Two new studies are throwing some new light on bone fractures. This information is especially important for women because they become more susceptible to these fractures as they go through the menopausal transition.
The first study actually expands upon previous studies by focusing on a more diverse population. Researchers from the University of Alabama at Birmingham looked at claims data for 1.7 million Medicare beneficiaries from 2000 to 2005 in order to determine whether they experienced fractures in six areas of the body.
The researchers found that that blacks actually had the lowest overall fracture rates, except for fractures of the ankle and tibia/fibula (two bones that are part of the shin). In addition, Asian, African and Hispanic Americans had lower fracture rates than white Americans.
The part of the United States you reside in also makes a difference. For instance, researchers found that study participants who lived in the U.S. South had higher rates of fractures of the hip and spine. However, other types of fractures were highest for study participants who lived in the Northeast.
Not surprisingly, women had more fractures then men. Older people also were more at risk for fractures than the younger participants in the study. The researchers found that median household income also was linked to the risk of fracture in that people with higher incomes have a lower risk of fractures.
Researchers also found that over the span of the study, hip fractures actually decreased while spine fractures increased. The rates of other types of fractures remained the same. In their analysis, the researchers found that fall-related conditions and depressive illnesses were associated with each kind of fracture. However, conditions (such as rheumatoid arthritis) treated with glucocorticoids were weakly associated with each kind of fracture and also were associated more strongly with spine fractures. Diabetes, on the other hand, was associated with fractures of the ankle and the humerus (the long bone of the upper arm that joins with the shoulder joint).
To address these risks of fractures, the researchers suggested that target interventions need to be developed that address the risk of specific fractures by subgroup (such as Americans who have lower socioeconomic status, those living in the South, and those with depression, diabetes, renal disease, cancer and conditions that require glucocorticoids). They also recommended interventions for people who have had previous fractures.
Another study from the Center on Aging and Mobility at the University of Zurick and Wald City Hospital found that taking more than 800 international units (IU) of vitamin D daily may reduce the chance of hip fractures in older women by 30 percent and the risk of non spine-related fractures by 14 percent. The researchers also found that daily doses below 792 IU did not reduce the risk.
The Swiss study involved more than 31,000 people. Of those, 91 percent were women. All of the participants were older than 65 and had an average age of 76.
This finding seems to be in line with the recommendations by the U.S. Preventive Services Task Force that I described in June. The task force suggested that postmenopausal women shouldn’t take low-dose vitamin D supplements that are 400 IU because studies do not show any benefit. The task force also noted that there wasn’t clear evidence on the effect of higher doses of vitamin D in order to make a recommendation.
The Swiss researchers noted that to receive the benefits of vitamin D, you need to make sure you’re getting between 1,000 and 1,200 milligrams of calcium (and more if you’re older). However, current analysis suggests that more than 1,000 mg of calcium may reduce the effect of vitamin D.
So what should you do? I still recommend trying to include foods that are rich in vitamin D and calcium in your daily diet. Vitamin D can be found in fatty fish, eggs, mushrooms, dairy products such as fortified milk, fortified cereals and breads, as well as through 10 minutes of sun exposure without sunscreen. And calcium, according to The George Mateljan Foundation, can be found in spinach, turnip greens, mustard greens, collard greens, tofu, blackstrap molasses, Swiss chard, yogurt, kale, mozzarella cheese, cow’s milk, goat’s milk, basil, thyme dill seed, oregano and cinnamon. And talk to your doctor if you are considering taking supplements for vitamin D and calcium.
Primary Sources for This Sharepost:
Agency for Healthcare Research and Quality. (2012). Study identifies demographic and clinic factors related to fractures among older Americans. The U.S. Department of Health and Human Services.
George Mateljan Foundation. (N.D.). Calcium.
MedlinePlus. (2012). Higher doses of vitamin D prevent fractures in older women.
Published On: July 06, 2012