Prevention of Fractures in Older People with Calcium and Vitamin D 英文参考文献.docVIP

Nutrients 2010, 2, 975-984; doi:10.3390/nu2090975 OPEN ACCESS nutrients ISSN 2072-6643 /journal/nutrients Review Prevention of Fractures in Older People with Calcium and Vitamin D Caryl A. Nowson School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood VIC 3125, Australia; E-Mail: caryl.nowson@.au Received: 3 August 2010; in revised form: 18 August 2010 / Accepted: 23 August 2010 / Published: 16 September 2010 Abstract: The greatest cause of fracture in older people is osteoporosis which contributes to increased morbidity and mortality in older people. A number of meta-analyses have been performed assessing the effectiveness of calcium supplementation alone, vitamin D supplementation alone and the combined therapy on bone loss and fracture reduction in older people. The results of these meta-analyses indicate that vitamin D supplementation alone is unlikely to reduce fracture risk, calcium supplementation alone has a modest effect in reducing total fracture risk, but compliance with calcium supplements is poor in the long term. The combination of calcium supplementation with vitamin D supplementation, particularly in those at risk of marginal and low vitamin D status reduces total fractures, including hip fractures. Therefore older people would be recommended to consume adequate dietary calcium (1100 mg/day) together with maintaining adequate vitamin D status (60 nmol/L 25(OH)D) to reduce risk of fracture. It is a challenge to consume sufficient dietary calcium from dietary sources, but the increasing range of calcium fortified foods could assist in increasing the dietary calcium intake of older people. In addition to the usual dairy based food sources, vitamin D supplements are likely to be required for older people with reduced mobility and access to sunlight. Keywords: calcium; vitamin D; fracture; meta-analysis 1. Introduc