Study Finds Men, Too, Can Fight Osteoporosis With Diet
Long known as a scourge of older women, the thinning, brittle bones of osteoporosis have now achieved a measure of gender parity: A new study suggests for the first time that aging men as well as women can reverse bone loss and prevent fractures by boosting their intake of calcium and vitamin D.
The study of 389 people, published today in the New England Journal of Medicine, bolsters federal dietary recommendations issued last month that urge Americans to substantially increase their calcium and vitamin D consumption to keep bones strong. Dairy products, certain green vegetables and other foods are rich in calcium.
About 28 million people are at risk of osteoporosis, which costs about $13 billion in health care annually.
Osteoporosis research has focused on women, who are more susceptible to the condition than men because they initially build up less bone and lose up to 10% of it during menopause. “There’s been a lot less work done on the benefits of additional calcium for older men,” said Suzanne Murphy, a nutrition scientist at UC Berkeley. “So this is an important finding.”
Beyond that, the Tufts University research also is among the first to show that healthy older people living at home may strengthen their bones by increasing vitamin D along with calcium. Because the human body makes vitamin D in response to sunlight, medical researchers have generally believed that the only people who really need extra dietary sources of the vitamin are children, with their fast-growing skeletons, and institutionalized elderly people, who get little sunlight.
Sherry Sherman, director of clinical endocrinology and osteoporosis research for the National Institute on Aging, which paid for the study, said its importance was that it showed gains against osteoporosis even in older people who were healthy and active. “If people can keep their calcium and vitamin D levels up, maybe we won’t have this problem at all,” she said.
In the new study, Tufts researchers led by Dr. Bess Dawson-Hughes supplied calcium and vitamin D supplements to 187 men and women over 65 for three years. Two hundred two others got placebos.
Every six months, the patients had bones in their neck, spine and hips measured with an X-ray scanner. To prevent skewing the results, neither the researchers nor the patients knew who got supplements and placebos until after all the data were collected.
Compared to the controls, women who received supplements lost little or no bone mass. And whereas men in the placebo group lost 1% of hip bone mass, those on supplements added 1%. That may seem like a small bonus, the National Institute on Aging’s Sherman said, but given the gradual weakening of bone tissue over time, someone who simply holds it in check is “ahead of the game.”
Also, fractures were half as common among those on supplements. There were 11 non-vertebral fractures in that group (5.9%), versus 26 in the placebo group (12.9%). Most of the fractures happened to women.
The supplement pills provided 500 milligrams of calcium (in the form of the compound calcium citrate malate). That brought the subjects’ daily intake to about the level of the new government recommendation of 1,200 milligrams for people 50 to 70.
The vitamin D pills contained 700 international units, which exceeds the new recommended intake of 400 for that age group. Tufts epidemiologist Susan Harris said the vitamin D supplement level in the study was probably higher than it needed to be.
Though the researchers used supplements to increase the nutrient levels in this study, the Institute of Medicine recommends that people first try to achieve the same effect with diet. Dairy products are the richest in calcium, and Berkeley’s Murphy, who was on the panel that revised the calcium guidelines, said the No. 1 message was that “people should be getting two or preferably three servings of dairy products per day.” Other calcium-rich foods are sardines with the bones, oysters, green leafy vegetables, broccoli and tofu.
Otherwise, she said, people should try calcium-fortified foods such as breakfast cereal and orange juice.
Supplement pills are a last resort, she said. Taking too much calcium supplement can be unpleasant or even dangerous, leading to gas, nausea, vomiting or kidney damage.
Excess vitamin D supplementation can reportedly cause high blood pressure, diarrhea and headache.
