Walter Willett, MD, DrPH, Chairman of Nutrition Harvard University

For years, people were urged to take calcium supplements to avoid losing bone density. This advice was aimed particularly at menopausal and postmenopausal women because they are especially susceptible to bone fragility and fractures. All the same, calcium supplements were often recommended to all older adults. Will taking calcium pills really keep your bones strong? Seniors were also supposed to take vitamin D pills so that they could avoid going out in the sun. Sun exposure is a double-edged sword, after all: it can lead to vitamin D production, which may help keep your bones strong. On the other hand, it also increases your chance of developing skin cancer. Weighing pros and cons is difficult, so many experts prefer to sidestep the question and recommend pills instead.

Will Vitamin D and Calcium Pills Keep Your Bones Strong?

In December 2017, a meta-analysis published in JAMA demonstrated no benefit from vitamin D or calcium supplementation. People taking the supplements were just as likely to break a bone as people taking placebo pills. Those on vitamin D pills were at higher risk for kidney stones, though. To make sense of this research, we talked with two experts: one, a researcher who specialized in studying bone strength and osteoporosis, and the other a leading nutrition scientist. They explain how we can make sense of the confusion. Are placebo-controlled trials the best way to learn about nutritional supplements and their value? How can you tell if your vitamin D levels are low? Are there supplements you might consider to keep your bones strong?

Other Studies:

Since the 2017 study appeared, scientists have published additional research results that bear on whether vitamin D and calcium supplements can keep your bones strong. One was another meta-analysis published in JAMA in April 2018. Like the previous meta-analysis, it showed no reduction in fractures for people taking supplements. Even more recently, investigators in New Zealand systematically reviewed randomized controlled trials of vitamin D supplements for preventing fractures (The Lancet, Oct. 4, 2018). They found no notable benefits. Both of these are meta-analyses, however, and subject to the criticisms our guests offer for such studies.

This Week’s Guests:

Robert R. Recker, M.D., M.A.C.P., F.A.C.E. is the O’Brien Professor of Medicine and Chief of the Division of Endocrinology at Creighton University Medical Center. He is also the Director of the Osteoporosis Research Center. He’s a Master of The American College of Physicians and Fellow of the American College of Endocrinology. Walter Willett, M.D., Dr.P.H., is Professor of Epidemiology and Nutrition at Harvard T. H. Chan School of Public Health and Professor of Medicine at Harvard Medical School. Dr. Willett (with Patrick Skerrett) is the author of Eat, Drink and Be Healthy, The Harvard Medical School Guide to Healthy Eating, Updated and Expanded (September 2017). The photograph is of Dr. Willett.

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Air Date:October 20, 2018

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  1. Pennypincher
    FLorida
    Reply

    The idea of getting calcium from dairy products isn’t very helpful for those of us with lactose intolerance. I’m thankful for the explanation for my increasing number of food intolerances that George supplied–changing body hormones as we age. It’s frustrating when some of the recommended foods just mean a stomach ache for some of us.

  2. Lawrence J
    FL
    Reply

    A daily mega-dose of mixed Vit. K analogs, such as provided by Life Extension, appears to be what is missing from supplementation guidance to strengthen bones. I’ve been taking it for many years, along with a high dose of Vit. D. My serum calcium levels, which are high, indicate I do not need calcium supplements. (They are high probably because of the D and K I take). High Vit. K is said to not only increase calcium levels in bone, but to get that calcium by removing it from the arteries, where it is harmful. This dosage of Vit. K cannot be supplied by dietary means and must be supplemented. It is non-toxic, but would interfere with some anticoagulants. I’m pleased with the result.

    • Miriam G
      Texas
      Reply

      I’m lactose intolerant but drink Lactaid milk that is calcium fortified & contains 500 mg of calcium in an 8 oz glass. Also calcium fortified orange juice has 300 mg of calcium . No problem getting 1200 – 1300 mg daily.

