Low-dose calcium supplements can effectively slow bone loss in peri- and postmenopausal Asian women

One out of 3 Indian females suffers from osteoporosis, making India one of the most affected countries in the world, according to the International Osteoporosis Foundation. Additionally, in most Western countries, the peak incidence of osteoporosis occurs at about 70 to 80 years of age; in India, it occurs 10 to 20 years earlier, at about 50 to 60 years of age.

To prevent osteopenia—the precursor to osteoporosis—in older adults with a low calcium intake, calcium supplements of 1,200 mg/day have been recommended. However, the[s2If !is_user_logged_in()]…

[/s2If][s2If is_user_logged_in()] safety of calcium supplements has been debated lately in the clinical literature; recent studies have shown that standard-dose calcium supplements (eg, 1,000 mg/day) may accelerate vascular calcification, a risk factor for myocardial infarction.

Key Point: One out of 3 Indian females suffers from osteoporosis, making India one of the most affected countries in the world. Recent studies have shown that standard-dose calcium supplements (eg, 1,000 mg/day) may have a detrimental effect on the cardiovascular system. This study demonstrated that lower-dose calcium supplements—250 mg/day and 500 mg/day— favorably affected spinal BMD changes. More studies are needed regarding long-term effects.

A recently published study conducted in Japan evaluated whether lower-dose calcium supplements—250 mg/day and 500 mg/day— would favorably affect bone metabolism, which would in turn prevent bone loss, with a minimal effect on the cardiovascular system. The study was a randomized, double-blind, placebo-controlled trial conducted over 2 years that included healthy women aged 50 to 75 years.

Baseline medical examinations of the study participants were conducted in November 2009 and data were recorded. Participants were then randomly assigned to 3 groups: 500 mg calcium, 250 mg calcium, or placebo, to be taken daily with meals. Baseline characteristics were comparable between the 3 groups. Follow-up examinations were conducted in November 2009 and 2010, using the same procedures as the baseline exam. Compliance was determined by counting the leftover tablets. Medical examinations assessed bone mineral density (BMD) of the lumbar spine and femoral neck.

Of the 450 women in the study, 418 underwent the follow-up examinations: 500 mg/day (n=142), 250 mg/day (n=139), or placebo (n=137). The average compliance rate was 83.4% for the 500 mg/day group, 84.6% for the 250 mg/day group, and 86.8% for the placebo group.

Spinal BMD changes over 2 years were -0.029 g/cm2 (-3.0%) for the 500 mg/d calcium supplement group, -0.034 g/cm2 (-3.7%) for the 250 mg/d calcium supplement group, and -0.040 g/cm2 (-4.2%) for the placebo group. Changes in femoral neck BMD over 2 years were -0.028 g/cm2 (-3.9%) for the 500 mg/d calcium supplement group, -0.037 g/cm2 (-5.3%) for the 250 mg/d calcium supplement group, and -0.034 g/cm2 (-4.7%) for the placebo group.

The concentration of serum calcium increased over 2 years in the 500 mg/day and 250 mg/day calcium supplement groups compared with the placebo group.

Thirty-two of the original 450 women did not undergo follow-up examinations for various reasons: 9 reported diseases or poor health; 15 cited personal reasons; 8 did not report a reason. A total of 20 of the original 450 women stopped taking the tablets due to disease or poor health: 5 had gastrointestinal symptoms; 2 had constipation; 3 had cancer; 2 experienced a rash; and 8 had other health issues.

The present study had some limitations. Long-term (>2 years) effects are unknown and should be investigated in future studies.

Sources: Nakamura K, Saito T, Kobayashi R, et al. Effect of low-dose calcium supplements on bone loss in peri- and postmenopausal Asian women: A randomized controlled trial. J Bone Miner Res. May 31, 2012 [epublication ahead of print].

International Osteoporosis Foundation Web site. Osteoporosis Fact Sheet. Available at: http://www.dolcera.com/wiki/images/Osteoporosis_factsheet.pdf.

Access the original journal information here:
http://www.ncbi.nlm.nih.gov/pubmed/22653713
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