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 .
Predictors of non-spine fracture in elderly men: the MrOS study.
UNLABELLED We examined determinants of  nonvertebral fracture in elderly men from six U.S. communities followed an average of 4.1 years . Six clinical risk factors predicted fracture risk independent of hip BMD : tricyclic antidepressant use , previous fracture , inability to complete a narrow walk trial , falls in previous year , age > or = 80 years , and depressed mood . INTRODUCTION There are few prospect i ve studies of fracture determinants in men . We examined the associations between a comprehensive set of clinical risk factors and risk of nonspine fracture in older men and whether determinants of fracture risk were independent of total hip BMD . MATERIAL S AND METHODS A total of 5995 men > or = 65 years of age were recruited from six communities in the Unites States and followed prospect ively for an average of 4.1 years . Baseline assessment s of demographic , lifestyle , medical history , functional status , anthropometry , and cognitive , visual , and neuromuscular function were assessed by question naire or examination . Triannual mailed question naires ascertained incident fracture ; reported fractures were adjudicated by physicians using medical records and X-ray reports . Proportional hazards models were used to develop multivariable models , selecting variables and controlling for BMD . RESULTS Of 5876 men , 4.7 % ( N = 275 ) reported an incident nonspine fracture during follow-up ( 11.46/1000 person-years ) .  Tricyclic antidepressant use ( hazard ratio [ HR ] , 2.36 ; 95 % CI , 1.25 - 4.46 ) , history of fracture at or after age 50 ( HR , 2.07 ; 95 % CI , 1.62 - 2.65 ) , inability to complete a narrow walk trial ( HR , 1.70 ; 95 % CI , 1.23 - 2.34 ) , falls in previous year ( HR , 1.59 ; 95 % CI , 1.23 - 2.05 ) , age > or = 80 years ( HR , 1.33 ; 95 % CI , 1.01 - 1.76 ) , depressed mood ( HR , 1.72 ; 95 % CI , 1.00 - 2.95 ) , and decreased total hip BMD ( HR , 1.53 ; 95 % CI , 1.34 - 1.74 ) were independently related to increased risk . Compared with having none ( 48.0 % of men ) , having three or more of the clinical risk factors ( 4.9 % of men ) increased fracture risk 5-fold , independent of BMD . Having three or more risk factors and being in the lowest tertile of BMD was associated with a 15-fold greater risk than having no risk factors and being in the highest BMD tertile . CONCLUSIONS Several clinical risk factors were independently associated with nonspine fractures in elderly men . The combination of multiple risk factors and low BMD was 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 .