  3. Kathleen
    Illinois
    Reply

    I am a 73 year old female. I have exercised my whole adult life including playing on a women’s soccer team for eight years in my 30s. I have never been overweight and consume a Mediterranean diet. In my 40s I started to take calcium/magnesium/ vitamin D supplements. After completing menopause I was on HRT for five years. By the time I was 65 I had gone from osteopenia to osteoporosis. I have recently completed three years of Boniva infusions. In my case, supplements were of no value, and I discontinued them about three years ago. My doctor says that my family history of osteoporosis and the fact that I’ve been thin my whole life are the main factors.

  4. Sharon
    Texas
    Reply

    I believe taking 5000 IUs daily of Vitamin D3 is a smart thing to do these days and I will continue to do so! My last D3 level was around 80 and from my research that seems to be a good level. There are MANY beneficial things about D3. I do NOT take any calcium supplements but get my calcium from whole milk, yogurt and cheese—“let food be your medicine”. I have no intention of adding to drug manufacturer’s profits. Just do the best you can and stay positive.

  5. Jeanni
    Washington
    Reply

    All I know is that after I was thrown from a horse landing on my neck and shoulder at the age of twenty I was having constant neck pain and headaches. I was living on tylenol to manage the pain I was having. Five years later I started taking calcium and vitamin D and most of my neck pain and headaches were manageable. If I stop taking these supplements within a few days I can feel the pain increasing again to the level it was before I started taking these supplements. I have been taking calcium and vitamin D for fifty three years and have had no problems. It is a lot better than taking drugs that have a lot of side effects. I am seventy three years old and take no prescription drugs.

  6. Jeanni Waites
    Reply

    All I know is that if I don’t take calcium and vitamin D supplements my neck starts to become painful and I get severe headaches. I was thrown from a horse and landed on my neck and shoulder when I was twenty and lived on asprin daily for five years for the pain. When I started calcium and vitamin D I was able to get off most of my need to take asprin daily. If I stop taking the supplements within days I can feel the pain in my neck coming back. I am now seventy three years old and have taken these supplements for fifty three years with no ill effects.

  7. William
    Texas
    Reply

    The current buzz is that we need Vitamin K2 and Vitamin D to make calcium go to our skeleton and teeth and not to our blood vessels. All these studies do not include K2.

  8. Judy
    Durango ,Co
    Reply

    Tell me about Reclast please- contraindications are many for 1x a year shot!

  9. Becky
    Kemp
    Reply

    I have taken vitamin supplements ALL my adult life. I was taking calcium supplements until I read a study that showed they did more damage than good. I am post-menopausal, but am a very healthy eater. I love veggies and eat a good diet of them. I try to limit the white foods such as rice, pasta, flour, and sugar in my diet. I started eating brown rice, whole wheat/grain bread, and oatmeal until I read an article on grains being used to fatten our COWS! I lived on a farm all my life, and I KNOW this is a true statement! (It’s common sense, that failed me for a short time.) Grains, corn, wheat, oats—ALL fatten our livestock for slaughter! I think we should all eat what we love, in reasonable amounts, exercise, not smoke, and not drink to excess. I think I’ve deprived myself of some good foods over the past years, by trying to keep up ‘with what the media says’. I was just diagnosed with osteoporosis!! Go figger! Enjoy life and food and remember that the Bible says literally, the “hairs on our head are numbered”. You are going to live every day that our Maker has set planned for you–not one day more–not one day less. Let’s go eat some chocolate!!

    • Laura
      IN
      Reply

      Love your comment ~ I trust Him, too!

  10. Michael
    N. Central Nebraska
    Reply

    Supplementation seems to hold empty promises just like an Rx like Fosamax. The Rx version quiets the osteoClast cells which clear out the old brittle bone but make the bone seem more dense. Progesterone creme, simple, inexpensive and safe- activates osteoBlast cells to create new, flexible healthy bone material. The late Dr. John Lee favored a product called “Natural Radiance” but hurry before the pharma ghouls put a hold on it by calling it an investigative drug and halt the over the counter version.

