The association, which is made up of researchers, dietitians, epidemiologists, nurses, and physicians, outlined its new position on preventing low bone mass to achieve high bone density in Mexico, a country that has a public health problem with osteoporosis.
Writing in Archives of Osteoporosis, the authors of the position paper state: “[M]ost research and clinical practice related to osteoporosis have focused on diagnosis and treatment, but general measures for primary prevention based on addressing modifiable risk factors as a public health priority to delay the onset of loss of bone mass have not been considered by Mexican authorities.
“[T]he AMMOM defines its position on calcium and vitamin D supplement use as an effective, safe, and cost-effective initiative to prevent low bone mass.”
Vitamin D and bone health
The potential benefits of vitamin D for bone health were recently questioned by a meta-analysis of 81 RCTs totaling almost 54,000 participants indicated that vitamin D supplementation did not significantly impact fracture, falls, or bone mineral density. The meta-analysis was published in Lancet Diabetes & Endocrinology (doi: 10.1016/S2213-8587(18)30265-1).
“Vitamin D supplementation did not have meaningful effects on fracture, falls, or bone mineral density, and future trials are unlikely to alter these conclusions,” wrote the authors, affiliated with the University of Auckland (NZ) and the University of Aberdeen (UK). “Therefore, there is little justification for the use of vitamin D supplements to maintain or improve musculoskeletal health, and clinical guidelines should reflect these findings.”
In response, Daniel Fabricant, PhD, president and CEO of the US-based Natural Products Association, pointed out that numerous health organizations in the United States and around the world advocate for sufficient vitamin D intake, including the US FDA and guidelines in the Netherlands, Canada, and Australia.
“We were shocked when this study came out because of its total disregard for the wealth of scientific research and medical guidance in the US and around the world,” said Dr Fabricant. “Vitamin D is critical to supporting bone mineral density and a daily supplement at the advice of a doctor is an excellent way for people to get the right amount.”
Health organizations advocating for vitamin D
US FDA guidance for health claims on calcium, vitamin D, and osteoporosis: “Adequate calcium and vitamin D throughout life, as part of a well-balanced diet, may reduce the risk of osteoporosis” or “Adequate calcium and vitamin D throughout life, along with physical activity, may reduce the risk of osteoporosis in later life.” (21 CFR 101.72(f))
The 2011 Dutch Guideline on Osteoporosis and Fracture Prevention (CBO Guideline) advises that nursing home residents should take a vitamin D supplement (800 IU per day), and patients with osteoporosis should take a vitamin D supplement (800 IU per day).
Osteoporosis Canada states that experts recommend daily vitamin D supplements. High-risk individuals over 50 should receive 800-2,000 IU vitamin D per day.
The Australian guideline advises for women over 50 years of age a calcium intake of 1,300 mg per day and a vitamin D intake of 800 IU.
Source: Archives of Osteoporosis
2018, Volume 13, Number 1, Page 105. doi: 10.1007/s11657-018-0520-y
“Prevention of low bone mass to achieve high bone density in Mexico: position of the Mexican Association for Bone and Mineral Metabolism”
Authors: R. Espinosa