Nav: Home

New guideline on calcium and vitamin D supplementation

October 24, 2016

1. The National Osteoporosis Foundation and American Society for Preventive Cardiology publish clinical guideline on calcium and vitamin D supplementation
No clear link between calcium with or without vitamin D supplementation and cardiovascular disease in generally healthy adults

Guideline (free):
Evidence review (free):
URLs go live when the embargo lifts

A new evidence-based clinical guideline from the National Osteoporosis Foundation (NOF) and the American Society for Preventive Cardiology (ASPC) says that calcium with or without vitamin D intake from food or supplements that does not exceed the tolerable upper level of intake (2,000 to 2,500 mg/d) should be considered safe from a cardiovascular standpoint. Obtaining calcium from food sources is preferred, but supplements can be used to address dietary shortfalls. The guideline is published in Annals of Internal Medicine.

Calcium supplements have been recommended for persons who do not consume adequate calcium from their diet as a standard strategy for preventing osteoporosis-related fractures. Conflicting reports have suggested that calcium intake, particularly from supplements, may have either beneficial or harmful effects on cardiovascular outcomes. To update the evidence on calcium and vitamin D, investigators from the Tufts University School of Medicine reviewed randomized trials and prospective cohort studies published since their last evidence report in 2009. Their findings were used to inform the joint clinical guideline from NOF and ASPC.

A total of 31 studies were included in the review. Of the four randomized trials reviewed, none found a statistically significant difference in risk for cardiovascular events or mortality between groups receiving supplements of calcium alone or calcium plus vitamin D compared to those receiving placebo. None of the 27 cohort studies included in the review conclusively linked total, dietary, or supplemental calcium intake levels to cardiovascular disease and cerebrovascular disease, mortality, or all-cause mortality. Because excessive calcium intake is nearly impossible to achieve via diet, safety of supplementation had been an area of concern. Of the three supplementation-specific trials included in the review, none found a statistically significant effect of calcium supplementation on cardiovascular disease outcomes. Based on this moderate-quality evidence, the review team concluded that calcium intake from food or supplement sources at levels within the recommended tolerable range should be considered safe for generally healthy adults.

Note: For an embargoed PDF, please contact Cara Graeff. To speak with the lead author of the evidence review, Dr. Mei Chung, please contact Siobhan E. Gallagher at or 617-636-6586. To speak with an author of the clinical guideline, please contact Michael Sandler at or 703-993-8815.

2. Noninvasive fecal test an 'excellent alternative to colonoscopy' for cancer prevention
URLs go live when the embargo lifts

The U.S. Multi-Society Task Force, a group comprised of the major U.S. gastroenterological professional associations, recently released a consensus statement on the use of the noninvasive fecal immunochemical test (FIT) for colorectal cancer screening in average risk populations. A group of colorectal cancer experts say their statement offers strong evidence for FIT as an excellent alternative for colorectal cancer prevention and, as such, should be promoted with the same enthusiasm as colonoscopy. Their commentary is published in Annals of Internal Medicine.

Colonoscopy accounts for 60 percent of all colorectal cancer screening in the U.S., despite its greater expense and risk of complications compared with other options. In addition, unlike fecal occult blood testing or flexible sigmoidoscopy, no controlled studies have shown that colonoscopy reduces colorectal cancer incidence or mortality. Still, given the preference for colonoscopy screening in the U.S., strong evidence would be required to shift this norm. While clinicians await the results of trials comparing colonoscopy with stool blood-based screening methods, the authors point to several characteristics that make FIT a more attractive primary screening method.
Note: For embargoed PDFs, please contact Cara Graeff. The lead author, Dr. David Weinberg, Chair of Medicine, Chief of Gastroenterology Section at Fox Chase Cancer Center, can be reached through Amy Merves at or 215-280-0810.

American College of Physicians

Related Colorectal Cancer Articles:

New method for early screening of colorectal cancer
A highly sensitive method that can detect even the earlier stages of colorectal cancer has been developed by researchers in Japan.
Adults with disabilities screened less often for colorectal cancer
Colorectal cancer is the fourth most common type of cancer in the United States, with nearly 135,000 cases reported in 2016.
Colorectal cancer statistics, 2017
Despite dramatic reductions in overall colorectal cancer incidence and mortality, striking disparities by age, race, and tumor subsite remain
Gene mutations among young patients with colorectal cancer
While many patients with colorectal are diagnosed when they are older than 50, about 10 percent of patients are diagnosed at younger ages.
Metabolite that promotes cancer cell transformation and colorectal cancer spread identified
Osaka University researchers revealed that the metabolite D-2-hydroxyglurate (D-2HG) promotes epithelial-mesenchymal transition of colorectal cancer cells, leading them to develop features of lower adherence to neighboring cells, increased invasiveness, and greater likelihood of metastatic spread.
More Colorectal Cancer News and Colorectal Cancer Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Teaching For Better Humans
More than test scores or good grades — what do kids need to prepare them for the future? This hour, guest host Manoush Zomorodi and TED speakers explore how to help children grow into better humans, in and out of the classroom. Guests include educators Olympia Della Flora and Liz Kleinrock, psychologist Thomas Curran, and writer Jacqueline Woodson.
Now Playing: Science for the People

#535 Superior
Apologies for the delay getting this week's episode out! A technical glitch slowed us down, but all is once again well. This week, we look at the often troubling intertwining of science and race: its long history, its ability to persist even during periods of disrepute, and the current forms it takes as it resurfaces, leveraging the internet and nationalism to buoy itself. We speak with Angela Saini, independent journalist and author of the new book "Superior: The Return of Race Science", about where race science went and how it's coming back.