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Longer-term calcium supplementation does not reduce the risk of fractures

PainSci » bibliography » Warensjö et al 2011
Tags: nutrition, vitamin D, random, self-treatment, treatment

One article on PainSci cites Warensjö 2011: Vitamins, Minerals & Supplements for Pain & Healing

PainSci notes on Warensjö 2011:

Does long-term supplementation with calcium reduce the risk of fractures? The answer, based on this study, appears to be no: "Gradual increases in dietary calcium intake above the first quintile in our female population were not associated with further reductions in fracture risk or osteoporosis." My interest in this evidence is mainly because it’s a good example of how supplements continue to turn out to be less useful than we all hoped in the 20th Century.

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

OBJECTIVE: To investigate associations between long term dietary intake of calcium and risk of fracture of any type, hip fractures, and osteoporosis.

DESIGN: A longitudinal and prospective cohort study, based on the Swedish Mammography Cohort, including a subcohort, the Swedish Mammography Cohort Clinical.

SETTING: A population based cohort in Sweden established in 1987.

PARTICIPANTS: 61 433 women (born between 1914 and 1948) were followed up for 19 years. 5022 of these women participated in the subcohort.

MAIN OUTCOME MEASURES: Primary outcome measures were incident fractures of any type and hip fractures, which were identified from registry data. Secondary outcome was osteoporosis diagnosed by dual energy x ray absorptiometry in the subcohort. Diet was assessed by repeated food frequency questionnaires.

RESULTS: 14 738 women (24%) experienced a first fracture of any type and among them 3871 (6%) a first hip fracture. Of the 5022 women in the subcohort, 1012 (20%) were measured as osteoporotic. The risk patterns with dietary calcium were non-linear. The crude rate of a first fracture of any type was 17.2/1000 person years at risk in the lowest quintile of calcium intake, and 14.0/1000 person years at risk in the third quintile, corresponding to a multivariable adjusted hazard ratio of 1.18 (95% confidence interval 1.12 to 1.25). The hazard ratio for a first hip fracture was 1.29 (1.17 to 1.43) and the odds ratio for osteoporosis was 1.47 (1.09 to 2.00). With a low vitamin D intake, the rate of fracture in the first calcium quintile was more pronounced. The highest quintile of calcium intake did not further reduce the risk of fractures of any type, or of osteoporosis, but was associated with a higher rate of hip fracture, hazard ratio 1.19 (1.06 to 1.32).

CONCLUSION: Gradual increases in dietary calcium intake above the first quintile in our female population were not associated with further reductions in fracture risk or osteoporosis.

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