Consuming the right amount of Calcium is key to prevent postmenopausal osteoporosis: EMAS guidelines

Courtesy: Washington post 

Intake of right amount of Calcium, preferably from dietary source is the key to manage bone health in postmenopausal women and anything in excessive may not help, and can be harmful, says the new European Menopause and Andropause Society (EMAS) clinical guidelines published in forthcoming issue of Maturitas.

Postmenopausal osteoporosis is rife throughout the world and despite recommendations about diet and lifestyle changes from societies and governmental bodies, many issues remain unresolved. Calcium is drug which is often consumed as either single supplement or in combination with Vitamin D3 and self-dosing is very common.

Different societies have recommended different doses ranging from 700 and 1200 mg/daily and uncertainties prevail about the most appropriate dose.

Excessive intake of calcium beyond 2000mg/day is linked to increases risk cardiovascular events, dementia, urolithiasis and even fractures, but the issue remains unresolved.

To develop the current EMAS guidelines the authors looked at systematic reviews, meta-analyses, and randomized controlled trials from 2007 till present.

The key recommendations by EMAS are:

The guidelines reiterate the role of adequate intake of calcium in preventing postmenopausal osteoporosis and fracture risk.

The recommended calcium intake should be between 700 and 1200 mg per day after menopause.

Diet should be the preferred method for sourcing the daily requirements, as the intake is uniformly distributed throughout day and avoids the calcium peaks in blood.

Higher than recommended amount is not useful, on the contrary it may do possible harm.

If women are not able to take supplements and the diet also does not supply the recommended amount of calcium, they should have regular physical exercise and take Vitamin D to maintain healthy bones.

The EMAS recommendation of 700 to 1200 mg per day differ from US guidelines in terms of daily dosage. The National Osteoporosis Foundation (NOF) and the American Society for Preventive Cardiology (ASPC) the US Institute of Medicine (IOM) Food and Nutrition Board, and the North American Menopause Society(NAMS) recommends 1200 mg of elemental calcium per day.

The National Institutes of Health (NIH) recommended 1500 mg of elemental calcium per day.

But, the study authors opined that the 300-mg difference between European and US guidelines does not matter much as the real problem starts if the daily intake exceeds 2000 mg or more.

The EMAS recommendations does not apply to women receiving antiosteoporotic drugs, which require concomitant supplementation with calcium and vitamin D. 

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