BMJ  2005;331:108 (9 July), doi:10.1136/bmj.331.7508.108-a

Letter

Calcium and vitamin D in preventing fractures

Dietary intake of calcium needs to be considered

The first 150 words of the full text of this article appear below.

EDITOR—In their prospective randomised trial of calcium and vitamin D supplementation, Porthouse et al found no evidence that this reduced the risk of clinical fractures in women at risk.¹ However, several aspects need closer examination before a therapeutic role can be defined.

Although these women all had risk factors for hip factors, they were highly self selected. Of 48 987 originally invited, only 3314 (7%) were eventually randomised. Median follow-up overall was only 25 months, and the design of the recruitment process means that this must have differed between the two groups. In the "unequally allocated group," followed up for longer, the evidence of a benefit of the intervention is greater.

Vitamin D concentrations were not measured to see the prevalence of insufficiency and whether this degree of supplementation was able to produce a significant improvement in values. It would also have been informative to see whether improved . . . [Full text of this article]

Hammersmith Hospital, Imperial College, London W12 0NN julian.walters@imperial.ac.uk

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Randomised controlled trial of calcium and supplementation with cholecalciferol (vitamin D₃) for prevention of fractures in primary care

Jill Porthouse, Sarah Cockayne, Christine King, Lucy Saxon, Elizabeth Steele, Terry Aspray, Mike Baverstock, Yvonne Birks, Jo Dumville, Roger Francis, Cynthia Iglesias, Suezann Puffer, Anne Sutcliffe, Ian Watt, and David J Torgerson
BMJ 2005 330: 1003. [Abstract] [Full Text] [PDF]