Experts say vitamin D supplements can provide some health benefits for some women after menopause.
- Research
suggests the use of calcium and vitamin D supplements may reduce the risk
of cancer deaths in postmenopausal women but may also increase the risk of
death from cardiovascular disease.
- Calcium
and vitamin D supplements are often recommended for postmenopausal women
to prevent bone loss.
- Experts
say the research should be interpreted with caution and women should
discuss with their doctor whether they should take supplements.
Use of calcium and
vitamin D supplements in women who are postmenopausal may reduce the risk of
death from cancer, but they may also increase risk of death from cardiovascular
disease.
That’s according
to research published today in the journal Annals
of Internal Medicine, which reports that women who took calcium and vitamin D supplements
had a 7% lower risk of death from cancer but a 6% higher risk of death from
cardiovascular disease.
“Our study also found an
11% lower risk for total cancer, including 31% and 19% lower incidences
of colorectal
cancer and invasive breast cancer,” the study
authors wrote.
To reach their findings,
the researchers from the University of Arizona conducted a follow-up analysis
to the largest ever randomized trial of calcium and vitamin D supplementation,
which examined the health outcomes of those supplements on more than 36,000 postmenopausal women.
However, the study
authors note that due to the way the study was undertaken, the results should
be interpreted carefully.
“Given the study design,
we could not disentangle the added benefit or harms of supplementation with
calcium and vitamin D in combination versus vitamin D alone, a topic worthy of
future study,” they wrote.
Women and
death from cancer
Dr. Howard Hodis, an internal medicine specialist with Keck
Medicine of USC in California who was not involved in the study, said there
could be a number of factors that might explain a reduction in cancer risk
among the group studied.
“It’s important to
understand that this is a follow-up that’s done after the trial ended. So it’s
really an observational follow-up of individuals who were in a previous trial
and so they’re no longer under randomized conditions,” he explained to Medical
News Today.
“There’s a lot of
factors that can bleed into that. It could be that with the reduction of
cancer, maybe that’s a more healthy group in some way. They exercise more,
they’re thinner, they’re eating better, there’s no way to know whether that’s
true or not,” Holis added.
Previous observational
studies have indicated that those who take calcium supplements
have a greater risk of cardiovascular disease-related events than those who
don’t take calcium supplements. Low levels of estrogen seen
in menopause can also raise the risk of heart disease and stroke.
The risk of
cardiovascular disease events is particularly significant for those who consume
more than 1,400mg of calcium a day.
For women aged over 50,
the recommended daily intake of calcium is 1,200mg a day.
Why women
need calcium in menopause
During menopause, a
decrease in the production of estrogen reduces the absorption of calcium and
increases urinary calcium loss.
After menopause, women
lose roughly 1% of their bone mineral density each year. As a result,
30% of postmenopausal women in the United States have osteoporosis and of these
at least 40% will experience at least one fracture that
occurs due to a minor trauma such as a fall.
“Every woman during this
menopause transition and beyond is at risk for osteopenia and osteoporosis.
And osteoarthritis fractures
will be deadly later in life. So that’s the reason why we are very, very
focused in women’s health on protecting women’s bones as they go through the
midlife transition and beyond,” Dr. Leah
Millheiser, a clinical professor of obstetrics and gynecology at
Stanford University in California who was not involved in the study, told Medical
News Today.
“So it is important to
get enough calcium and vitamin D, but you have to weigh that… We have to look
at every woman as an individual. What are her risk factors? Does she have a
medical condition where we don’t want her to get extra calcium? Is she somebody
who has a high calcium
score?… They are all things that we need to take into
consideration,” Millheiser added.
Dr. G Thomas
Ruiz, a lead OB/GYN at MemorialCare Orange Coast Medical Center in
California who wasn’t involved in the study, says hormone replacement
therapy can also be useful for protecting the bone health of
postmenopausal women.
“In my ideal world,
you’d have women on hormone replacement therapy, taking vitamin D and calcium
supplementation to really minimize the risk of osteoporosis. However, women
with breast cancer don’t have the option of hormone replacement therapy,” Ruiz
told Medical News Today.
“The thought is
with weight
bearing exercise, and supplementing with calcium and vitamin D, that
you will slow down the loss of calcium from the bone. And that seems to be
true. It’s not perfect, but it’s better than nothing,” he added.
The link
between vitamin D and reduced cancer mortality
The Arizona research
builds on previous research that indicates a potential
connection between vitamin D levels and reduced risk of cancer.
Past research has
found a 17% lower
cancer mortality among men and women with prostate, lung,
colorectal, and ovarian cancers and higher concentrations of vitamin D.
“Our findings that
effects on cancer end points seem more prominent among those without prior
calcium and vitamin D supplementation suggest that calcium and vitamin D
supplementation may affect cancer biology primarily in the setting of
augmenting an insufficiency in nutrient status,” the authors of the new study
wrote.
Experts say the best
thing women can do to stay healthy during and after menopause is to be active,
quit smoking, have a healthy diet,
and discuss whether supplements are appropriate with a healthcare provider.
“This isn’t a one size
fits all conversation. You have to look at every woman and her medical
history,” Millheiser said.
https://www.medicalnewstoday.com/articles/how-calcium-vitamin-d-supplements-can-lower-postmenopausal-womens-risk-of-cancer-but-raise-risk-of-heart-disease
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