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Vitamin D and calcium are important for overall health but do not reduce the risk of falls or fractures in generally healthy older adults, according to a new draft recommendation from the US Preventive Services Task Force.
To prevent the risk of falls or fractures in adults, the task force recommends not relying on extra vitamin D and calcium – and for the first time, men are included in this guideline.
Older people should still take vitamin D or calcium for general health, but they should take different measures to prevent fractures or reduce the risk of falls.
In 2018, the task force It is recommended to prevent extra food every day Primary prevention of postmenopausal fractures with 400 units or less of vitamin D and 1,000 milligrams or less of calcium. But it concluded that there was insufficient evidence to recommend prevention of first-time fractures in men.
The task force's draft recommendation would update the current guidelines to include advice against supplements for men age 60 or older and remove the mention of specific amounts. The draft recommendation is not yet final, but is available at Task force website For public comment until January 21, along with a review of draft evidence.
“When we made the 2018 recommendation, we didn't have enough male participants in cross-sectional studies and vitamin D deficiency. Since then, it's been enough to draw at least some conclusions, and we've taken the same thing. Conclusion – it's not useful in prevention,” said task force member Dr. Gotham Rao, chair of the Department of Family Medicine and Community Health and chief medical officer of the University Hospitals Health System at Cleveland Clinic. Experience Officer, Ohio
“The other thing is there's been some question about whether higher doses are beneficial for vitamin D and calcium,” Rao said. But what we found in our recent recommendation was that there was no amount associated with any benefit.
However, Rao adds, in addition to preventing falls and fractures in older adults, vitamin D and calcium are still essential nutrients for overall health. Vitamin D It helps the body absorb CalciumAnd it benefits the immune system, brain and muscle performance, among other functions.
“One of the key messages that we want to get out there is to suggest that no one should take vitamin D and calcium because the National Academy of Medicine has specific recommendations for how much vitamin D and calcium you should have in your diet. Every day, and it's very important for bone health, mental health, all kinds of things.” “The only thing we haven't seen is the breakage and the fallout,” he said.
Dr Sherry-Anne Burnett-Bowie, an associate professor of medicine at Harvard Medical School, said the draft proposal could come across as “challenging” because people could interpret the recommendations as saying vitamin D and calcium are not necessary at all. A clinical investigator in the Endocrine Department at Brigham General, Mass., who was not involved in the USPSTF's new draft recommendation.
“Everyone should have the recommended daily allowance, as outlined in the draft recommendation, which is 600 to 800 units of vitamin D if you're 1 year and older and 700 to 1,200 milligrams of calcium,” Burnett-Bowey said, adding that Many people in the United States consume less than the recommended amount of calcium.
“There are racial and ethnic differences in who consumes the recommended daily allowance in their diet—higher levels of dietary calcium deficiency in non-Hispanic blacks or non-Hispanic Asians. So if the goal is to get calcium or vitamin D from diet or supplements, including Insure or Boost, most people don't get there through diet alone.” “Taking extra calcium with vitamin D to facilitate calcium absorption is something that a person can't get based on diet,” she says. It fills things up.”
The USPSTF draft recommendation specifically recommends vitamin D supplementation with or without calcium in postmenopausal women and men aged 60 and over who live in their own homes and do not live in a nursing home, to prevent long-term care. facilities or entered the hospital.
In a systematic review of research, the task force concluded with “moderate certainty” that supplementation with vitamin D has no primary benefit in preventing fractures and falls in older age groups.
Although this rate of harm was assessed as small, the task force suggested that vitamin D supplementation with or without calcium may increase the incidence of kidney stones. Calcium is a major component of many of them. Kidney stones.
“If they're taking the normal dose, they're less likely to get hurt,” Burnett-Bowie said. “If you stay within the recommended daily allowance, kidney stones are uncommon.”
In the year New England Journal of Medicine.
In particular, taking 2,000 IU (international units) of additional vitamin D3 without calcium According to the study, it did not reduce total fractures, hip, wrist or hip fractures compared to taking a placebo daily over five years. A placebo is a fake pill given to patients, so they think they are getting the real supplement.
“We found that supplementation with vitamin D and placebo did not reduce fracture risk, including 25,871 adults enrolled from all 50 states, and this was generally true in healthy middle-aged and older adults,” said study author Dr. Merrill LeBoeuf, M.D., chief of the calcium and bone division of endocrinology, diabetes, and hypertension at Boston's Brigham and Women's Hospital and professor of medicine at Harvard Medical School, is involved in the new USPSTF draft recommendation.
But while the findings are consistent with the new USPSTF draft recommendations, “it is not generalizable to adults with severe vitamin D deficiency, low bone mass, osteoporosis, osteoporosis medications, malabsorption, or older adults who are at high risk of falling or living in residential communities,” LeBoeuf said. It is a disease that causes bones to become very brittle, and even a fall or minor stress can cause a fracture.
Every year in the United States, More than 1 in 4 elderly people Experience falls that can cause broken bones, broken hips, or other injuries.
Actions that the elderly can take Reduce the chance of falling and breaking They include getting screened for osteoporosis, especially in women age 65 and older, and getting regular exercise. If a person has osteoporosis, treatment may be prescribed To prevent breakage.
“Our recommendation is focused on preventing falls and preventing fractures – that's what we want to emphasize, vitamin D and calcium are not helpful in this regard. But there are things you can do, including screening for osteoporosis and structured exercise.”
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Regularly performing strength training exercises such as lifting weights or using resistance bands and improving balance through exercises such as yoga, pilates or tai chi can be helpful.
When doing daily activities, get up slowly as getting up early can lower blood pressure and cause you to lose balance.
Some adults may benefit from having their vision and hearing tested or using assistive devices such as a cane or walker to reduce their risk of falling.
During the winter, it's important to take extra care when walking in wet or icy conditions and consider staying indoors when the weather cools down.
Also, remember to tell your doctor about any falls or fractures that may have occurred since your last check-up, as these can alert the doctor to new medical problems or issues that may be emerging and treatable.