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BOX 4-4

AHRQ Findings by Life Stage for Vitamin D and Calcium and BMC/BMD*

0–6 months: No data

7 months–2 years: No data

3–8 years: No data

9–18 years: One RCT showed that, compared with placebo, there was no significant effect of vitamin D3 (200 IU/day) plus calcium (1,000 mg/day) on BMC changes in healthy girls between 10 and 12 years of age.

19–50 years: No data

51–70 years: No new data were identified in AHRQ-Tufts

71 years: No new data were identified in AHRQ-Tufts

Postmenopause: Findings from the AHRQ-Ottawa report showed that vitamin D3 (≤ 800 IU/day) plus calcium (~500 mg/day) supplementation resulted in small increases in BMD of the spine, total body, femoral neck, and total hip in predominantly populations of late-menopausal women. Two of the three new RCTs showed a significant increase in hip or total BMD in postmenopausal women, comparing vitamin D3 or vitamin D2 (300 or 1,000 IU/day, respectively) plus calcium (1,200 mg/day) with placebo.

Pregnant and lactating women: No new data were identified in AHRQ-Tufts


*Evidence from AHRQ-Ottawa; information from AHRQ-Tufts as noted.

SOURCE: Modified from Chung et al. (2009).

Fractures and BMD in postmenopausal women and older men: Serum 25OHD The association between risk of fractures and vitamin D in combination with calcium, as well as vitamin D alone, was addressed by AHRQ. Neither analysis focused on fracture risk and calcium intake alone.

AHRQ-Ottawa, which included some studies that combined calcium and vitamin D, identified observational studies (ranging from poor to fair quality) that reported on the association between serum 25OHD concentrations and fractures. The studies are identified in Table 4-10. The analysis concludes that there is inconsistent evidence to support an association between serum 25OHD concentration and an increased risk of fracture. Five studies of good quality evaluated the association between serum 25OHD concentration and risk of falls (see discussion in section above on Falls and

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