Calcium and vitamin D in the prevention of osteoporotic fractures

Abstract

Osteoporosis has been defined as a skeletal disorder characterized by compromised bone strength, predisposing a person to increased risk of fracture. ¹ The three major osteoporotic fractures are those of the forearm, vertebra and hip, but fractures of the humerus, pelvis and ribs are also common. The incidence of these fracture rises steeply with age, such that most occur in people aged >65 years, where they are associated with excess mortality, substantial morbidity, and significant health and social services expenditure. ² This paper outlines the physiological roles of calcium and vitamin D, and assesses the current criteria for adequate calcium intake and optimal vitamin D status in adults. It highlights the prevalence of vitamin D insufficiency and low calcium intake in the UK, and reviews studies of vitamin D supplementation, with and without calcium, in the prevention of falls and fractures. Relevant clinical trials were identified using the search strategies described in recent meta-analyses. ^{3, 4}