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): http://annals.org/aim/article/doi/10.7326/M16-1743
Evidence review (free): http://annals.org/aim/article/doi/10.7326/M16-1165
Editorial: http://annals.org/aim/article/doi/10.7326/M16-2193
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 siobhan.gallagher@tufts.edu or 617-636-6586. To speak with an author of the clinical guideline, please contact Michael Sandler at msandle3@gmu.edu or 703-993-8815.




2. Noninvasive fecal test an 'excellent alternative to colonoscopy' for cancer prevention
Abstract: http://annals.org/aim/article/doi/10.7326/M16-2341
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.
-end-
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 amy.merves@fccc.edu or 215-280-0810.

American College of Physicians

Related Colorectal Cancer Articles from Brightsurf:

Colorectal cancer treatment: the winning combinations
Chemotherapy has distressing side effects for patients and increases the risk of developing resistance to the treatment.

A new model to predict survival in colorectal cancer
This signature could be useful in clinical practice, especially for colorectal cancer diagnosis and therapy.

Roadmap to reducing colorectal cancer deaths
The American Gastroenterological Association has outlined a strategy to increase the number of people screened via tests that are more convenient, accurate and less expensive and tailored to people's individual cancer risks.

Study provides new insight on colorectal cancer growth
A new study by researchers at the University of Kentucky identifies a novel function of the enzyme spermine synthase to facilitate colorectal cancer growth.

Researchers ID target for colorectal cancer immunotherapy
Researchers at the Indiana University Melvin and Bren Simon Comprehensive Cancer Center have identified a target for colorectal cancer immunotherapy.

Colorectal cancer partner-in-crime identified
A protein that helps colorectal cancer cells spread to other parts of the body could be an effective treatment target.

Cancer cell reversion may offer a new approach to colorectal cancer treatment
A novel approach to reverse the progression of healthy cells to malignant ones may offer a more effective way to eradicate colorectal cancer cells with far fewer side effects, according to a KAIST research team based in South Korea.

A novel pathway to target colorectal cancer
Survival rates for patients with late-stage colorectal cancer are dismal, and new therapeutic strategies are needed to improve outcomes.

Colorectal cancer rates in Canada
The incidence of colorectal cancer among younger adults increased in recent years in this analysis of data from Canadian national cancer registries that included about 688,000 new colorectal cancers diagnosed over more than 40 years.

Cancer drugs promote stem cell properties of colorectal cancer
Scientists from the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) and the Mannheim University Medical Center have now discovered that a certain group of cancer drugs (MEK Inhibitors) activates the cancer-promoting Wnt signalling pathway in colorectal cancer cells.

Read More: Colorectal Cancer News and Colorectal Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.