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 .
Clinical risk factors for fractures in multi-ethnic women: the Women's Health Initiative.
UNLABELLED To identify risk factors for fractures in multi-ethnic women , we studied 159,579 women enrolled in the Women 's Health Initiative . In general , risk factors for fractures were similar across ethnic groups . However , irrespective of their ethnicity , women with multiple risk factors have a high risk of fracture . Targeting these high-risk women for screening and intervention could reduce fractures . INTRODUCTION Fracture rates tend to be lower in minority women , but consequences may be greater . In addition , the number of fractures is expected to increase in minority women because of current demographic trends . There are limited prospect i ve data on risk factors for fractures in minority women . MATERIAL S AND METHODS We studied 159,579 women 50 - 79 yr of age enrolled in the Women 's Health Initiative . Information on risk factors was obtained by question naire or examination . Nonspine fractures that occurred after study entry were identified over an average follow-up of 8 + /- 2.6 ( SD ) yr . RESULTS Annualized rates ( % ) of fracture in whites , blacks , Hispanics , Asians , and American Indians were 2.0 , 0.9 , 1.3 , 1.2 , and 2.0 , respectively . Significant predictors [ HR ( 95 % CI ) ] of fractures by ethnic group were as follows : blacks : at least a high school education , 1.22 ( 1.0 , 1.5 ) ; ( + ) fracture history , 1.7 ( 1.4 , 2.2 ) ; and more than two falls , 1.7 ( 1.9 , 2.0 ) ; Hispanics : height ( > 162 cm ) , 1.6 ( 1.1 , 2.2 ) ; ( + ) fracture history , 1.9 ( 1.4 , 2.5 ) ; more than two falls , 1.8 ( 1.4 , 2.3 ) ; arthritis , 1.3 ( 1.1 , 1.6 ) ; corticosteroid use , 3.9 ( 1.9 , 8.0 ) ; and parental history of fracture , 1.3 ( 1.0 , 1.6 ) ; Asians : age ( per 5 yr ) , 1.2 ( 1.0 , 1.3 ) ; ( + ) fracture history , 1.5 ( 1.1 , 2.0 ) ; current hormone therapy ( HT ) , 0.7 ( 0.5 , 0.8 ) ; parity ( at least five ) , 1.8 ( 1.1 , 3.0 ) ; more than two falls , 1.4 ( 1.1 , 1.9 ) ; American Indian : ( + ) fracture history , 2 . 9 ( 1.5 , 5.7 ) ; current HT , 0.5 ( 0.3 , 0.9 ) . Women with eight or more risk factors had more than a 2-fold higher rate of fracture compared with women with four or fewer risk factors . Two ethnicity x risk factor interactions were identified : age and fall history . CONCLUSIONS Irrespective of their ethnicity , women with multiple risk factors have a high risk of fracture . Targeting these high-risk women for screening and intervention could reduce fractures
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 .