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Title: Who should receive calcium and vitamin D supplementation?
Authors: VERBRUGGE, Frederik 
Gielen, Evelien
Milisen, Koen
Boonen, Steven
Issue Date: 2012
Source: AGE AND AGEING, 41 (5), p. 576-580
Abstract: Combined calcium and vitamin D supplementation is recommended in the prevention and treatment of osteoporosis. Until recently, supplementation was perceived as harmless without adverse effects. However, recent meta-analyses have provided evidence suggesting that calcium supplements, whether or not in combination with vitamin D, may be associated with cardiovascular risks. Although this finding constitutes a safety signal that has to be taken seriously, these data have to be interpreted with some caution. Current data do not allow definite conclusions to be drawn, but require further independent confirmation, since in numerous large studies, combined calcium and vitamin D supplementation did not increase cardiovascular events, even in the most frail and elderly populations. Nevertheless, it seems appropriate to correct calcium deficiency preferably by enhancing dietary intake and to target supplementation on individuals at high risk of fracture or in whom calcium and vitamin D deficiency is highly prevalent. Other trials have shown an increased risk of falls and fractures with annual oral administration of high dose of vitamin D. Therefore, supplementation with more frequent, lower doses is preferred. Yet, the optimal dosing schedule is unknown and needs further study. In order to correct age-associated secondary hyperparathyroidism and to prevent osteoporotic fractures, a daily dose of 1,000-1,200 mg calcium and 800 IU vitamin D is recommended in elderly or institutionalised people, patients with established osteoporosis and individuals on glucocorticoids.
Notes: Boonen, S (reprint author), [Gielen, Evelien; Boonen, Steven] Katholieke Univ Leuven, Dept Clin & Expt Med, Louvain, Belgium. [Verbrugge, Frederik H.] Ziekenhuis Oost Limburg, Dept Cardiol, Genk, Belgium. [Verbrugge, Frederik H.] Hasselt Univ, Doctoral Sch Med & Life Sci, Diepenbeek, Belgium. [Gielen, Evelien; Boonen, Steven] UZ Leuven, Ctr Metab Bone Dis, Louvain, Belgium. [Milisen, Koen] Katholieke Univ Leuven, Dept Publ Hlth, Ctr Hlth Serv & Nursing Res, Louvain, Belgium.
Keywords: Geriatrics & Gerontology; osteoporosis; calcium; vitamin D; dietary supplements; fracture prevention; cardiovascular complications; myocardial infarction;osteoporosis; calcium; vitamin D; dietary supplements; fracture prevention; cardiovascular complications; myocardial infarction
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ISSN: 0002-0729
e-ISSN: 1468-2834
DOI: 10.1093/ageing/afs094
ISI #: 000308011000005
Category: A2
Type: Journal Contribution
Appears in Collections:Research publications

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