Older adults who take vitamin D and calcium supplements may live a bit longer than their peers, a new research review suggests.
Researchers found that older adults who were given vitamin D and calcium supplements were 9 percent less likely to die over three years than those given placebo pills.
Vitamin D on its own, however, showed no effect on death rates.
The findings are based on data from eight past clinical trials - where people were randomly assigned to take vitamin D (with or without calcium) or get inactive placebos for comparison.
Those types of studies offer the strongest kind of evidence on whether the supplements have health effects or not, said Dr. Lars Rejnmark, the lead researcher on the review.
A 9 percent dip in death risk over a three-year period might sound small. To put it in context, Rejnmark’s team - some of whom have connections to supplement makers that market vitamin D and calcium products - estimates that to prevent one death, 151 older adults would have to take vitamin D and calcium for three years.
But that effect is “at least as pronounced” as the benefits linked to cholesterol-lowering statins and blood pressure drugs, said Rejnmark, an associate professor at Aarhus University in Denmark.
“In my view, a 9 percent reduced mortality in the general population of elderly is of major importance,” Rejnmark told Reuters Health by email.
Taking calcium supplements to build stronger bones may be bad for the heart, according to a new study that suggests getting similar doses from calcium-rich foods is a safer alternative.
The study, which followed nearly 24,000 German men and women between the ages of 35 and 64, found those who regularly took calcium supplements were 86 percent more likely to have a heart attack than those who did not. Study subjects who relied completely on supplements for their daily calcium intake were 139 percent more likely to have a heart attack.
“Calcium supplements, which might raise [heart attack] risk, should be taken with caution,” the authors wrote in their report, published Wednesday in the journal Heart.
Calcium is critical for strong bones and teeth. But the new study suggests supplements, many of which are sold as tasty gummy candies and chocolates, are no replacement for healthy foods.
“Except for stopping smoking,” he added, “there are not many other known interventions that are capable (of) such a reduction in the risk of death.”
EIGHT TRIALS, 70,000 PEOPLE
Rejnmark and his colleagues report the findings in the Journal of Clinical Endocrinology & Metabolism.
For their study, the researchers combined the results from eight clinical trials that involved more than 70,000 older adults altogether - mostly women.
Q: Calcium works with what vitamin to give us healthy teeth and bones?
A: Vitamin D. Calcium is a mineral that is an essential part of bones and teeth. The heart, nerves, and blood-clotting systems also need calcium to work. Food fact: Milk, yogurt, and cheese are the main food sources of calcium for the majority of people in the United States.
Q: Which ranks number one in antioxidant activity?
A: Blueberries. Delicious and rich in antioxidants, blueberries rank number one in antioxidant activity when compared with 40 other fresh fruits and vegetables. Anthocyanin, the antioxidant that is thought to be responsible for this major health benefit, can also be found in blackberries, black raspberries, black currants, and red grapes.
Q: What is the most abundant mineral in the body?
A: Calcium. Calcium is the most abundant mineral in the body.
In each trial, people were randomly assigned to take vitamin D or a placebo; some studies used a combination of vitamin D and calcium.
The doses varied, but most trials used a daily vitamin D dose of 10 to 20 micrograms. That’s in the recommended range: in the U.S., health officials suggest that most adults get 15 micrograms (or 600 IU) of vitamin D per day, while people older than 70 should strive for 20 micrograms (or 800 IU).
In trials that used calcium, the dose was 1,000 milligrams per day. In general, women older than 50, and all adults older than 70, are told to get 1,200 milligrams of calcium each day.
Vitamin D and calcium are probably best known as bone-builders. Older women often take the supplements to ward off the bone-thinning disease osteoporosis.
And some trials have found that the supplement combination can prevent falls and bone fractures in the elderly.
But that probably does not explain the lower death risk in this study. When the researchers factored in hip and spine fractures, they did not account for the dip in death risk.
Another possibility is that supplements curbed people’s risk of dying from cancer. There’s some evidence that calcium and vitamin D may lower the odds of colon cancer, Rejnmark said. But he added that the evidence is not yet “firm.”
SUPPLEMENTS MAY CARRY RISKS
For now, Rejnmark said the findings support getting the recommended amounts of vitamin D and calcium.
But that doesn’t mean supplements don’t carry any risks.
In particular, Rejnmark noted, some research has linked calcium supplements (not calcium-rich food) to an increased risk of heart attack in older adults - though it’s not clear if the supplement is to blame.
As for known side effects, calcium supplements may boost a person’s risk of kidney stones. And very high levels of vitamin D can cause symptoms like nausea, vomiting, constipation and poor appetite.
In the U.S., the Institute of Medicine says people should get no more than 100 micrograms, or 4,000 IU, of vitamin D each day. The upper limit for calcium in older adults is 2,000 milligrams.
People can, of course, get calcium and vitamin D through food too. Dairy foods are rich in calcium; other sources include greens like broccoli and kale, and fortified juices and breakfast cereals. Food sources of vitamin D are relatively few, but include fatty fish like salmon and tuna, plus fortified milk, juice and cereals.
SOURCE: Journal of Clinical Endocrinology & Metabolism, online May 17, 2012
Vitamin D with Calcium Reduces Mortality: Patient Level Pooled Analysis of 70,528 Patients from Eight Major Vitamin D Trials
Results: The IPD analysis yielded data on 70,528 randomized participants (86.8% females) with a median age of 70 (interquartile range, 62–77) yr. Vitamin D with or without calcium reduced mortality by 7% [hazard ratio, 0.93; 95% confidence interval (CI), 0.88–0.99]. However, vitamin D alone did not affect mortality, but risk of death was reduced if vitamin D was given with calcium (hazard ratio, 0.91; 95% CI, 0.84–0.98). The number needed to treat with vitamin D plus calcium for 3 yr to prevent one death was 151. Trial level meta-analysis (24 trials with 88,097 participants) showed similar results, i.e. mortality was reduced with vitamin D plus calcium (odds ratio, 0.94; 95% CI, 0.88–0.99), but not with vitamin D alone (odds ratio, 0.98; 95% CI, 0.91–1.06).
Conclusion: Vitamin D with calcium reduces mortality in the elderly, whereas available data do not support an effect of vitamin D alone.
Haakon E. Meyer,
Kerrie M. Sanders,
Helen E. Smith,
Elizabeth. T. Jacobs,
Rebecca D. Jackson,
JoAnn E. Manson,
John A. Robbins,
Roger M. Francis and