Beruflich Dokumente
Kultur Dokumente
Dr. P
NUTR 346
11 March 2018
observed in order to determine if more vitamin D and calcium prevented bone fractures in older
populations. Other studies had come to mixed conclusions as to whether or not supplementation
helped, leading to the conduction of this study. Many trials were studied to find that
calcium, and the two combined led to a decreased number of bone fractures or was associated
with a lower risk of fractures in community-dwelling adults. There are a lot of older adults
(especially women) over the age of 50 who suffer from hip fractures. One study showed that
“more than one-fifth of patients died within 1 year of hip fracture” (Liu). This is an alarming
number of women who suffer traumatically from hip fractures. This study was conducted to see
if hip fractures could be prevented. If said fractures could be prevented, death could possibly be
prevented as well. The reason as to why the investigation was geared toward community-
meals are regulated. The meals they serve have to contain a certain amount of vitamin D and
calcium in each meal. All meals given have a nutrient requirement. In a community, everyone is
responsible for the food they eat. They get to choose what they do or do not eat. The meals aren’t
regulated which can mean that adults are not choosing calcium or vitamin D-rich foods.
This investigation used many resources such as PubMed, Chochrane library, and
EMBASE databases to research more about calcium and vitamin D analyses. They used these
databases because they are highly respected. They searched with the “keywords calcium, vitamin
D, and fracture” (Liu) in order to find published reviews on the interactions of supplements and
their relationship with fracture incidences. Another factor in their research methods was that they
only sought out systematic reviews “published in the last 10 years from December 24, 2006, to
December 24, 2016” (Liu). The reason there is only a ten year range of where they obtained their
research is because nutrition is a fairly young research category. Science has changed drastically
in the past recent years and systematic reviews from longer than ten years may not be relevant to
the more recent research today. Along with research methods, there are three inclusion criteria
for this study. They include randomized clinical trials that compared calcium, vitamin D, or the
two supplements combined with a placebo group. The second inclusion criteria included adults
over 50 years living in a community. The last criteria were trials that provided fracture data. The
exclusion criteria contained randomized clinical trials with no placebo group, trials with
treatments. Other exclusion criteria included trials with other forms of vitamin D and trials of
The end point of the study was the number of hip fractures, which could be measured. It
showed that supplements did not really help in the prevention of fractures. There were 51,145
participants involved of which supplementation was not beneficial. The same was the case for
calcium supplementation as well as for vitamin D. The combination of vitamin D and calcium
also had no significant difference in the number of fractures. Because of these results, it is
suggested that calcium not be recommended in order to prevent fractures. The conclusion that
this study reached was that the evidence was not there that supplementation reduces the risk of
hip fractures.
Even though there was a lot of evidence supporting the lack of effectiveness of
supplementation, there are many weaknesses and limitations of this study. It only included
participants in a community. However, previous trials had found that supplementation lowered
the risk of fractures for people living in an institution. These patients are more likely to develop
osteoporosis because of less mobility and not being able to get as much exposure to sun. Another
limitation is that it is a correlational study and did not include a measure of the vitamin D
baseline, so there was no way of measuring if their vitamin D and calcium levels had improved.
Based on the evidence here, I would not recommend supplementation to patients. It is clear that
without other treatment, supplements of vitamin D and/or calcium do not help with the
prevention of fractures.
The evidence of this study concluded that there was no evidence that supplements
lowered the risk of fractures in community-dwelling adults. There were many databases that
were researched and many trials performed. Although there were weaknesses, the evidence could
not be clearer that supplementation was not helpful in lowering the risk of fractures in older
adults.