A study published in the Journal of the American Medical Association is challenging the accepted knowledge that calcium and vitamin D supplements are important for supporting bone health. Conducted by Jia-Guo Zhao, MD of Tianjin Hospital, Tianjin, China, the meta-analysis of 33 randomized clinical trials that included 51,145 participants living in the general community, not nursing homes or hospitals, determined that “the use of supplements that included calcium, vitamin D, or both was not associated with a significant difference in the risk of hip fractures compared with placebo or no treatment.”
Industry trade groups and medical professionals were quick to criticize the study and defend the use of calcium and vitamin D to reduce the risk of fracture as people age. One criticism is the fact that calcium and vitamin D are short-fall nutrients in the American population. “Generalized recommendations relying on this study should be mindful that further reductions in calcium and vitamin D consumption may exacerbate these public health concerns,” said Andrea Wong, Ph.D., vice president, scientific & regulatory affairs, of the Council for Responsible Nutrition in an official statement. Indeed, Wong points out, the researchers even acknowledged that the trials included in the analysis did not all test baseline vitamin D blood levels in test subjects, therefore unable to verify whether they were deficient or not in the first place.
They also take issue with the broad generalization that supplementation with these nutrients helps no one considering that the analysis focused on a healthy segment of the population. U.S. News and World Report quotes orthopedic surgeon, Daniel Smith, M.D., assistant professor of orthopedics at the Icahn School of Medicine at Mount Sinai in New York City, NY saying, “The big picture, which seems to be lost in this study, is that the personal health cost of a hip fracture can be catastrophic. The potential benefit of calcium and vitamin D supplementation in preventing even a small number of hip fractures far outweighs the otherwise minimum risks associated with routine calcium and vitamin D supplementation in at-risk populations.”
Daniel Fabricant, Ph.D., president and CEO of the Natural Products Association expresses the same concern in an official statement. “This study draws its conclusions with too broad of a brush, and has many flaws as it only focused on the healthiest segment of the population, which are those living at home,” he explains. “It likely includes many people who may be getting — and benefitting — from calcium and vitamin D from their diet or other sources. And people who live in nursing homes or assisted living facilities were not part of it, which means there is a lot missing. People with prior bone breaks or family incidence of osteoporosis may still need vitamin D and calcium supplementation, or other nutrition.”
This is not the first time supplementation has been challenged, nor will it be the last. Indeed, we need new and varied research to further our knowledge, but one study flawed in its execution will not prevent medical practitioners from making recommendations they have been comfortable making for years, nor should you let it dissuade customers from purchasing calcium and vitamin D products in your stores.