title: Calcium and vitamin D intake influence bone mass, but not short-term fracture risk, in Caucasian postmenopausal women from the National Osteoporosis Risk Assessment (NORA) study.
abstract: The impact of calcium and vitamin D intake on bone density and one-year fracture risk was assessed in 76,507 postmenopausal Caucasian women. Adequate calcium with or without vitamin D significantly reduced the odds of osteoporosis but not the risk of fracture in these Caucasian women.
  
  
  BACKGROUND
  Calcium and vitamin D intake may be important for bone health; however, studies have produced mixed results.
  
  
  METHODS
  The impact of calcium and vitamin D intake on bone mineral density (BMD) and one-year fracture incidence was assessed in 76,507 postmenopausal Caucasian women who completed a dietary questionnaire that included childhood, adult, and current consumption of dairy products. Current vitamin D intake was calculated from milk, fish, supplements and sunlight exposure. BMD was measured at the forearm, finger or heel. Approximately 3 years later, 36,209 participants returned a questionnaire about new fractures. The impact of calcium and vitamin D on risk of osteoporosis and fracture was evaluated by logistic regression adjusted for multiple covariates.
  
  
  RESULTS
  Higher lifetime calcium intake was associated with reduced odds of osteoporosis (peripheral BMD T-score < or =-2.5; OR = 0.80; 95% CI 0.72, 0.88), as was a higher current calcium (OR = 0.75; (0.68, 0.82)) or vitamin D intake (OR = 0.73; 95% CI 0.0.66, 0.81). Women reported 2,205 new osteoporosis-related fractures. The 3-year risk of any fracture combined or separately was not associated with intake of calcium or vitamin D.
  
  
  CONCLUSIONS
  Thus, higher calcium and vitamin D intakes significantly reduced the odds of osteoporosis but not the 3-year risk of fracture in these Caucasian women.
authors.affiliation: Clinical Research Center, Helen Hayes Hospital, West Haverstraw, NY 10993, USA. Nievesj@helenhayeshosp.org
authors.forename: J W
authors.initials: JW
authors.lastname: Nieves
authors.forename: E
authors.initials: E
authors.lastname: Barrett-Connor
authors.forename: E S
authors.initials: ES
authors.lastname: Siris
authors.forename: M
authors.initials: M
authors.lastname: Zion
authors.forename: S
authors.initials: S
authors.lastname: Barlas
authors.forename: Y T
authors.initials: YT
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000187:drug effects*; D002136:Calcium, Dietary / Q000008:administration & dosage*; D004032:Diet; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology*; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000453:epidemiology*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014807:Vitamin D / Q000008:administration & dosage*; D014815:Vitamins / Q000008:administration & dosage*; D044465:White People
chemical_list: D002136:Calcium, Dietary; D014815:Vitamins; D014807:Vitamin D