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Are calcium and vitamin D supplements a waste of time?

Many people think so after recent reviews of a lot of research concluded that they don’t reduce our fracture risk. 

So if they don’t reduce our likelihood of breaking bones, is there any point in taking them?

Well, it’s complicated.

For a start, calcium and vitamin D aren’t the only factors that influence whether or not you break a bone. For example, people who fall over more often are more likely to break something.

There’s also a broad range of nutrients needed for healthy bone; it’s not just about calcium and vitamin D. 

And it’s argued that while calcium and vitamin D can’t be shown to reduce fractures or build bone, they slow bone loss, which is also valuable.

In addition, calcium supplements vary. Calcium carbonate is most widely used because it’s cheaper. But it’s not the best form for absorption, and it’s the form that seems more likely to end up in the wrong places — in your arteries rather than your bones, for instance. 

Vitamin D also seems to be an important factor in a raft of health issues, not just bone.

Somehow, we have to weave our way through that maze to make sense of what it means for us as individuals.

Here are my thoughts.

The smartest thing we can do is to eat the best quality diet that we can (you know the drill: plenty of vegetables and fruit, protein at each meal, and healthy fats), exercise to stay strong and healthy, and be smart about sleep and stress.

As far as diet is concerned, calcium may not be the be-all-and-end-all but it’s essential for healthy bones, muscles and organs so it makes sense to eat plenty of high-calcium foods.

The recommended daily requirement for women is 1000mg before menopause and 1200 or 1300mg after. Most of us have to be highly intentional to eat that much. 

The reason for the increased amount post-menopause is that with lower estrogen levels the breakdown of old bone outpaces our formation of new bone. In the 70s it was theorised that more calcium in our diets would help to compensate for this.

A fellow called Walter Willet — an internationally respected nutrition professor at Harvard — isn’t convinced that we need that much. He thinks half that amount will suffice.

A lot of us would still need to make a concerted effort to manage 600-700mg, so for example, include yoghurt at breakfast, tinned fish with bones at lunch, tahini in salad dressings or hummus, cheese and almonds for snacks.

Eat slowly, chew well, and avoid taking Proton Pump Inhibitors (Nexium, Losec and the like) for reflux because they decrease our absorption of calcium.

All of those comprise Step One. 

Then, if your calcium intake needs a boost and you decide to take a supplement, ideally choose one that’s well absorbed, such as calcium citrate or hydroxyapatite. 

If you use calcium carbonate, it’s probably wise not to take it all in one lot; divide the dose and take it with meals.

Vitamin D helps us utilise calcium, but low vitamin D levels also seem to be implicated in a range of chronic diseases as well as depression and muscle weakness. 

There’s still a huge amount we don’t know about it, and there are plenty of arguments that we’re over-testing and overprescribing — which may be valid. But given the issues linked with low vitamin D, I’d be making sure mine was adequate.

Have a blood test to check yours and work out with your doctor whether you need to supplement. As you know, we get it from sunlight, so most of us will have higher levels at this time of year. Maybe you can give it a break over summer.

Look for well-balanced supplements that include other bone health nutrients such as magnesium and vitamin K2. It also pays to include magnesium-rich foods in your diet — nuts and seeds, pulses and leafy greens (and, of course, chocolate). K2 is a bit harder to find in food.

The most recent information for GPs advises against routine supplementation of calcium and vitamin D for non-institutionalised people. But everyone’s an individual and there may still be a sensible argument for taking either or both. 

Photo Source: Bigstock

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Tuesday, January 23, 2018 | Rhonda Anderson