise or other assistance or advice the reader should consult a physician and/or other qualified health professionals. The author specifically disclaims all responsibility for any injury, damage or loss that the reader may incur as a direct or indirect consequence of following any directions or suggestions given in this blog or participating in any programs described in this blog or in the book, The Building Blocks of Health––How to Optimize Your Health with a Lifestyle Checklist (available in print or downloaded at Amazon, Apple, Barnes and Noble and elsewhere). Copyright 2021 by J. Joseph Speidel.
