Study finds adherence to supplement regimen improves protection against fracture risk
The results of a study reported in the February 16, 2006 New England Journal of Medicine found a small benefit in hip fracture risk reduction associated with calcium and vitamin D supplementation for 36,282 postmenopausal women enrolled in the Women’s Health Initiative Trial. Participants who received calcium and vitamin D experienced a 12 percent reduction in hip fracture risk compared to those who received a placebo. However, even though 76 percent of the participants were still taking their supplements at the end of the seven year study, only 59 percent were taking the recommended dose. When data from women whose adherence to their regimens was below 80 percent was excluded from the analysis, the reduction in hip fracture risk among those taking calcium and vitamin D more than doubled to a 29 percent lower risk than the placebo group.
The dosage of vitamin D in this study was 400 international units, an amount determined to be too low to maintain optimal serum levels of the vitamin in other research. Additionally, the form of calcium used was calcium carbonate, which is commonly sold as an antacid and is not known to be one of better absorbed forms of the mineral.
The study also found that the supplements had a greater effect on older women than on those who were recently menopausal. The authors of the study conclude that “the findings provide evidence of a positive effect of calcium with vitamin D on bone health in older postmenopausal women.”
Lead author Rebecca Jackson, who is an associate professor of internal medicine and physical medicine at Ohio State University Medical Center, commented, “ The value of a study this large is that it does show, even if only on a small scale, that the intervention can be effective to lower the risk of osteoporosis within two to three years. A physician isn't needed to prescribe these supplements. All this means any supplementation of this kind is potentially beneficial, particularly in women over 60 years old. That's a huge finding.”
“This all really points to the ability of women at highest risk for osteoporosis to make their own informed choices about supplements they take,” Dr Jackson added.
Calcium is the mineral that automatically comes to mind when considering osteoporosis treatment. However, although bone contains large amounts of calcium, other minerals need to be considered as important in the treatment and prevention of osteoporosis. For example, other trace minerals (minerals needed in small amounts for specific tasks--usually enzyme activation) would include zinc, magnesium, boron, and silicon.
Many people in North America who consume an average diet have magnesium deficiency, and magnesium is important in bone structure. Magnesium deficiency comes about because most magnesium in our diet comes from the magnesium contained in the chlorophyll molecule found mainly in dark green leafy vegetables--not something that most people eat on a daily basis. Magnesium intake should be about half that of calcium, approximately 300-500 mg per day. If not provided in the diet, then magnesium should be supplemented. Some researchers are now also reporting that magnesium deficiency plays a significant role in the development of osteoporosis (Dreosti 1995). Studies have shown that women with osteoporosis tend to have a lower magnesium intake than normal and lower levels of magnesium in their bones. Recommendations for postmenopausal women to increase calcium intake can lead to an unfavorable Ca to Mg ratio unless the magnesium intake is increased accordingly; the optimum ratio of Ca to Mg is believed to be 2:1. A magnesium deficiency can also affect the production of the biologically active form of vitamin D, thereby further promoting osteoporosis. Some research shows that magnesium supplementation is effective in treating osteoporosis. Magnesium supplementation (over and above the current recommended daily allowance) may suppress bone turnover in young adults and some researchers speculate that it may also help prevent age-related osteoporosis (Dimai et al. 1998).
Regular soy consumption reduces bone fracture risk in postmenopausal women, according to recent findings published in the Archives of Internal Medicine.Researchers at the Vanderbilt University School of Medicine in Nashville and the Shanghai Cancer Institute in Shanghai, China, examined the relationship between soy food consumption and fracture incidence in nearly 25,000 postmenopausal women as part of the Shanghai Women’s Health Study. Women who consumed the most soy had an approximately 35% decreased risk of fractures compared to women who consumed the least soy. The benefit was greatest for women within 10 years of menopause, as high soy food consumption in that group was related to an approximately 50% reduction in bone fracture risk.
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