Among patients with a recent low-energy fracture, a year of treatment with calcium and vitamin D reduces bone turnover, according to findings published in the July issue of the American Journal of Clinical Nutrition. The intervention increases bone mineral density (BMD) in those younger than 70 years of age, and decreases bone loss in older patients.

"Low-energy fractures of the hip, forearm, shoulder, and spine are known consequences of osteoporosis," Dr. Mette F. Hitz, of Copenhagen University Hospital Hvidovre, Denmark, and colleagues write. "Hip fractures occur mainly in older individuals at risk of being deficient in calcium and vitamin D," they note.

In a double-blind study, the researchers examined the effect of one year of treatment with calcium and vitamin D on BMD and bone markers in 122 patients with a recent low-energy fracture. Participants were randomly assigned to receive 3000 mg calcium carbonate plus 1400 IU cholecalciferol or placebo.

In an intention-to-treat analysis, BMD of the lumbar spine increased in the intervention group and decreased in the placebo group. The difference was significant between groups after 12 months. There was no significant change for BMD of the hip.

"Stratification according to age showed a more pronounced effect of treatment (lumbar spine BMD) in the patients aged younger than 70 years than in those aged older than 70 years (p < 0.05)," the team reports.

They also found that the change in BMD of the lumbar spine correlated significantly with physical performance, "which emphasizes the importance of mobilization."

As the researchers point out, "Because frail patients older than 70 years of age are immobile, they are not able to decrease bone resorption and increase bone mass when treated with calcium and vitamin D. The importance of sufficient mechanical loading has been shown in clinical trials; the effect of intervention with calcium and vitamin D is reduced if patients are immobile."