CONCLUSIONS Dietary calcium intake is not associated with risk of fracture , and there is no clinical trial evidence that increasing calcium intake from dietary sources prevents fractures .
OBJECTIVE To examine the evidence underpinning recommendations to increase calcium intake through dietary sources or calcium supplements to prevent fractures .
Independent predictors of all osteoporosis-related fractures among healthy Saudi postmenopausal women: the CEOR Study.
This study was design ed to identify independent predictors of all osteoporosis-related fractures ( ORFs ) among healthy Saudi postmenopausal women . We prospect ively followed a cohort of 707 healthy postmenopausal women ( mean age , 61.3±7.2 years ) for 5.2±1.3 years . Data were collected on demographic characteristics , medical history , personal and family history of fractures , lifestyle factors , daily calcium intake , vitamin D supplementation , and physical activity score . Anthropometric parameters , total fractures ( 30.01 per 1000 women/year ) , special physical performance tests , bone turnover markers , hormone levels , and bone mineral density ( BMD ) measurements were performed . The final model consisted of seven independent predictors of ORFs : [ lowest quartile ( Q(1 ) ) vs highest quartile ( Q(4 ) ) ] physical activity score ( Q(1 ) vs Q(4 ) : ≤12.61 vs ≥15.38 ) ; relative risk estimate [ RR ] , 2.87 ; ( 95 % confidence interval [ CI ] : 1.88 - 4.38 ) ; age≥60 years vs age<60 years ( RR=2.43 ; 95 % CI : 1.49 - 3.95 ) ; h and grip strength ( Q(1 ) vs Q(4 ) : ≤13.88 vs ≥17.28 kg ) ( RR=1.88 ; 95 % CI : 1.15 - 3.05 ) ; BMD total hip ( Q(1 ) vs Q(4 ) : ≤0.784 vs 0.973 g/cm(2 ) ) ( RR=1.86 ; 95 % CI : 1.26 - 2.75 ) ; dietary calcium intake ( Q(1 ) vs Q(4 ) : ≤391 vs ≥648 mg/day ) ( RR=1.66 ; 95 % CI : 1.08 - 2.53 ) ; serum 25(OH)D ( Q(1 ) vs Q(4 ) : ≤17.9 vs ≥45.1 nmol/L ) ( RR=1.63 ; 95 % CI : 1.06 - 2.51 ) ; and past year history of falls ( RR=1.61 ; 95 % CI : 1.06 - 2.48 ) . Compared with having none ( 41.9 % of women ) , having three or more clinical risk factors ( 4.8 % of women ) increased fracture risk by more than 4-fold , independent of BMD . Having three or more risk factors and being in the lowest tertile of T-score of [ total hip/lumbar spine ( L1-L4 ) ] was associated with a 14.2-fold greater risk than having no risk factors and being in the highest T-score tertile . Several clinical risk factors were independently associated with all ORFs in healthy Saudi postmenopausal women . The combination of multiple clinical risk factors and low BMD is a very powerful indicator of fracture risk
CONCLUSIONS Dietary calcium intake is not associated with risk of fracture , and there is no clinical trial evidence that increasing calcium intake from dietary sources prevents fractures .
OBJECTIVE To examine the evidence underpinning recommendations to increase calcium intake through dietary sources or calcium supplements to prevent fractures .