Vitamin D and Calcium Pills: Not Enough Proof?

The American Society for Bone and Mineral Research (ASBMR) is wondering about the new recommendations by the U.S. Preventive Services Task Force (USPSTF) that address the use of the combination of vitamin D and calcium supplements to prevent bone fractures. The USPSTF statement suggests that there is not enough evidence, one way or the other, about how supplements affect bone fractures for men and premenopausal women.

The ASBMR indicates that the USPSTF’s recommendations differ from the 2010 Institute of Medicine’s (IOM) findings, primarily because these recommendations are based only on fracture outcomes, while the IOM included an examination of the underlying biology of the impact of calcium and vitamin D.

“The ASBMR continues to support the recommendations of the IOM because they are based on a broader evaluation of the data rather than only fracture outcomes, ” says Sundeep Khosla, M.D., in the February 25, 2013 news release. Dr. Khosla is past president of the ASBMR and a practicing endocrinologist and research scientist at the Mayo Clinic at Rochester, Minnesota.

The ASBMR has long supported that calcium and vitamin D are important to bone health and the best way to get them is through food that is naturally rich in these supplements. Calcium and vitamin D are the most crucial, yet simple, first steps in promoting good bone health.

“Research has shown us that healthy adults who are receiving the recommended amount of calcium and vitamin D in their diet and through sunlight exposure, need not take supplements for bone health, ” says Cliff Rosen, M.D., Past President of ASBMR and Director of Clinical and Translational Research and a Senior Scientist at Maine Medical Center’s Research Institute in Scarborough, Maine. “But the report leaves out a crucial and large population—the elderly, especially those at high risk for fractures in assisted living and nursing home facilities. This population has less exposure to sunlight and is at high risk for hip fracture. They should be receiving supplements. The evidence generally supports benefits of calcium and vitamin D for building strong skeletons and preventing fractures and bone loss in high risk, elderly individuals.”