Vitamin D Alone Doesn’t Prevent Fractures, New Study Finds

Vitamin D Alone Doesn’t Prevent Fractures, New Study Finds

FRIDAY, Dec. 20, 2019 (HealthDay News) — Taking calcium and vitamin D might help older adults curb the risk of a bone fracture, but vitamin D alone does not do the job, a new research review concludes.

The analysis of 28 past studies found that older adults with higher blood levels of vitamin D were less likely to suffer a broken hip or other fracture over five to 15 years.

But the picture was different in studies that actually tested the effects of using vitamin D supplements: They found no evidence that vitamin D alone reduced older adults’ risk of fractures.

In contrast, trials that tested a combination of calcium and vitamin D showed modest protective effects.

“Combined treatment with both calcium and vitamin D reduced the risk of hip fracture by one-sixth, and was more beneficial than taking standard doses of vitamin D alone,” said senior researcher Dr. Robert Clarke, a professor of epidemiology and public health medicine at the University of Oxford in England.

The findings, published online Dec. 20 in JAMA Network Open, are not the final word on vitamin D and fractures. Some ongoing trials are testing high-dose vitamin D in people who are at increased risk of bone breaks.

But for now, there’s no proof that it works, according to Clarke.

In the United States alone, about 54 million people have low bone mass or outright osteoporosis — the brittle-bone disease that can lead to fractures, according to the National Osteoporosis Foundation (NOF). It’s estimated that after age 50, half of women and one-quarter of men will break a bone due to osteoporosis.

Calcium is critical to building and maintaining strong bones, while vitamin D helps the body absorb calcium and supports the muscle function needed to avoid falls.

But when it comes to preventing fractures in people with osteoporosis, there’s only so much that supplements can do, said the NOF’s Beth Kitchin. She was not involved with the study.

“The expectation that vitamin D and calcium, alone, will prevent fractures is probably unrealistic,” said Kitchin, who is also an assistant professor of nutrition sciences at the University of Alabama at Birmingham.

To help preserve bone mass and keep muscles strong, people need regular exercise, according to Kitchin. Exercise that makes the body move against gravity while staying upright — like jogging, jumping rope or dancing — can help maintain bone density. And exercise that builds muscle strength or improves balance can help lower the risk of falls.

Avoiding smoking and excessive drinking is also critical to preventing bone loss, according to the NOF.

Once osteoporosis is diagnosed, medications — which either slow bone breakdown or boost bone formation — may be necessary, Kitchin said. “Fall-proofing” your home is another important step. That means getting rid of tripping hazards inside and outside the house; installing grab bars in bathrooms; and keeping stairways well lit, among other measures.

Of the studies Clarke’s team analyzed, 11 were observational. They followed older adults in the “real world,” tracking fracture rates anywhere from five to 15 years. Overall, the higher a person’s blood levels of vitamin D were at the outset, the lower the risk of fracture.

“But that doesn’t prove cause and effect,” Kitchin stressed. “High vitamin D levels can be a marker of something else.”

Few foods contain vitamin D, she noted. Instead, the body synthesizes it when the skin is exposed to sunlight. So people with high vitamin D levels may spend a lot of time outdoors, for example.

The review also included 11 trials testing vitamin D alone, and six testing vitamin D and calcium. Study participants’ average age ranged from 62 to 85, and they were followed for up to five years.

Overall, people given calcium and vitamin D had a 16% lower risk of hip fracture than those given placebos or no treatment. Their risk of any bone break was 6% lower.

So how do you know if you should take supplements? You could ask your doctor to measure your blood level of vitamin D, to detect any deficiency, Kitchin said. As for calcium, she added, “take a look at your diet.”

If you’re not eating much dairy, green vegetables and foods fortified with calcium, you might need a supplement.

According to the NOF, adults younger than 51 should strive for 1,000 mg of calcium a day; after that, the recommendation goes up to 1,200 mg. As for vitamin D, people younger than 50 should get 400 to 800 international units (IU) per day, while older adults need 800 to 1,000 IU.

The advice on vitamin D does vary, however, with some groups recommending more. According to the Institute of Medicine, the safe upper limit of vitamin D is 4,000 IU per day for most adults.

More information

The National Osteoporosis Foundation has more on calcium and vitamin D.

SOURCES: Robert Clarke, M.D., professor, epidemiology and public health medicine, University of Oxford, U.K.; Elizabeth Kitchin, Ph.D., R.D.N., assistant professor, nutrition sciences, University of Alabama at Birmingham, and volunteer faculty, National Osteoporosis Foundation; JAMA Network Open, online, Dec. 20, 2019

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How to Manage Your Osteoarthritis

How to Manage Your Osteoarthritis

(HealthDay News) — Osteoarthritis is the most common form of arthritis, affecting about 31 million Americans, and is the leading cause of disability among adults.

Known as OA, it causes pain and other symptoms in joints, which can affect the ability to do everyday tasks. There’s no known cure, but there are treatments that can relieve pain and maintain joint function, according to a rheumatologist at Wake Forest Baptist Health in Winston-Salem, N.C.

“Osteoarthritis is the thinning or wearing down of cartilage, which is the cushion between the separate bones in a joint,” Dr. Francis Luk said in a health system news release. “When your doctor says you have arthritis, most often they are referring to osteoarthritis.”

The main risk factors are aging, obesity, prior injury, repetitive stress on a joint and genetics. OA can occur in any joint, but the most common are knees, hips and hands.

