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 .
Risk Factors for Perimenopausal Fractures: A Prospective Study
Abstract : This prospect i ve study was aim ed at determining the risk factors for the development of fractures in perimenopausal women . The study group ( n= 3068 ) was comprised of a stratified population sample of women aged between 47 and 56 years . During the follow-up period of 3.6 years , 257 ( 8.4 % ) of the women sustained a total of 295 fractures . After adjustment for covariates , the relative risk ( RR ) of sustaining a fracture was found to be 1.4 [ 95 % confidence interval ( CI ) 1.2–1.6 ] for a 1 st and ard deviation ( SD ) decrease in the spinal and femoral neck bone mineral density ( BMD ) . Women with a previous fracture history were found to have an increased risk of fracture [ RR 1.7 ( 95 % CI 1.3–2.2 ) ] and those reporting three or more chronic illnesses exhibited a RR of 1.4 ( 95 % CI 1.0–1.9 ) . Women not using hormone replacement therapy ( HRT ) had a RR of 1.5 ( 95 % CI 1.1–2.2 ) for all fracture types . When osteoporotic fractures ( vertebral , hip , proximal humerus and wrist fractures ; n= 98 ) were used as an endpoint , the independent risk factors were found to be a low BMD ( RR for a 1 SD decrease in both spinal and femoral neck BMD was 1.6 , 95 % CI 1.3–2.0 ) , a previous fracture history ( RR 1.9 , 95 % CI 1.3–2.9 ) and nonuse of HRT ( RR 2.2 , 95 % CI 1.3–4.0 ) . The independent risk factors for all other fractures ( n = 158 ) were a low BMD ( RR for a 1 SD decrease in the spinal BMD was 1.4 , 95 % CI 1.2–1.6 and in the femoral neck BMD was 1.3 , 95 % CI 1.1–1.5 ) , a previous fracture history ( RR 1.6 , 95 % CI 1.1–2.2 ) , smoking ( RR 1.8 , 95 % CI 1.1–2.7 ) and having had three or more chronic illnesses ( RR 1.6 , 95 % CI 1.1–2.2 ) . Weight , height , age , menopausal status , maternal hip fracture , use of alcohol , coffee consumption or dietary calcium intake were not independently associated with the development of any particular type of fracture . We conclude that the independent risk factors for perimenopausal fractures are a low bone density , previous fracture history , nonuse of HRT , having had three or more chronic illnesses and smoking , the gradient of risk being similar for spinal and femoral neck BMD measurements in the perimenopausal population . The risk factors are slightly different for perimenopausal osteoporotic than for other types of 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 .