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The role of calcium supplementation in healthy musculoskeletal ageing

The role of calcium supplementation in healthy musculoskeletal ageing
The role of calcium supplementation in healthy musculoskeletal ageing
The place of calcium supplementation, with or without concomitant vitamin D supplementation, has been much debated in terms of both efficacy and safety. There have been numerous trials and meta-analyses of supplementation for fracture reduction, and associations with risk of myocardial infarction have been suggested in recent years. In this report, the product of an expert consensus meeting of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the International Foundation for Osteoporosis (IOF), we review the evidence for the value of calcium supplementation, with or without vitamin D supplementation, for healthy musculoskeletal ageing. We conclude that: 1) calcium and vitamin D supplementation leads to a modest reduction in fracture risk, although population-level intervention has not been shown to be an effective public health strategy; 2) supplementation with calcium alone for fracture reduction is not supported by the literature; 3) side effects of calcium supplementation include renal stones and gastrointestinal symptoms; 4) vitamin D supplementation, rather than calcium supplementation, may reduce falls risk; and 5) assertions of increased cardiovascular risk consequent on calcium supplementation are not convincingly supported by current evidence. In conclusion, we recommend, on the basis of the current evidence, that calcium supplementation, with concomitant vitamin D supplementation, is supported for patients at high risk of calcium and vitamin D insufficiency, and in those who are receiving treatment for osteoporosis.
0937-941X
1-34
Harvey, Nicholas
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Biver, E.
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Kaufman, J.M.
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Bauer, J.
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Branco, J.
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Brandi, M.L.
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Bruyere, O.
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Coxam, V.
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Cruz-Jentoft, A.
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Czerwinski, E.
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Dimai, H.
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Fardellone, P.
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Landi, F.
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Reginster, J.Y.
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Dawson-Hughes, B.
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Kanis, J.A.
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Rizzoli, R.
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Cooper, Cyrus
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Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Biver, E.
652d49a5-9785-481e-a762-239e284271e1
Kaufman, J.M.
b79b47cd-16f0-4619-bf7c-fb77b115d2cd
Bauer, J.
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Branco, J.
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Brandi, M.L.
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Bruyere, O.
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Coxam, V.
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Cruz-Jentoft, A.
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Czerwinski, E.
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Dimai, H.
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Fardellone, P.
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Landi, F.
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Reginster, J.Y.
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Dawson-Hughes, B.
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Kanis, J.A.
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Rizzoli, R.
2214fb77-8fb7-4c0b-bfc4-9f8d3cace5d7
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6

Harvey, Nicholas, Biver, E., Kaufman, J.M., Bauer, J., Branco, J., Brandi, M.L., Bruyere, O., Coxam, V., Cruz-Jentoft, A., Czerwinski, E., Dimai, H., Fardellone, P., Landi, F., Reginster, J.Y., Dawson-Hughes, B., Kanis, J.A., Rizzoli, R. and Cooper, Cyrus (2016) The role of calcium supplementation in healthy musculoskeletal ageing. Osteoporosis International, 1-34. (In Press)

Record type: Article

Abstract

The place of calcium supplementation, with or without concomitant vitamin D supplementation, has been much debated in terms of both efficacy and safety. There have been numerous trials and meta-analyses of supplementation for fracture reduction, and associations with risk of myocardial infarction have been suggested in recent years. In this report, the product of an expert consensus meeting of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the International Foundation for Osteoporosis (IOF), we review the evidence for the value of calcium supplementation, with or without vitamin D supplementation, for healthy musculoskeletal ageing. We conclude that: 1) calcium and vitamin D supplementation leads to a modest reduction in fracture risk, although population-level intervention has not been shown to be an effective public health strategy; 2) supplementation with calcium alone for fracture reduction is not supported by the literature; 3) side effects of calcium supplementation include renal stones and gastrointestinal symptoms; 4) vitamin D supplementation, rather than calcium supplementation, may reduce falls risk; and 5) assertions of increased cardiovascular risk consequent on calcium supplementation are not convincingly supported by current evidence. In conclusion, we recommend, on the basis of the current evidence, that calcium supplementation, with concomitant vitamin D supplementation, is supported for patients at high risk of calcium and vitamin D insufficiency, and in those who are receiving treatment for osteoporosis.

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nch_eb ESCEO CaD review_v5 R1 10092016 clean.docx - Accepted Manuscript
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Accepted/In Press date: 26 September 2016
Organisations: Faculty of Medicine

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Local EPrints ID: 401073
URI: http://eprints.soton.ac.uk/id/eprint/401073
ISSN: 0937-941X
PURE UUID: d7e15054-7a04-4ed4-bef4-63c51327fd3e
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 03 Oct 2016 15:56
Last modified: 07 Oct 2020 05:46

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Contributors

Author: Nicholas Harvey ORCID iD
Author: E. Biver
Author: J.M. Kaufman
Author: J. Bauer
Author: J. Branco
Author: M.L. Brandi
Author: O. Bruyere
Author: V. Coxam
Author: A. Cruz-Jentoft
Author: E. Czerwinski
Author: H. Dimai
Author: P. Fardellone
Author: F. Landi
Author: J.Y. Reginster
Author: B. Dawson-Hughes
Author: J.A. Kanis
Author: R. Rizzoli
Author: Cyrus Cooper ORCID iD

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