Men's Osteoporosis Support Group
Calcium intake and fracture risk; atypical femur fracture
BMJ. 2011 May 24;342:d1473. doi: 10.1136/bmj.d1473. Dietary calcium intake and risk of fracture and osteoporosis: prospective longitudinal cohort study. Warensjö E and others. PMID: 21610048. This study in women involved the association between dietary calcium intake and the risk of fracture and osteoporosis. This 19-year Swedish study started in 1987 and included 61,433 women born between 1914 and 1948 whose diets were analyzed with food frequency questionnaires.
The results showed that 14,738 women had any type fracture and 3,871 had a first hip fracture. Interestingly, the first quintile of calcium intake had decreased fracture and osteoporosis risk, but not the higher quintiles. In fact, the highest quintile was associated with a higher rate of hip fracture. The authors concluded, “Gradual increases in dietary calcium intake above the first quintile in our female population were not associated with further reductions in fracture risk or osteoporosis.” [Emphasis added]
Editor's comments. Calcium's effects on fractures and osteoporosis are not gender-related, so the fact that there were only women in this study should not mean the results don't also apply to men. These results are suggestive that striving to eat massive amounts of calcium is not only unnecessary, but possibly harmful regarding fracture risk and osteoporosis. There is apparently a point beyond which adding calcium to the diet has no beneficial effect on either bone mineral density (BMD), fracture risk, or, therefore, osteoporosis. These results are in agreement with those of a recent Update that showed no effect on BMD from adding 1000 mg/day calcium and 800 IU/day of vitamin D3 to a weight-bearing impact exercise program.
Recent Updates have also shown that excess calcium from supplements is likely a contributor to heart disease. Thus there appears to be little reason to get excess calcium from diet or supplements.
J Osteoporos. 2011;2011:754972. Epub 2011 Mar 31. Bisphosphonates and atypical fractures of femur. Yli-Kyyny T. PMID: 21603147. Free full text. This is a review of the information available regarding atypical femur fractures in bisphosphonate users, such as Fosamax and Actonel. The review finds insufficient definitive information to prove a correlation between long-term bisphosphonate use and atypical fractures. If this topic interests you, you should find the free full text informative. Also, here is a recent Update with information from two studies on this topic.
The images of the X-rays are interesting and show exactly what happens in an atypical femur fracture. Click on the small image in the abstract for a better view. And, here is an interesting series of images that depict the treatment and healing of a femur fracture. Although this fracture was not atypical, but caused by an auto accident, the treatment method should be similar to what would be needed to treat an atypical fracture.