In people over 50 years of age, calcium supplements have a small effect on preventing fractures

Bolland MJ, Leung W, Tai V, et al. Calcium intake and risk of fracture: systematic review. BMJ. 2015 Sep 29;351:h4580.

Review question

In people over 50 years of age, does increasing calcium in the diet or with supplements affect risk of fractures? See related Evidence Summary of a review by Tai.

Background

Calcium is important for bone health, but people often don’t get enough in the food they eat. As we age, we lose bone mass (osteopenia or osteoporosis) and have greater risk of fractures (broken bones). Doctors often recommend eating more calcium-rich foods or taking calcium supplements to reduce fractures.

How the review was done

The researchers did a systematic review, including studies up to September 2014. They found 26 randomized controlled trials of calcium supplements that included 69 107 people.

The main results were total number of fractures and fractures at the hip, vertebrae (bones of the spinal column), and forearm.

Calcium supplements could be combined with other treatments such as vitamin D as long as both groups received the other treatment.

What the researchers found

3 trials had a low risk of bias; the rest had a higher risk of bias.

Calcium supplements reduced total fractures and vertebral fractures by a small amount but did not affect hip or forearm fractures.

When only studies with low risk of bias were analyzed, there were no differences in fractures between calcium and no calcium groups.

Conclusion

In people over 50 years of age, calcium supplements reduce risk of total and vertebral fractures by a small amount and do not reduce hip or forearm fractures.

Calcium supplements vs no calcium supplements in people over 50 years of age

*Although the rates for the 2 groups look different, the differences were not statistically significant. This means that the difference could simply be due to chance rather than due to different treatments.