Vitamin D, Calcium Increase Bone Density, Reduce Falls

Women who have experienced a hip fracture may improve their bone mass and reduce their chances of falling down and of suffering another fracture if they supplement with vitamin D and calcium, according to a study in Age and Aging. (2004;33:45–51).

Osteoporosis is a bone condition characterized by low bone mass, changes in bone structure that lead to weakening of the bones, and increased susceptibility to fractures. Hip fractures are the most serious osteoporosis-related fractures, and are a significant cause of disability and mortality in the elderly. Among people who survive a hip fracture, the chance of developing a fracture in the other hip greatly increases.

Many older people are deficient in vitamin D. Calcium and vitamin D have been shown to protect against initial fractures in elderly people, but little is known about how to prevent subsequent fractures.

The current study investigated the effects of various vitamin D and calcium supplementation regimens on markers of bone metabolism, bone mineral density, fractures, and falls in elderly women who had recently undergone surgery for a hip fracture.

One hundred fifty women aged 67 to 92 years were observed for one year after undergoing hip surgery for a fracture due to osteoporosis. The women were randomly assigned to receive one of the following: (1) 300,000 units of vitamin D by a single injection; (2) 300,000 units of vitamin D by a single injection and 1 gram of calcium per day; (3) 800 units of vitamin D and 1 gram of calcium per day; or (4) no treatment. Bone mineral density and blood markers of bone health were assessed at the beginning of the study. After 12 months, these measurements were repeated and numbers of falls and fractures among participants were assessed.

Among those people receiving vitamin D (all groups combined), the rate of falling was about half of that in the group receiving no treatment. The chance of developing a fracture among the vitamin D-treated groups was also half of that in the group receiving no treatment. There was a small, yet statistically significant increase in bone mineral density at the hip (but not the spine) in the vitamin D-treated groups compared with the group receiving no treatment. While it appears that the oral calcium and vitamin D combination was the most effective regimen, further studies are needed to confirm this finding.

For people with osteoporosis, the implications of this study are profoundly encouraging. As most fractures result from falling, a 50% reduction in the falling risk represents a substantial decrease. While the positive effect of vitamin D on bone density has been known for years, the observation that vitamin D can prevent falls is relatively new. Recent studies have shown that correcting vitamin D deficiency improves both muscle strength and balance, effects which likely account for the reduction in the rate of falls.

Kimberly Beauchamp, ND, received her bachelor’s degree from the University of Rhode Island and her Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. Dr. Beauchamp is a co-founder and practicing physician at South County Naturopaths, Inc. in Wakefield, RI. Her emphasis is on women’s health, pediatrics, and detoxification.

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