People over the age of 50 who either take calcium supplementation alone, or along with vitamin D supplementation have a 12% lower risk of fracture or bone loss, compared to people who don’t take them, says an article in The Lancet, this week’s issue.

Dr. Benjamin Tang, University of Western Sydney, Australia, and team carried out an analysis of 17 previous studies involving 52,625 people over the age of 50. They each received treatment for an average of 3.5 years.

The researchers found that where patients were keeping to their dosing regimen correctly the risk of fracture was 24% lower. They also found that doses higher than 1200 mg lowered fracture risk more, compared to doses of under 1200mg. Protection from fracture was also greater when Vitamin D was also taken at doses of 800 international units (IU) or more, compared to lower doses.

The treatment had the greatest impact on people who were elderly, lived in institutions, weighed less, consumed little calcium, or were at a more elevated baseline risk than normal. The writers suggest that people in institutions may have fared well with this treatment because nurses make sure they take their tablets (better compliance).

The researchers also looked at 23 trials that examined bone density as an outcome. They found that calcium supplementation alone, or together with vitamin D, also lowered bone loss rate at the hip by 0.54% and the spine by 1.19%.

“Our meta-analysis has shown that calcium supplementation, alone or in combination with vitamin D, is effective in the preventive treatment of osteoporotic fracture…poor compliance is a major obstacle to obtaining the full benefit of calcium supplementation,” the authors concluded.

“Although addition of vitamin D supplementation was not shown to offer additional risk reduction over and above the use of calcium alone, a significant difference was observed between the effects of different vitamin D doses,” they added.

“Unlike previous meta-analyses, Tang provides clear answers to several questions which could be of immediate practical importance for the daily management of osteoporosis…Tang and colleagues contribution is important because it paves the way for future research aiming at the best clinical, pharmacological, and economic optimisation of the use of calcium and vitamin D in patients at increased risk of osteoporotic fractures,” Dr Jean-Yves Reginster, Bone and Cartilage Metabolism Unit, Liege, Belgium, wrote in an accompanying Comment.

Written by: Christian Nordqvist