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VNA of Care New England

Case Vignette: Calcium Supplements in Fracture Prevention

Case vignette article notes calcium-rich diet is preferred approach to ensuring adequate intake
WEDNESDAY, Oct. 16 (HealthDay News) -- The issues related to calcium supplementation in postmenopausal women are discussed in a clinical practice piece published in the Oct. 17 issue of the New England Journal of Medicine.
Douglas C. Bauer, M.D., from the University of California in San Francisco, discusses the case of a postmenopausal, healthy woman (aged 62 years) with no history of fracture, but whose mother had a hip fracture. The woman exercises regularly and takes supplemental calcium carbonate (1,000 mg three times a day) alongside a diet rich in fruits, vegetables, and low-fat dairy products.
The author notes that adequate calcium intake is important for skeletal health, and that inadequate intake is common, especially in older adults. The recommended daily dietary intake of calcium is 1,000 and 1,200 mg for women aged 19 to 50 and women older than 50, respectively, with intake above 2,500 mg to be avoided. For men, the recommended daily dietary intake is 1,000 and 1,200 mg for those aged 19 to 70 and those aged older than 70, respectively. Calcium-rich foods and drinks are the preferred approach to ensuring sufficient calcium intake; supplements should be considered when intake is inadequate. Side effects of calcium supplementation include constipation and bloating (common) and nephrolithiasis (occurs infrequently). Recent studies have raised concern about the use of calcium supplements and increased cardiovascular risk, but the findings are inconclusive.
"Pending further data, a reasonable approach is to preferentially encourage dietary calcium intake and discourage the routine use of calcium supplements," Bauer writes.
The author disclosed financial ties to Amgen and Novartis.
Full Text (http://www.nejm.org/doi/full/10.1056/NEJMcp1210380 )
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