Calcium and vitamin D supplements for the treatment and prevention of osteoporosis. Should it be widely used?

Abstract

Osteoporosis is the most common age-related skeletal diseases, which is characterized by the rapid loss of bone mineral density and increased risk of fragility fractures. The social significance of osteoporosis is attributed to its complications, which increase disability and mortality rates mostly among older people. Inadequate dietary calcium intake and vitamin D deficiency are well-known risk factors for osteoporosis. Thus, for many years, calcium and vitamin D have been considered crucial in the prevention and treatment of osteoporosis. However, in recent years, the efficacy and safety of calcium and vitamin D have been questioned because some randomized clinical trials have reported only a weak positive effect of calcium with or without vitamin on reducing fragility fracture risks. On the contrary, besides the gastrointestinal side effects of calcium supplements and the risk of kidney stones related to the co-administration of calcium and vitamin D supplements, other recent data suggested that calcium supplementation has potential adverse cardiovascular effects. This study focused on the evidence regarding the possible usefulness for bone health and the potential harmful effects of calcium and/or calcium with vitamin D supplementation.