Vitamin D and Calcium Supplementation to Prevent Fractures in Adults
Authors: Virginia A. Moyer, Michael L. LeFevre, Albert L. Siu
Journal: Annals of Internal Medicine (2013)

Letters17 December 2013Vitamin D and Calcium Supplementation to Prevent Fractures in AdultsVirginia A. Moyer, MD, MPH, Michael L. LeFevre, MD, MSPH, and Albert L. Siu, MD, MSPHVirginia A. Moyer, MD, MPHFrom U.S. Preventive Services Task Force, Rockville, Maryland., Michael L. LeFevre, MD, MSPHFrom U.S. Preventive Services Task Force, Rockville, Maryland., and Albert L. Siu, MD, MSPHFrom U.S. Preventive Services Task Force, Rockville, Maryland.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-12-201312170-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:The USPSTF anticipated the challenges and honest scientific disagreements on the use of vitamin D and calcium supplementation to prevent fractures.Dr. Sugiyama's suggestion that mechanical effects play a substantial role in bone strength and quality—and therefore in risk for fractures, regardless of or despite supplement use—is an important observation. The Task Force agrees that more research is needed.Dr. Reidenberg highlights the challenges of drawing conclusions from the WHI study and other randomized, controlled trials of vitamin D and calcium. As he mentions, the standard technique for studying the effectiveness of an intervention is intention-to-treat analysis to ...References1. Cranney A, Horsley T, O'Donnell S, Weiler H, Puil L, Ooi D, et al. Effectiveness and Safety of Vitamin D in Relation to Bone Health. Evidence Report/Technology Assessment no. 158. Rockville, MD: Agency for Healthcare Research and Quality; 2007. Accessed at www.ncbi.nlm.nih.gov/books/NBK38410/ on 31 May 2012. Google Scholar2. Chung M, Balk EM, Brendel M, Ip S, Lau J, Lee J, et al. Vitamin D and Calcium: A Systematic Review of Health Outcomes. Evidence Report/Technology Assessment no. 183. Rockville, MD: Agency for Healthcare Research and Quality; 2009. Accessed at www.ncbi.nlm.nih.gov/books/NBK32603/ on 31 May 2012. Google Scholar3. Chung M, Lee J, Terasawa T, Lau J, and Trikalinos TA. Vitamin D with or without calcium supplementation for prevention of cancer and fractures: an updated meta-analysis for the U.S. Preventive Services Task Force. Ann Intern Med. 2011;155:827-38 LinkGoogle Scholar4. DIPART (Vitamin D Individual Patient Analysis of Randomized Trials) Group. Patient level pooled analysis of 68 500 patients from seven major vitamin D fracture trials in US and Europe. BMJ. 2010;340:b5463. [PMID: 20068257] CrossrefMedlineGoogle Scholar5. Bischoff-Ferrari HA, Willett WC, Orav EJ, Oray EJ, Lips P, Meunier PJ, et al. A pooled analysis of vitamin D dose requirements for fracture prevention. N Engl J Med. 2012;367:40-9. [PMID: 22762317] CrossrefMedlineGoogle Scholar6. Tang BM, Eslick GD, Nowson C, Smith C, and Bensoussan A. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet. 2007;370:657-66. [PMID: 17720017] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Virginia A. Moyer, MD, MPH; Michael L. LeFevre, MD, MSPH; Albert L. Siu, MD, MSPHAffiliations: From U.S. Preventive Services Task Force, Rockville, Maryland.Disclosures: Disclosure forms from USPSTF members can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-0215. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoVitamin D and Calcium Supplementation to Prevent Fractures in Adults: U.S. Preventive Services Task Force Recommendation Statement Virginia A. Moyer , on behalf of the U.S. Preventive Services Task Force* Vitamin D and Calcium Supplementation to Prevent Fractures in Adults Marcus M. Reidenberg Vitamin D and Calcium Supplementation to Prevent Fractures in Adults Toshihiro Sugiyama Metrics 17 December 2013Volume 159, Issue 12Page: 856-857KeywordsBoneBone fractureCalciumNutritionSystematic reviewsVitamin D ePublished: 17 December 2013 Issue Published: 17 December 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...