Abstract
Many older adults do not achieve recommended intakes of calcium and there is some concern over the potential impact of this on bone health. The objective of this review was to examine evidence from cohort studies on the relationship between calcium intake and change in bone mineral density (BMD) in older adults, something not undertaken in the last two decades. Data sources included Ovid Medline, Embase, and PubMed and references from retrieved reviews and articles. The final search was performed in February 2021. We included cohort studies of calcium intake in participants aged >50 years with change in BMD over ≥1 year as an outcome. We identified 23 studies of women and 7 of men. Most studies found no association between calcium intake and change in BMD in women (71%) or men (71%). Among women, five studies reported high rates (>30% of participants) of hormone treatment or osteoporosis therapy (HT/OT) use; 80% of these studies reported a positive association between calcium intake and change in BMD, compared with 10% of studies in which HT/OT use was low. No study in women in which the mean age was >60 years reported a positive association between calcium intake and change in BMD. We conclude that calcium intake across the ranges consumed in these studies (mean intake in all but one study >500 mg/day) is not an important determinant of bone loss, particularly among women >60 years. The positive findings in studies with high rates of HT/OT use are likely to arise from confounding as a result of co-administration of calcium supplements with these medications.
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Funding
This study was supported by the Health Research Council of New Zealand. SMB is supported by an Auckland Medical Research Foundation Edith C. Coan Research Fellowship and a Kelliher Charitable Trust Emerging Research Start-Up Award.
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All authors contributed to the study design. Literature searches were carried out by WL and SMB. SMB wrote the first draft of the manuscript, which was critically appraised by all authors. Statistical analyses were carried out by GDG.
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IRR has received personal fees from Amgen. The other authors have no conflicts of interest to declare.
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Bristow, S.M., Bolland, M.J., Gamble, G.D. et al. Dietary calcium intake and change in bone mineral density in older adults: a systematic review of longitudinal cohort studies. Eur J Clin Nutr 76, 196–205 (2022). https://doi.org/10.1038/s41430-021-00957-8
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DOI: https://doi.org/10.1038/s41430-021-00957-8