The supplements provided a modest benefit in preserving bone mass and stopping hip fractures, especially in older ladies, but had no impact on other kinds of fractures.
The findings appear in two reports in the current (Feb. 6, 26) problem of the New England Journal of Medicine.
Jean Wactawski-Wende, Ph.D., associate professor of social and preventive medicine in the UB School of Public Wellness and Wellness Professions, is first author on the colorectal cancer study and a co-author on the hip fracture study.
“There has been a public perception that calcium and vitamin D supplements can prevent colorectal cancer and observational studies have suggested that those who have greater intakes have less illness,” stated Wactawski-Wende. “Sadly, this lengthy-term clinical trial, in which some of the ladies had been followed for much more than nine years, does not support this assumption.
“Outcomes on the impact of calcium and vitamin D supplementation on bone fractures showed a substantial positive impact on bone density, as nicely as a non-substantial 2 percent reduce in threat of hip fractures much more than all,” she stated.
“Further analyses showed that the group who took most of the suggested supplements much more than the course of the trial had a 29 percent reduction in threat of hip fracture, and ladies much more than age 6 had a 2 percent reduction in threat of hip fracture.
“Overall, the most essential message to ladies from these studies,” stated Wactawski-Wende, “is that all ladies ought to have an adequate intake of calcium and vitamin D to preserve their bone density. For ladies much more than 6, this might be especially essential. Even though ladies ought to consider taking calcium and vitamin D supplements along with adequate dietary intake to safeguard their bones, they ought to not expect these supplements to provide protection against colorectal cancer.”
A total of 6,282 postmenopausal ladies, including 96 from Western New York, took component in the WHI calcium/vitamin D trial. Half had been assigned randomly to obtain , mg of calcium carbonate combined with 4 International Units of vitamin D every day, whilst the other half took matching placebos. Participants had been followed for 6- years.
Colorectal cancer is the third most typical cancer in U.S. ladies and the third leading cause of cancer deaths in ladies, according to the American Cancer Society. Observational studies had suggested that each greater intakes of calcium, as nicely as vitamin D intake, might reduce the threat of colorectal cancer, even though there was little clinical trial information accessible.
Outcomes of the colon-cancer analysis showed that much more than an average of seven years, a total of 22 ladies in the study had been diagnosed with invasive colorectal cancer. There was no statistically substantial distinction in between the supplement and comparison groups in the number of colorectal cancer instances — colorectal cancer instances per , person-years in the supplement group and 2 per , person-years in the placebo group — or in the characteristics or severity of tumors.
There also was no distinction in between groups in the number of polyps reported by the participants. When the investigators analyzed only the information obtained from participants who had the greatest compliance in taking their study pills, there was nonetheless no benefit seen from calcium/vitamin D supplementation on colorectal cancer. The supplements had been generally nicely tolerated nevertheless, participants in the supplement group had a greater threat of creating kidney stones.
To figure out if baseline vitamin D level might have some impact on the outcome, researchers measured blood levels of vitamin D in a subgroup of participants at the begin of the study. The impact of the intervention on colorectal cancer did not differ by baseline blood levels of vitamin D.
In assessing the colon cancer findings, Wactawski-Wende noted that participants already had fairly high personal intakes of each calcium and vitamin D at the begin of the study — about twice the national average. These initial high levels might have prevented the intervention supplements from affecting colon-cancer rates further, she stated. However, even when looking at those participants with the lowest personal intakes of calcium, the findings on colorectal cancer did not alter.
Wactawski-Wende also noted that the average follow-up of seven years might not have been lengthy adequate to discover an impact. “Colorectal cancer is believed to take -2 years to develop. Even though we saw no evidence of a trend toward protection in the later years of follow-up, we’ll continue to follow these ladies for 5 much more years, which might permit us to identify any later effects of the intervention.”
Overall, there had been fewer deaths in the supplement group than in the placebo group, 744 compared to 87, hinting that calcium and vitamin D supplements might have a positive impact on mortality, stated Wactawski-Wende. Analyses that will take a closer appear at mortality are planned.
Outcomes of the impact of calcium and vitamin D supplementation on hip fractures supported conventional wisdom that these supplements can help keeps bones effective. The fracture analyses showed that 74 ladies had hip fractures, for a rate of 4 per , ladies per year in the supplement group, compared to 6 per , per year in the placebo group.
Osteoporosis, a skeletal disorder characterized by weakened bones leading to an elevated threat of fracture, is a primary cause of disability, loss of independence and death, according to the National Institutes of Wellness. It contributes to an estimated , hip fractures in the U.S. every year. Four out of ladies much more than 5 will expertise a fracture at the hip, spine or wrist in their lifetime. Ten million people in the U.S. are estimated to have osteoporosis and 4 million much more have low bone mass, placing them at greater threat for fracture.
“There are severe wellness consequences following hip fracture. Prevention of hip fracture is a essential,” stated Wactawski-Wende. “Achieving adequate intake of calcium and vitamin D is essential factor in sustaining bone density and stopping hip fracture.
“Use of calcium with vitamin D supplements along with a diet plan wealthy in calcium and vitamin D might result in essential benefits to bone density and hip fracture prevention,” she stated. “However, results of the WHI calcium plus vitamin D study do not support their use for colorectal cancer prevention”.
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