“Symptoms vary from person to person but someone with osteoarthritis of the knee typically will have pain when they stand up from a seated position or when they’re walking, especially when going up and down stairs,” Luk said.

“With osteoarthritis of the hands, people typically experience pain when they do things that involve gripping — washing dishes, holding a wrench, opening a jar, things like that,” he added.

Treatments include over-the-counter drugs such as acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs, or NSAIDs, such as aspirin, ibuprofen (Advil, Motrin) and naproxen sodium (Aleve).

Other nonprescription options include topical creams and gels, such as those containing trolamine salicylate (Aspercreme), and the use of heating pads and ice packs.

Assistive devices such as canes, shoe orthotics, jar openers and tools with thicker handles can help with routine tasks.

For more advanced cases of OA, there are prescription pills and creams and steroid injections. The last resort is joint replacement surgery, especially of knees and hips.

“We always try to delay turning to surgery for as long as we can,” Luk said. “However, if you get to a point where you can’t walk from your living room chair to the bedroom, it would be a good idea to see an orthopedic surgeon.”

And, remember, two of the best ways to combat OA are maintaining a normal weight and getting regular exercise, he said.

“I tell people to do as much as they can tolerate until they have some pain and then rest,” Luk said. “I never recommend completely stopping activities, because the downside of inactivity is worse than osteoarthritis.”

More information

The American Academy of Family Physicians has more on osteoarthritis.

SOURCE: Wake Forest Baptist Health System, news release, Oct. 10, 2019

Copyright ©2019 HealthDay. All rights reserved.
Health Tip: Signs of a Herniated Disc

Health Tip: Signs of a Herniated Disc

(HealthDay News) — The bones that form your spine are cushioned by round discs. A herniated disc is a disc that has been pushed out of place, says the American Association of Neurological Surgeons.

The group mentions warning signs of a herniated disc:

  • Low backache.
  • Numbness or weakness in parts of the body.
  • A sharp, electric shock-like pain on one side of the body.
  • Burning or tingling that radiates into the leg or shoulder.

Sometimes, these symptoms can worsen with standing, walking or sitting.

Copyright ©2019 HealthDay. All rights reserved.
How to Manage Your Osteoarthritis

How to Manage Your Osteoarthritis

(HealthDay News) — Osteoarthritis is the most common form of arthritis, affecting about 31 million Americans, and is the leading cause of disability among adults.

Known as OA, it causes pain and other symptoms in joints, which can affect the ability to do everyday tasks. There’s no known cure, but there are treatments that can relieve pain and maintain joint function, according to a rheumatologist at Wake Forest Baptist Health in Winston-Salem, N.C.

“Osteoarthritis is the thinning or wearing down of cartilage, which is the cushion between the separate bones in a joint,” Dr. Francis Luk said in a health system news release. “When your doctor says you have arthritis, most often they are referring to osteoarthritis.”

The main risk factors are aging, obesity, prior injury, repetitive stress on a joint and genetics. OA can occur in any joint, but the most common are knees, hips and hands.

“Symptoms vary from person to person but someone with osteoarthritis of the knee typically will have pain when they stand up from a seated position or when they’re walking, especially when going up and down stairs,” Luk said.

“With osteoarthritis of the hands, people typically experience pain when they do things that involve gripping — washing dishes, holding a wrench, opening a jar, things like that,” he added.

Treatments include over-the-counter drugs such as acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs, or NSAIDs, such as aspirin, ibuprofen (Advil, Motrin) and naproxen sodium (Aleve).

Other nonprescription options include topical creams and gels, such as those containing trolamine salicylate (Aspercreme), and the use of heating pads and ice packs.

Assistive devices such as canes, shoe orthotics, jar openers and tools with thicker handles can help with routine tasks.

For more advanced cases of OA, there are prescription pills and creams and steroid injections. The last resort is joint replacement surgery, especially of knees and hips.

“We always try to delay turning to surgery for as long as we can,” Luk said. “However, if you get to a point where you can’t walk from your living room chair to the bedroom, it would be a good idea to see an orthopedic surgeon.”

And, remember, two of the best ways to combat OA are maintaining a normal weight and getting regular exercise, he said.

“I tell people to do as much as they can tolerate until they have some pain and then rest,” Luk said. “I never recommend completely stopping activities, because the downside of inactivity is worse than osteoarthritis.”

More information

The American Academy of Family Physicians has more on osteoarthritis.

SOURCE: Wake Forest Baptist Health System, news release, Oct. 10, 2019

Copyright ©2019 HealthDay. All rights reserved.
Health Tip: The ‘Wall Test’ For Good Posture

Health Tip: The ‘Wall Test’ For Good Posture

(HealthDay News) — Proper posture can prevent pain and injury, says Mayo Clinic. To check if you have proper posture, Mayo suggests the “wall test.”

Here’s what it involves:

  1. Stand so the back of your head, shoulder blades and buttocks touch the wall. Your heels should be 2 to 4 inches apart.
  2. Place a flat hand behind the small of your back. You should be able to slide your hand between your lower back and the wall.
  3. If there’s too much space behind your lower back, draw your belly button toward your spine.
  4. If there’s too little space behind your lower back, arch your back so your hand can slide behind you.
  5. Walk away from the wall while holding proper posture. Return to the wall to check whether you kept the correct posture.
Copyright ©2019 HealthDay. All rights reserved.
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