Is Calcium Ineffective for Improving Bone Density?

The False News About Calcium

Calcium plus vitamin D has been recommended for years as an effective treatment to improve bone health. Chronic research has indicated calcium to reduce the risk of osteoporosis and fractures especially in middle-aged individuals and older adults. A few recent studies have stirred up some controversy indicating this may not be the case and the potential for fracture is the same regardless of calcium supplementation. 

The calcium study published in the British Journal of Medicine caused a flurry of news releases questioning the effectiveness of calcium supplementation to reduce bone fractures. Many of us listen and read the news daily believing these headlines. The problem is news often happens before solid evidence is produced. Preliminary studies mean further research is required and animal research really can’t be applied to human physiology. Many news stories stem from this type of research.

Headlines are for shock value so before tossing out bottles of calcium and pouring milk down the drain, sifting through the evidence is really required. We have come from the age of “milk does a body good” and reducing the incidence of osteoporosis with prescribed calcium supplements. How could a few news reports based on minimal research cause such skepticism? This is more an alarmist approach to gain readers than sharing detailed accurate facts about calcium research in a news story. 

What was left out of the headlines that individuals who supplement or want to supplement with calcium should know? 

  

What You Should Know

Calcium tablets
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The British Journal of Medicine published research on whether increasing calcium from dietary sources or supplementation would be beneficial to reduce fractures. Did you catch that? The studies are not referring to standard daily values of calcium or saying calcium is not beneficial. They examined if additional calcium is required beyond a normal balanced diet. This debate has been ongoing for years and remains inconclusive. 

Further evidence to support more calcium as needed for improved bone density or to decrease fracture risk is required. The research reviews are impressive but inconsistencies between studies continue to exist. It appears researchers have yet to identify and accurately compare the findings between increased calcium intake and fracture risk.

Some of the strengths of the calcium studies included:   

  • Randomized controlled trials
  • Observational studies
  • Assessment of four fracture points - hip, vertebral, and forearm

Some of the weakness of the calcium research included: 

  • Referenced cohort studies
  • Not performing a quality assessment of the studies but using the results anyway
  • Short trial duration
  • Using bone mineral density (BMD) as the endpoint instead of fracture
  • Limiting trial participants to healthy populations or those with low risk of osteoporosis

Research findings are considered inconclusive based on not having a broader scope of people and more accurate endpoint. Some of the findings revealed minimal evidence to support increased dietary calcium as a factor to decrease fracture risk, however, supplementation showed inconsistent improvements. The study indicated pros and cons of calcium intake through dietary and supplemental sources

 

 

Other Important Information

Headlines tend to lean more toward the negatives than sharing positive information as occurred in the case of questioning the effectiveness of calcium. According to research findings, calcium supplements may be beneficial in populations if widely used, tolerated and considered safe. This information was not contained within the news article. 

Apparently, possible gastrointestinal upset and potential cardiovascular issues with increased calcium stimulated a general recommendation not to supplement with calcium. Evidently, the unfavorable risk outweighs the small benefits according to a few studies. 

Further conclusions do reveal small improvements in bone mineral density (BMD). Since the margin measured a 1-2% improvement, the study considered these findings insignificant to support a reduced risk of fracture. The question to consider here is when did small improvements become insignificant? 

Other studies produced a statistically significant 15 % reduced risk of total fractures supplementing with calcium plus vitamin D. Additionally, numerous research findings support calcium plus vitamin D supplementation as an effective intervention to reduce fracture risk among middle-aged to older adults. 

A Word From Verywell

Calcium plus vitamin D is shown to be an effective treatment to reduce the risk of osteoporosis and subsequent fracture. When solid research on essential nutrients like calcium is questioned, it’s important to read beyond a news story and work with real facts. Research is an important part of providing evidence to support the role of vitamins and minerals in our health and wellness. Chronic human studies from reliable sources are an excellent way to review trusted information. If you’re considering taking calcium, it’s recommended to discuss with your doctor before taking this or any other supplement. 

Sources:
C. M. Weaver et al., Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation, 2016

Karl Michaëlsson et al., Calcium supplements do not prevent fractures, British Journal of Medicine, 2015

Mark J Bolland et al., Calcium intake and risk of fracture: systematic review, British Journal of Medicine, 2015

Vicky Tai et al., Calcium intake and bone mineral density: systematic review and meta-analysis, research, British Journal of Medicine, 2015 

 

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