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Calcium and vitamin D supplementation: state of the art for daily practice.

van der Velde RY, Brouwers JR, Geusens PP, Lems WF, van den Bergh JP - Food Nutr Res (2014)

Bottom Line: Data on difference between calcium absorption with calcium carbonate compared to calcium citrate with simultaneous use of proton pump inhibitors are lacking.In most patients 500 mg per day is required to achieve a total intake of 1,200 mg, or in some 1,000 mg per day.More calcium is absorbed from calcium citrate compared to calcium carbonate.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, VieCuri Medical Centre for North Limburg, Venlo, The Netherlands.

ABSTRACT

Background: Calcium and vitamin D play an essential role in bone metabolism but deficiency and/or inadequate intake are common.

Objectives: To describe a practical approach based on the literature regarding clinically important aspects of calcium and vitamin D supplementation.

Methods: A systematic evaluation of relevant literature in Medline was conducted. We included physiological studies, publications on relevant guidelines, meta-analysis, randomized clinical trials, and cohort studies.

Results: An adequate calcium intake and vitamin D supplementation is recommended in most guidelines xon fracture prevention. Daily supplementation with 800 IU is advocated in most guidelines, appears to be safe, and with this approach it is generally not necessary to determine vitamin D levels. There are no data on additional effects of loading doses of vitamin D on fracture or fall prevention. Calcium supplementation should be tailored to the patient's need: usually 500 mg per day is required. The intestinal absorption of calcium citrate is approximately 24% better than that of calcium carbonate independent of intake with meals. Data on difference between calcium absorption with calcium carbonate compared to calcium citrate with simultaneous use of proton pump inhibitors are lacking. Concern has arisen about a possible link between calcium supplementation and an increased risk of myocardial infarction. Probably only well-designed prospective randomized controlled trials will be able to allow definite conclusions on this subject.

Conclusion: Daily supplementation with 800 IU vitamin D is a practical and safe strategy without the need for prior determination of vitamin D levels. Calcium supplementation should be tailored to the patient's need based on total daily dietary calcium intake. In most patients 500 mg per day is required to achieve a total intake of 1,200 mg, or in some 1,000 mg per day. More calcium is absorbed from calcium citrate compared to calcium carbonate.

No MeSH data available.


Related in: MedlinePlus

Calcium intake and serum 25(OH)D in 50+ patients with a recent fracture, according to gender, age, fracture location and BMD.
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Figure 0005: Calcium intake and serum 25(OH)D in 50+ patients with a recent fracture, according to gender, age, fracture location and BMD.

Mentions: As demonstrated in Fig. 5, this shortage applies to both men and women, in all examined age categories >50 years and with all types of fractures. It is noteworthy that the inadequate calcium intake occurred in equal measures with a normal BMD, osteopenia, and osteoporosis. Therefore, inadequate calcium intake is an endemic problem in patients presenting with a fracture (50). Based on these data, one can conclude that one should check the calcium intake and vitamin D level in all fracture patients, even in those with a normal BMD.


Calcium and vitamin D supplementation: state of the art for daily practice.

van der Velde RY, Brouwers JR, Geusens PP, Lems WF, van den Bergh JP - Food Nutr Res (2014)

Calcium intake and serum 25(OH)D in 50+ patients with a recent fracture, according to gender, age, fracture location and BMD.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126954&req=5

Figure 0005: Calcium intake and serum 25(OH)D in 50+ patients with a recent fracture, according to gender, age, fracture location and BMD.
Mentions: As demonstrated in Fig. 5, this shortage applies to both men and women, in all examined age categories >50 years and with all types of fractures. It is noteworthy that the inadequate calcium intake occurred in equal measures with a normal BMD, osteopenia, and osteoporosis. Therefore, inadequate calcium intake is an endemic problem in patients presenting with a fracture (50). Based on these data, one can conclude that one should check the calcium intake and vitamin D level in all fracture patients, even in those with a normal BMD.

Bottom Line: Data on difference between calcium absorption with calcium carbonate compared to calcium citrate with simultaneous use of proton pump inhibitors are lacking.In most patients 500 mg per day is required to achieve a total intake of 1,200 mg, or in some 1,000 mg per day.More calcium is absorbed from calcium citrate compared to calcium carbonate.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, VieCuri Medical Centre for North Limburg, Venlo, The Netherlands.

ABSTRACT

Background: Calcium and vitamin D play an essential role in bone metabolism but deficiency and/or inadequate intake are common.

Objectives: To describe a practical approach based on the literature regarding clinically important aspects of calcium and vitamin D supplementation.

Methods: A systematic evaluation of relevant literature in Medline was conducted. We included physiological studies, publications on relevant guidelines, meta-analysis, randomized clinical trials, and cohort studies.

Results: An adequate calcium intake and vitamin D supplementation is recommended in most guidelines xon fracture prevention. Daily supplementation with 800 IU is advocated in most guidelines, appears to be safe, and with this approach it is generally not necessary to determine vitamin D levels. There are no data on additional effects of loading doses of vitamin D on fracture or fall prevention. Calcium supplementation should be tailored to the patient's need: usually 500 mg per day is required. The intestinal absorption of calcium citrate is approximately 24% better than that of calcium carbonate independent of intake with meals. Data on difference between calcium absorption with calcium carbonate compared to calcium citrate with simultaneous use of proton pump inhibitors are lacking. Concern has arisen about a possible link between calcium supplementation and an increased risk of myocardial infarction. Probably only well-designed prospective randomized controlled trials will be able to allow definite conclusions on this subject.

Conclusion: Daily supplementation with 800 IU vitamin D is a practical and safe strategy without the need for prior determination of vitamin D levels. Calcium supplementation should be tailored to the patient's need based on total daily dietary calcium intake. In most patients 500 mg per day is required to achieve a total intake of 1,200 mg, or in some 1,000 mg per day. More calcium is absorbed from calcium citrate compared to calcium carbonate.

No MeSH data available.


Related in: MedlinePlus