Breakthrough Study Establishes New Guidelines For Calcium And Vitamin D Supplementation To Prevent Osteoporosis

James Meschino DC, MS, ROHP

In brief:
A recent study in the American Journal of Clinical Nutrition showed that supplementation with 1500 mg of calcium and 1400 IU of vitamin D per day increased bone density in older subjects (men and women) who had previously sustained bone fractures due to poor bone density. Prior to this study it was believed that calcium and vitamin D supplementation could only slow the loss of bone density in persons over 50 years of age. However, we now realize that bone density can actually be increased if sufficient calcium and vitamin D is supplemented daily. These new findings suggest that adults over 50 should supplement their diet with dosages of calcium and vitamin D that are higher than were previously recommended by health authorities.

Bones Require Specific Nutrients To Remain Strong For A 
It is well established that developing and maintaining strong bones is dependent upon feeding your body the nutrients required for bone support. Many of these nutrients are provided by taking a high potency multiple vitamin and mineral per day, which ensures that your bones get fed some extra calcium, vitamin D, vitamin C, certain B-vitamins, magnesium, zinc, and copper – all of which serve necessary functions in building bone proteins and facilitating bone mineralization (the process that hardens and strengthens bone by laying down key minerals within the protein framework of bone). As most people do not acquire optimal levels of many of these nutrients each day from food, taking a high potency multiple vitamin and mineral supplement is an important step in osteoporosis prevention and management. However, even a high potency multiple vitamin and mineral supplement can only provide 500 mg of calcium and 400 IU of vitamin D. And that is simply not enough to prevent osteoporosis as we get older. As well, studies now show that supplementing with ipriflavone and silica can also help to support bone density, helping to decrease osteoporosis risk. Ipriflavone is a nutrient derived from soy beans and silica is a mineral required in small doses by the human body (required for healthy bones, skin, hair and collagen). As such, after age 40 for women and after age 50 for men, it is wise to take an additional supplement that provides additional calcium and vitamin D along with other targeted bone support nutrients, like ipriflavone, silica and additional zinc, magnesium, phosphorous and boron. Based on recent findings the new goal is to supplement your body with 1500 mg of calcium per day and at least 1200 IU of vitamin D. This can easily be accomplished by taking 2 caplets of Adeeva’s Bone Support Formula, at two meals each day. In addition to boosting your intake of calcium to 1500 mg and vitamin D to 1200 IU (when used in conjunction with Adeeva’s  high potency multiple vitamin and mineral supplement), the Bone Support Formula provides added targeted nutrients to help prevent osteoporosis – namely ipriflavone, silica, zinc, copper, magnesium, phosphorous, boron and others.

Osteoporosis Causes More Deaths Than Breast And Ovarian Cancer
The big tragedy around osteoporosis is that consequences of osteoporosis fractures kills more people each year in Canada than the combined mortality rate for breast and ovarian cancers. The bigger tragedy is that unlike breast and ovarian cancer, we know exactly how to prevent osteoporosis from developing. Yet one in four women and one and eight men over 50 develop this problem. It is clearly up to health care professionals to educate patients about how to prevent this problem and ensure that each patient is given a practical strategy involving food, physical activity and supplementation to maximize their defense.

Studies are now showing that even in patients who already have osteoporosis or osteopenia (the stage between normal bone density and full-blown osteoporosis) that supplementation with 1500 mg of calcium and 1400 IU of vitamin D per day can reverse the process and strengthen their bones. This was shown to be true in a recent study by MF Hitz and fellow researchers (Amer J Clin Nutr 2007). They showed that calcium and vitamin D supplementation at these dosages increased bone mineral density (in the lumbar spine) in individuals who previously experienced a recent low-energy fracture and exhibited low bone mineral density upon base-line testing. In this double-blinded study involving 122 subjects, over 50 years of age (84% were postmenopausal women), who had sustained a low energy fracture of the hip or upper extremity, subjects were randomly assigned approximately 1500 mg of elemental calcium plus 1400 IU of vitamin D or a placebo (containing 200 IU of vitamin D). Bone density of their hips and lumbar spine were taken at base-line and after 12 months of intervention. Other markers of bone turnover as well as parathyroid hormone levels were also evaluated during the study period. The timed Up & Go test was used to assess physical performance. After 12 months of intervention the group receiving the calcium and vitamin D supplements showed reduced bone turnover, and significantly increased their bone mineral density (specifically in the lumbar spine). The sub-group of individuals who were the most physically active, within the group ingesting the calcium and vitamin D supplements (1400 IU) realized the best overall outcomes in regards to increased bone density and bone turnover indicators. In contrast to the group receiving calcium and vitamin D (1400 IU) supplementation, subjects in the placebo group showed a decrease in bone density during the 12-month study period, including those who were physically active.

Don’t Let It Happen To You Or A Loved 
The bottom line is that no one should ever develop osteoporosis and certainly no one should die from complications that ensue following an ostorporotic fracture. We know exactly how to prevent this problem and how to do it safely. Yet, thousands of seniors either die from these complications or spend the rest of their lives relying on walkers and wheel chairs to get around due to spinal compression fractures and/or hip factures, at which point their quality of life and functional living is severely compromised. The solution is simple: begin today to employ a strategy for optimal bone support that will carry you through your retirement years, enabling you to maintain the quality of life and degree of functional living you deserve. Real prevention requires day-to-day application of these practices to ensure optimal bone density for a lifetime. Its’ up to you to do this for yourself and to share your strategy with loved ones who may be less enlightened. I would encourage you to consider how a high potency multiple vitamin and mineral and supplement and an additional bone support supplement maybe a practical and vital component of your game plan for success. As a final note, these same levels of calcium and vitamin D supplementation (1500 mg calcium and minimum 1,000 IU vitamin D) were also recently shown to reduce overall risk of cancer by 50-60% in a recent study by JM Lappe and fellow researchers. Not a bad side effect if you ask me.

Selected References:

• Edmunds MW and Mayhew MS (editors). Pharmacology for the primary care provider (2^nd edition) 2004; chapter 40 (Osteoporosis Treatment): 440-447.
• Kaunitz, Andrew M., M.D. Use of Combination Hormone Replacement Therapy in Light of Recent Data From the Women’s Health Initiative. Medscape Women’s Health eJournal, Jul 12, 2002
• Heaney RP, Dowell S, Bierman J, Hale C and Bendich AB. Absorbability and cost-effectiveness in calcium supplementation. J Am College Nutr, 20; 3:239-246. 2001
• Veith R, Bischoff-Ferrari H, Boucher BJ, Dawson-Hughes B, Garland CF, Heaney RP et al. The urgent need to recommend an intake of vitamin D that is effective. Am J Clin Nutr, 85:649-50. 2007
• Hitz MF, Jenson JB, Eskildsen PC. Bone mineral density and bone markers in patients with recent low-energy fracture: effect of 1-year treatment with calcium and vitamin D. Am J Clin Nutr, 86:251-9. 2007
• Lappe JM, Travers-Gustafson D, Davies KM, Recker RR and Heaney RP. Vitamin D and calcium supplementation reduces cancer risk: result from a randomized trial. Am J Clin Nutr, 85:1586-91. 2007
• Veith R. Vitamin D supplementation, 25-hydroxy Vitamin D concentrations and safety.  Am J Clin Nutr 1999; 69(5):842-56
• Optimal calcium intake: NIH consensus panel. JAMA 1994;272:1942-8.
• Lappe JM et al. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007;85:1586-91