Mind & Body

Calcium Causes Increase in Hip Fractures?

Surprising findings of studies on calcium
TIMEMarch 18, 2014

How many of us are not taking calcium supplements today? Not many if my patients are a good sample of what’s happening. But do you know that calcium supplementation may cause an increased number of hip fractures? Can meat help to make stronger bones?

Dr. Bischoff-Ferrari, professor of Clinical Research at the University Hospital in Zurich, Switzerland, is a world authority on calcium metabolism. She’s also visiting professor at Tufts University in Boston. She says the science behind calcium is not as simple as most people believe.

Bischoff-Ferrari reported in Tufts Health and Nutrition Letter in 2009 that two major studies have come up with contradictory findings.

The first study analyzed 19 different trials and found no overall benefit to taking greater than average amounts of calcium. One would think that the logical conclusion would be, don’t take too much or too little calcium, normally a wise approach to many medical issues.

The trouble in life, as one wise sage commented, is that there are always “buts” that upset the apple cart. In this case, a second, more-recent study showed that calcium supplementation decreased the risk of bone fracture by a whopping 72 percent! That type of figure is hard to ignore.

Balance Is Key

So who is right about calcium supplementation? Dr. Bischoff-Ferrari said that the most important thing to remember is that bone is not just calcium, and that this mineral does not function in isolation. Her studies came up with two major surprises.

She reported that higher calcium intake does not decrease the number of hip fractures, the most common and serious fracture among the elderly. What was more shocking was the suggestion that taking calcium supplements without vitamin D may cause a 64 percent increase in hip fractures! That’s also a figure that is hard to ignore.

So what could be causing the increased number of hip fractures in those who are popping their calcium pills every day?

One explanation is that there must be a balanced amount of calcium and phosphate to build calcium into bone. Some people, particularly the elderly, are not eating enough protein to absorb sufficient phosphate.

This is good news for me. Now I can tell my anti-meat friends that a good steak provides protein and ensures adequate amounts of phosphate. This along with 1,000 units of vitamin D daily will provide good insurance against brittle bones.

Dr. Bischoff-Ferrari said it’s time to reverse our brains and think about vitamin D first, and then calcium. If we have enough D, we will automatically increase calcium absorption.

She added that vitamin D has another important benefit. It improves the strength of muscles. She says muscles need three things: vitamin D, calcium, and protein. Moreover, there is good evidence that adequate amounts of D prevent both falls and broken bones.

So how can we all get sufficient amounts of vitamin D? We obtain this vitamin from the sun. But in Canada and northern parts of the United States, we receive zero help from the sun from October to February. During these months, the sun’s rays strike the earth at an oblique angle, making it impossible for the skin to manufacture D. And as the skin ages, or if sunscreen is used, less vitamin D is produced.

I remind my patients that milk isn’t just for kids. But milk only provides 300 milligrams of vitamin D per glass. So I also tell them to add more salads to their diet, such as lettuce, celery, and other vegetables. Remember that cows get their calcium from grass.

Diet alone will not enable you to have a sufficient amount of D. So it may be prudent to take a daily supplement.

I’m also going to make sure I’m not phosphate deficient. I’ve known for a long time that having meat as part of your diet has many virtues. But I wasn’t aware that a lack of protein could make me phosphate deficient and increase the risk of fractures. I can hardly wait to order my next rare steak.

Dr. Gifford-Jones is a medical journalist with a private medical practice in Toronto. His Web site is Mydoctor.ca/gifford-jones

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