Increasing calcium intake may not improve bone health of older people suggests research in leading journal
Bone density and fracture risk of older people may not improve with increased calcium intake, according to two new studies in the British Medical Journal.
The average daily calcium intake in older people in Western countries is around 700mg–900mg a day. The NHS recommends that adults need a daily intake of 700mg and osteoporosis experts suggest that if people are taking an osteoporosis drug treatment, they may benefit from calcium intake of around 1000mg a day.
In other countries, such as the US, older people are encouraged to take more calcium. It is suggested that men aged 51 years – 70 years get around 1,000mg each day, and women of the same age around 1,200mg. And men and women aged 71 years and older are advised to have 1,200mg.
Encouraged by claims that increasing calcium may improve bone density and reduce the risk of fractures, many people turn to calcium supplements to boost their intake.
But the new research highlights that this is unlikely to be the case.
Experts reviewed research that looked at how increased intake of dietary or supplemental calcium impacts bone density and fracture risk in men and women aged 50 years and older.
One of the new reviews assessed 59 trials about calcium intake and bone density. It found that men and women who increased their calcium intake through diet or by taking supplements had a 1%–2% increase in bone mineral density, which the team says is “unlikely to lead to a clinically significant reduction in risk of fracture”.
The second review involved 44 studies and two trials that assessed the link between increased calcium intake from supplements and dietary sources.
It found that dietary calcium intake is not linked with reduced risk of fracture in older people, and there is no evidence that increasing calcium intake from dietary sources prevents fractures.
“Evidence that calcium supplements prevent fractures is weak and inconsistent,” they say.
Prof Karl Michaëlsson, from the Department of Surgical Sciences at Uppsala University in Sweden, comments that given the lack of evidence that increasing calcium intake improves the bone health of older people, current claims and advice is “puzzling.” And taking too much calcium can actually be bad for health:
“Most will not benefit from increasing their [calcium] intakes and will be exposed instead to a higher risk of adverse events such as constipation, cardiovascular events, kidney stones or admission for acute gastrointestinal symptoms,” he says. “The weight of evidence against such mass medication of older people is now compelling, and it is surely time to reconsider these controversial recommendations.”
Commenting on the new studies, National Osteoporosis Society senior nurse and helpline manager, Sarah Leyland says:
“These studies confirm what is already known about the role of calcium supplements in bone health. Calcium supplements may increase bone density, but on their own do not reduce the risk of fractures.
“General recommendations for the adult population are to make sure you are eating a well-balanced healthy diet providing adequate calcium and all the other nutrients needed for bone health. Other lifestyle factors continue to be important and are explained in the healthy living section of the website. If you are at high risk of having a fracture because of osteoporosis then a drug treatment will be recommended.”
Good dietary sources of calcium include milk, yogurt, cheese, sardines, kale and broccoli.
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