“Vitamin D and calcium supplements may not lower fracture risk.”
In 2015, studies showed that Calcium supplements have risks and side effects, and are not likely indicated for most healthy community-dwelling adults over 50. These folks are not in a high-risk category for vitamin deficiencies, osteoporosis, and fractures, and we usually advise them to get their calcium from food.
Dietary sources of calcium are everywhere, including milk and yogurt, but also include green leafy veggies like collard greens, legumes like black-eyed peas, tofu, almonds, orange juice.
Research found that taking vitamin D supplements did not protect against fractures in people over 50.
Indeed, the original recommendations for calcium supplementation were based on a study of elderly, nursing-home bound women with vitamin deficiencies and low bone density, for whom calcium and vitamin D supplements did significantly reduce fracture risk.
Advice to healthy patients is still to get calcium from foods, and the best diet for this is a Mediterranean-style diet rich in colorful plants, plenty of legumes, and fish. This plus high-protein, low-fat, and low-sugar dairy (yogurt is ideal) can supply plenty of calcium.
Vitamin D deficiency includes people with eating disorders; people who have had gastric bypass surgeries; those with malabsorption syndromes like celiac sprue; pregnant and lactating women; people who have dark skin; and those who wear total skin covering (and thus absorb less sunlight). In addition, people with or at risk for low bone density (perimenopausal and postmenopausal women, people diagnosed with other skeletal disorders, or who take certain medications), should discuss whether they need supplements and to have blood levels of vitamin D monitored.
Vitamin D supplement of 1,000 IUs daily is advised.
For people who would rather avoid a supplement but may need a boost of vitamin D, it is also found in some common foods, including sardines, salmon, tuna, cheese, egg yolks, and vitamin-fortified milk.
For “healthy community-dwelling adult” category, a supplement of anywhere from 400 to 2,000 IUs of vitamin D daily is not likely to cause harm.
Yes, vitamin D toxicity is a thing, usually seen at levels above 80 ng/ml, which causes excessive calcium to be released into the bloodstream.
Other important and effective ways to protect your bones:
There are other methods that may be more effective at maintaining bone health and reducing fracture risk.
One that we can likely all agree on is regular physical activity.
Weight-bearing exercise like walking, jogging, tennis, and aerobics definitely strengthens bones.
Core exercises like yoga and Pilates can improve balance.
All of this can help reduce falls and fracture risk.
Rcommendations: A mediterranean-style diet rich in colorful plants, plenty of legumes, fish, plus low-sugar, low-fat dairy and plenty of varied physical activity throughout your entire life and maybe calcium and/or vitamin D supplementation for certain people, following a discussion with their doctors.
