Task Force findings taken to task

Healthy post-menopausal women should avoid taking low doses of vitamin D and calcium. These supplements  don’t help prevent bone fractures. So says the government’s U.S. Preventive Services Task Force.

But before you follow their senseless advice, and cut out calcium and vitamin D supplements, you need to get the real facts of the study.

The Task Force made this recommendation last month in a report published in the Annals of Internal Medicine. For the report, the Task Force analyzed data taken from the Women’s Health Initiative (WHI).

The WHI study looks at calcium and vitamin D supplementation. And it stems from an initiative we started 30 years ago at NIH. The original NIH study, however, looked at many aspects of diet, nutrition, and health in various groups of women. Not just calcium and vitamin D data.

But the Task Force only pulled out a small part of the WHI data. And according to their analysis, taking calcium and vitamin D showed little to no effect on preventing bone fractures in more than 35,000 postmenopausal women.

Even if this is true–and women actually don’t need to take calcium and vitamin D to avoid broken bones–that does not equate to telling them to avoid taking healthy levels of these critical nutrients.

That’s like saying we figured out that daily exercise doesn’t help you avoid skin cancer … so we recommend that you avoid exercising!

But, first, is it even true? Does calcium and vitamin D really have little to no effect on preventing bone fractures?

Probably not.

And here’s why…

It turns out many of the women in the calcium group did not actually follow their calcium regimen. That is, they didn’t take their calcium regularly. And, women in the placebo group got close to the recommended levels of calcium, on their own, without taking a supplement.

So, both groups ended up with the same or similar calcium intake. Therefore, when the Task Force found no added benefit to women who took supplements, I’m not surprised.

This represents a major trend in diet research that I warned about before in my Insiders’ Cures newsletter.

You see, most women are already concerned about getting enough calcium and vitamin D for bones. Not to mention the other health benefits of calcium and vitamin D. As a result, most women already do what they can, on their own, to increase their levels.

Plus, the researchers who actually run the WHI study reanalyzed the data. They looked specifically at only those women who strictly followed the calcium protocol. Those results showed a highly significant 38 percent reduction in hip fractures. And no increased incidence of kidney stone development.

So, if everyone essentially gets the same amounts of calcium–either as a supplement or by other means–how can you do a comparison study? You are comparing red apples to green apples.

And–should you deprive women of calcium just to help prove the latest half-baked dietary “advice” by the government?

There is already a great deal of data that supports the need for adequate calcium and vitamin D. It does help prevent factures, plus there are many other health benefits. Therefore, studies that require some of the participants to become malnourished are ethically problematic.

And, of course, the researchers simply pulled out one endpoint–broken bones. This reductionist approach ignores all the other health consequences that correlate to low calcium and vitamin D intake. For example, what about the low vitamin D-Multiple Sclerosis link, as I reported on a few weeks ago?

I do agree with part of what the Task Force recommends: You should strive to get some calcium from foods in your diet.

It makes sense that some calcium should come from your diet. But your body needs large amounts of calcium. And you need more than what you can reasonably get in a dietary supplement.

But getting enough calcium into your diet is difficult. Though not quite as difficult as figuring out the confusing government guidelines and “expert” recommendations on the topic.

As a mineral, calcium is not available in many food sources. Muscles require a lot of it for every day functioning–so that means meat and fish are higher in calcium than other food sources.

You find the most concentrated source of calcium in bones and cartilage. So that is why smaller fish, especially with the bones in, such as sardines and anchovies are such good sources.

If you’re a vegetarian, getting enough calcium can be a real challenge. In the wild, many herbivores–such as deer–resort to eating bones in order to get enough calcium in the diet.

In the end, the Task Force’s recommendation is based on sloppy science. It represents another instance where research fails to account for compliance with the study protocol.

This same problem caused confusion over antioxidants and heart disease a few years ago. That time, researchers found that antioxidants caused increases in heart disease rates. But when researchers eliminated the non-compliant participants from the data analysis, antioxidants actually showed a 25 percent reduction in heart disease rates.

The Task Force says it considered many studies, but mainly looked at the old Women’s Health Initiative.

And that’s not good enough.

A Task Force worthy of its name should look beyond the confines of a single scientific study to make its recommendations. They should consider the realities of modern dietary patterns.

And we know for a fact that only 5 percent of Americans get all the nutrients they need from diet. For example, an elderly person who does not sit in the afternoon sun for 15 minutes a day, or live in the northern two-thirds of the country, should clearly take vitamin D as a supplement.

I happened to catch Dr. Nancy Snyderman, chief medical officer on the NBC Nightly News, weighing in on this study a few weeks ago. And what did she have to say about the Task Force’s report to get calcium just from foods?

She said: “You could file this story under “F” for foods.”

But I say, don’t file this new report under F. Just give it an F.

Dr. Snyderman said the results vouch for getting your nutrients from foods and not supplements. “Better you get your calcium and vitamin D through real food and dairy. Eat your food, forget the pills.”

Easier said than done, Dr. Snyderman.

1. http://www.uspreventiveservicestaskforce.org/uspstf12/vitamind/finalrecvitd.htm