Recently, JAMA published a meta-analysis of the effects of calcium supplementation and vitamin D on fracture risk by Zhao and Zeng Xiantie of Tianjin Hospital.

This article is the cover paper of JAMA website home page.

The conclusion is that calcium and vitamin D supplementation cannot prevent fracture or hip fracture in the elderly. No matter what dosage, gender of the elderly, fracture history and calcium content in the diet, these supplements have not shown obvious benefits. This caused an uproar in the academic circle.

This also makes the people can't help but question whether the calcium in these years is all white? Especially for the elderly, do calcium supplementation and vitamin D really have no effect on preventing fractures? What are the misunderstandings of calcium supplementation in daily life, and how to supplement calcium reasonably? It's time to be clear.

What caused the fracture?

There are many kinds of fractures, including traumatic fractures and osteoporotic fractures. I often meet some old people who accidentally fall down and break their bones when walking. In fact, falling is only an inducement, and the biggest cause of this fracture is osteoporosis.

This is about the cause of osteoporosis, and the main cause of osteoporosis is calcium deficiency. In fact, calcium deficiency in the body can not be solved only by supplementing calcium. There are three reasons for calcium deficiency in the body: one is calcium deficiency, the other is calcium absorption disorder, and the third is increased calcium excretion.

Traumatic fracture cannot be prevented by calcium supplementation and vitamin D. Calcium supplementation only solves the first cause. For patients with osteoporosis, it is necessary not only to take enough calcium, but also to absorb it well to reduce the loss of calcium, which requires anti-osteoporosis drugs combined with calcium tablets.

Several misunderstandings of calcium supplementation

Calcium supplementation increases the risk of stones, or patients with stones should not take calcium supplementation.

In fact, most urinary calculi are caused by calcium oxalate, and doctors suggest adding calcium carbonate. Rational use of calcium carbonate will not only cause stones, but also release oxalate in human body to inhibit the formation of stones. Calcium oxalate mainly exists in green leafy vegetables, such as spinach. It is recommended to blanch with boiling water before eating.

Calcium supplementation is not recommended when hypertensive patients take calcium channel blockers.

Calcium channel blockers are very important drugs for the treatment of hypertension, and many hypertensive patients are taking them, but there is no contradiction between calcium supplementation and taking calcium channel blockers. On the contrary, correct and effective calcium supplementation will lower blood pressure.

Drinking bone soup and eating shrimp skin can supplement calcium.

Affected by intestinal environment, sodium salt, high protein and oily food will inhibit the absorption of calcium. Therefore, for middle-aged and elderly people who want to supplement calcium, pay attention to a light diet.

Although the bone soup has high calcium content, the cholesterol content is too high, which greatly affects the absorption of calcium, so the effect of drinking bone soup to supplement calcium is minimal. Shrimp skin belongs to weakly alkaline food, and calcium is best absorbed in weakly acidic environment. Eating a lot of shrimp skin is easy to form a weak alkaline environment in the intestine, which is not conducive to the absorption of calcium.

People think that the more calcium is added, the better.

In fact, calcium supplementation is not the more the better, but there is a limit. China stipulates that the maximum tolerable intake of all ages is 2000mg, which means that each person can't exceed 2g per day, otherwise it may cause adverse reactions.

How to supplement calcium reasonably?

Reasonable diet

Usually pay attention to eat foods with high calcium content, such as milk and dairy products, beans, hard fruits, shrimp skin, small fish and shrimp, green vegetables, kelp, seaweed and other foods with high calcium content.

Vitamin d supplement

Vitamin D can promote the absorption of calcium, so it is best to have vitamin D to supplement calcium, so that calcium can be well absorbed and utilized.

Osteoporosis drugs

For patients with osteoporosis, in addition to basic supplements, some anti-osteoporosis drugs need to be added. There are mainly drugs that inhibit bone resorption and drugs that promote bone formation.

In short, we can't deny the role of calcium supplementation and vitamin D in preventing osteoporotic fractures, but for patients with osteoporosis, it is difficult to reduce the incidence of fractures simply by calcium supplementation and vitamin D, and they need to be taken together with anti-osteoporosis drugs to effectively reduce the incidence of osteoporotic fractures.