Healthy Older Women Advised Against Taking Calcium

U.S government experts found no evidence that calcium, vitamin D supplements help prevent fractures

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"With the IOM taking the physiological perspective, their work might be considered more sensitive [more able to pick up potential benefits or risks]," he said

Marion Nestle, a professor of nutrition, food studies and public health at New York University, co-wrote a journal editorial suggesting that statements from the task force are unlikely to settle the ongoing debate about the use of vitamin D and calcium. "The task force looks at one or two nutrients and one condition at a time, but that's not how people eat or live," she said.

Yet Nestle said she thinks the guidelines suggest reasonable approaches to prevention. "Clinicians ought to be advising healthy diets, plenty of activity and at least 15 minutes a day of sun exposure," she said.

Dr. Margery Gass, executive director of the North American Menopause Society, helped create clinical guidelines on osteoporosis for the American College of Obstetricians and Gynecologists published last year. Gass said she thinks the sheer number of guidelines being disseminated from a variety of different groups is "likely to stir up a little confusion and frustration" among clinicians and the public. But she added that the core message of the USPSTF guidelines is actually simple. "The good thing is that healthy people who do eat a variety of foods may not need to feel compelled to take supplements," she said.

Some expressed concern that the guidelines from the USPSTF are often slow to be implemented because doctors typically practice medicine the way they were trained, and are unlikely to respond quickly to new recommendations.

"I think the response will be very similar to the reaction physicians had to the mammogram guidelines [in 2009]," said Dr. Christine Gerbstadt, a registered dietitian and a spokesperson for the Academy of Nutrition and Dietetics. "Most physicians are just sending their patients for annual mammograms despite the recommendations. Dietitians will get the word out, but where the lag is going to be is with physicians who will be a lot slower to stop [recommending] the calcium," she said.

Moyer, the task force chair, suggested that consumers review the guidelines and bring them along when they see their physician. "Just say, 'I've printed this out and let's talk about it.'" Depending on your particular situation, the best option may require a thorough discussion, she said.

Rather than being confused by the debate between constituencies and organizations about how to deal with preventing fractures, Moyer urged consumers to digest the key message: "Don't bother with inadequate supplemental doses and look for new research about how much vitamin D we really need."

More information

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