Author
Dawson-Hughes, Bess |
Submitted to: New England Journal of Medicine
Publication Type: Other Publication Acceptance Date: 3/21/2006 Publication Date: 5/25/2006 Citation: Dawson-Hughes, B. 2006. Calcium plus vitamin D and the risk of fractures. New England Journal of Medicine. 354(21):2285-7. Interpretive Summary: Technical Abstract: The long-awaited WHI results reveal that calcium and vitamin D supplementation (1000 mg/400 IU) didn't lower fracture rates but did increase risk of kidney stones in calcium-replete (1150 mg/d mean intake) but vitamin D insufficient (serum 25-hydroxyvitamin D 46 nmol/L) postmenopausal women. How should these results influence clinical practice? They should have no impact on the evidence-based recommendation that postmenopausal women, who typically consume 600 mg, increase their calcium intake to 1200 mg/d. Similarly, the results shouldn't deter physicians from recommending 800 IU/d of vitamin D, the amount the average postmenopausal woman needs to raise her 25-hydroxyvitamin D to the level needed to lower fracture risk ('75 nmol/L). Finally the increased risk of kidney stones in WHI women consuming a mean of 2150 compared with those consuming 1150 mg/d of calcium shouldn't be assumed to apply to women who increase their intake to 1200 mg/d. It is important that the WHI results not be used to sanction the inadequate calcium and vitamin D intakes that are so widespread among postmenopausal women today. |