  11. Becky Horner
    Kemp
    Reply

    I have taken supplemental vitamins ALL my adult life. I took calcium supplements until I started reading where calcium is

  12. Michele
    WI
    Reply

    What is missing is the importance of Silica. That’s what will get the bones stronger and what we get depleted from our bodies. Do the research…Silica!

  13. Bill
    Charleston, SC
    Reply

    So what about supps. In combo with weight training and 15 minutes of sun exposure daily?

  14. Mary
    Michigan
    Reply

    Does anyone know if this applies to fish oil as a vitamin D supplement?

  15. george miller
    West Virginia
    Reply

    The studies should take into account level of individual physical active life style . The more active people will tend to absorb more of the supplements which might be why we seem to get impression that older persons lose ability to benefit from supplement use compared to younger more active persons. It might be a function of demands we make upon our bodies. Older persons metabolism does slow down due in part to aging process but added to that is the lower physical activity in general . Our bodies become more fragile and some dietary items even become toxic as hormones level change so do our needs . We can make mistakes in treating for low thyroid T 3 by introducing thyroid replacement and the body responds by lowering it’s own production levels even farther . Our bodies are amazing pharmacies and dispence what we need unless there is organ damage.

  16. Luther
    Pittsboro NC
    Reply

    Not sure about the basis of these conclusions. The occurrence of fractures has way too many variables to draw the conclusions put forth. Seem to be no mention of bone density analysis.

  17. Laura
    Seattle WA
    Reply

    I had no help from calcium and Vit. D supplements. But I have very good DEXA results by using Algaecal and Prunes. Algaecal is calcium and minerals from sea plants, and Prunes showed good results in the 5 year human studies, and now in 10 studies.

  18. Luke
    Florida
    Reply

    Evidence-based studies often change, and I seen mixed results with these. But for sure calcium supplementation won’t do any good unless there is weight bearing exercise which is the only way for bones to absorb this mineral. If you take dairy products, those are supplemented with calcium anyway due to pasteurization so you are going to take calcium supplements one way or another. Now I seen studies that show vitamin D3 is good for the immune system, but I wouldn’t take too much. I also wonder how many people who take calcium supplements ALSO take TUMS antacid which is loaded with calcium and people are not aware of that so they get overdosed which can predispose to kidney stones.

  19. Mary
    Pittsboro, NC
    Reply

    I had aortic valve replacement surgery in 2015. I was born with a bi- instead tri- valve but the cardiac surgeon said I had a large deposit of calcium on the valve, probably from the large amounts of supplemental calcium that I was told to take. It took hours to remove the deposits before the valve could be replaced. I will never take calcium supplements again, I will instead get calcium and vitamin D from food sources, practice yoga, and lift weights. I have what is called “stable osteopenia” . I am 76, by the way.

  20. Avaline
    Washington State
    Reply

    My own experience is that I’ve had three different kinds of skin cancer, including melanoma, in the past 14 years, and I’ve worn sunscreen on all exposed skin 365 days a year for the past 40 years. My dermatologist tells me it’s from the sun exposure I got in my childhood, growing up in Southern California in the 1950’s, when sunscreen use was rare, unless you were a lifeguard, and then it was only zinc oxide on the nose. I take vitamin D and a small amount of calcium religiously, consume lots of dairy and green vegetables, stay out of the sun, and have my renal function tested yearly. My risk of skin cancer is much greater than my risk of kidney stones.

  21. Elizabeth
    Sydney
    Reply

    I’m advised by a medical person to take Vit D 2-3000
    mg but I take 1000 mg per day as I live in a sunny area.
    I definitely notice my mood will gradually go down if I don’t take it as it acts like a hormone in the body which
    is needed in anti ageing diet.

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