The task force found evidence that Vitamin D and calcium supplements increase the risk of developing kidney stones.
Task force: Evidence for Vitamin D, calcium supplements lacking
You’ve seen it added to cereal boxes, gallons of milk and bottles of orange juice. Experts
tout its benefits – from strong bones to a strong immune system – and warn of the dangers of Vitamin D deficiency.
New recommendations from the U.S. Preventative Services Task Force
could bump those sales even higher, or - if critics are right - confuse
consumers as they head down the pharmacy aisle.
After completing a review of existing research, the USPSTF, an
independent panel of doctors and experts in prevention and
evidence-based medicine, is advising against taking moderate amounts of
Vitamin D and calcium supplements because there is not enough evidence
to prove the supplements reduce the risk of bone fractures.
More specifically, the USPSTF is recommending against supplements of
Vitamin D in daily doses of less than 400 IU (international units), and
calcium in daily doses of less than 1,000 milligrams for post-menopausal
women.
Doctors currently recommend these supplements for women to prevent
fractures; approximately 56% of women aged 60 years and older take
supplemental vitamin D, and 60% take a supplement containing calcium,
according to the USPSTF report. The
report was published in this week’s edition of the Annals of Internal Medicine journal.
The task force found evidence that Vitamin D and calcium supplements
increase the risk of developing kidney stones in this population, and
insufficient evidence to show that the supplements reduce the risk of
fractures.
Basically it boils down to this: “Don't take modest doses, they don't
do any good,” says Dr. Virginia Moyer, chair of the USPSTF.
More research is needed, Moyer says, to determine whether higher
doses of Vitamin D or calcium would prevent fractures in older men or
women. She says the task force will be looking in the future at whether
doctors should be screening for Vitamin D deficiencies.
The USPSTF’s recommendations don’t apply to those who are prone to
falling, according to the report, or those who have a history of
fractures, a documented Vitamin D deficiency or a diagnosis of
osteoporosis.
Vitamin D is not actually a vitamin, according to nutrition experts
Marion Nestle and Malden C. Nesheim; it’s a hormone produced by the body
in reaction to sunlight.
“Like other hormones, vitamin D has multiple roles in the body, not
all of them well-understood,” the experts wrote in an editorial about
the USPSTF recommendations. As such, Vitamin D supplements must be
considered a form of hormone replacement therapy, they wrote, and be
subjected to similar probes about efficacy, dose and side effects.
As we’ve seen with recommendations from this group in the past (think
prostate or
cervical cancer screenings), there are those that disagree with the task force’s conclusion.
“These recommendations fail to recognize the well-established role of
calcium and vitamin D in maintaining bone health,” the Council for
Responsible Nutrition said in a statement. “If these recommendations are
taken to heart, or misconstrued as general recommendations against
calcium and vitamin D, consumers could be compromising their bone health
and missing out on important other benefits from these nutrients.
“The bottom line: calcium and vitamin D are vital to staying healthy.”
The
Centers for Disease Control and Prevention says
African-Americans have the highest rates of Vitamin D deficiency -
along with the highest bone density and fewest fractures. Approximately
12% of Mexican-Americans are deficient, while only 3% of non-Hispanic
whites are at risk.
The Institute of Medicine recommends adults get at least 800 to 1000
mg of calcium daily, depending on their age, and at least 400 IU of
Vitamin D. Adults can safely absorb up to 2,500 mg of calcium and 4,000
IU of Vitamin D.
Calcium is most
commonly found
in dairy products like milk, cheese and yogurt, but it’s also available
in green leafy vegetables like spinach and kale. Vitamin D is crucial
for helping your body absorb calcium, which is why the nutrients are
often talked about together. Vitamin D can be found in fatty fish or
fortified foods like cereal and orange juice. It’s also found in sun
rays, where it’s absorbed through the skin.
