September Blog Summary

This was the first long-term randomized study to examine calcium and vitamin D supplementation in older women. The results of this study did not support the benefit of supplementing calcium and vitamin D to protect against the decline of physical functioning in older women.

Question one stated that average calcium and vitamin D levels in the U.S. are below optimal. Then question one asked what would you, as a dietitian, would do to bring awareness to this issue and to state what recommendations should be made to clients. There were some great responses to this question. Some of the future dietitians recommended having a health fair, creating handouts, having a cooking demonstration, create goals, taking a vitamin, consuming fortified foods, and education classes. A majority of the responses recommended consuming more foods with calcium and vitamin D and letting your clientele know exactly what those foods are by providing a list and/or handout. It was also recommended that getting vitamin D from sunlight for about ten minutes each day is also important. A lot of the responses included consuming more milk and less juice, pop and other calorie dense beverages. It is vital to talk with clients as individuals and discover what will work best for them and what foods they are willing to consume to promote overall wellness. These ideas are all excellent ways to increase calcium and vitamin D consumption and bring awareness to this issue.

Question two explained that this study used post-menopausal women, ages 50-79 years old. The question asked for the respondents to explain how the study would have differed if the population used were younger, pre-menopausal women. Many of the respondents explained how estrogen plays a critical role in building bones and because during menopause estrogen is decreased, bone loss occurs. This is very crucial to this study and the results that occurred. It is proven as we age, bone loss does occur. It is very important to start while you are young, to build muscle, stay active, and eat a balanced diet (incorporating calcium and vitamin D). Hormone replacement therapy was mentioned and how that could increase the absorption of calcium and vitamin D. Another issue is that post-menopausal women are at higher risk for osteoporosis. Using a younger population in this study could have drastically altered the results. Younger women are typically more active and are producing more estrogen.

Question three asked about possible reasons why the participants in this study did not show improvements in physical functioning after taking the vitamin D and calcium supplements and to discuss how they feel about supplement use. The study mentions, that the level of vitamin D supplementation used (400 IU/day) is not considered adequate today. This is one reason why physical function did not improve. There are a variety of other factors to look at when analyzing this study including: calcium intake, each patient is different, the length of the study could have played a role, and the age of the participants. It was also mentioned to break up the calcium dosage into two to three doses a day. All of these ideas could have altered the results of this study. More research is needed to obtain accurate conclusions about calcium and vitamin D. Most respondents preferred using food for the bodies nutrient need, but in some cases supplements are needed. As long as supplements are used for the right reason and are not being abused, it may be necessary to take a supplement. It may be possible that a multivitamin is all the client needs. Always check out what other medications the patient is on and learn more about his or her diet to insure proper supplement use.

In conclusion, more research and studies are needed to gain a broader knowledge of calcium and vitamin D supplementation. Overall, recommending a balanced, healthy diet and incorporating exercise into our daily lives is critical. In the field of dietetics, it is important to stay on top of the research because things are always changing. Being positive and discussing with patients what will work for them individually, and what they are willing to do, will make goals more attainable for them.