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BrMedJ 1990;300:1056-60 In a recent review Kanis and Passmore concluded that there was no case for supplementation of the diet with calcium for the prevention or treatment of osteoporosis.1 We consider that present evidence, taken as a whole, points to a different conclusion. We consider the matter under five main headings: experimental calcium deficiency; human calcium requirements; the relation between calcium intake, bone mass, and bone loss; the relation between calcium and hip fracture; and the role of calcium in established osteoporosis.

One of the remarkable features of the paper by Bolland and colleagues on the risk from calcium supplementation and vitamin D is its failure to draw attention to the hazard ratio of 0.84 in favour of calcium supplements for deaths from all causes in the “any personal …

Guidance on hypertensive disorders of pregnancy from the National Institute for Health and Clinical Excellence (NICE) says that evidence for the preventive effect of calcium supplementation is “conflicting and confusing.”1 A cynic might say that this was a handy conclusion if your department’s future funding depends on …

Bolland and colleagues have followed-up their 2008 paper on calcium supplementation and cardiac risk with a better constructed meta-analysis supporting their original conclusions.1 2 However, by excluding trials of calcium and vitamin D supplements, they have drastically limited the generalisability of their findings. In …

Bolland et al showed an increased risk of vascular events, particularly myocardial infarction, in healthy postmenopausal women receiving calcium supplements.1 2 We recently completed a similar study with a primary skeletal end point.3 4 We queried our database about the principal adverse events reported by Bolland et al. We followed up 1179 women for four years, similar to the …

The article by Bolland et al was reviewed at our public health department’s monthly journal club.1 This raised some issues concerning the outcomes used, the method of allocation of the women, and the presented results. The use of a composite end point (myocardial infarction, stroke, or sudden death) creates difficulties in …

Bolland et al did not control for vitamin D concentrations during their study but said only that the women with serum 25-hydroxyvitamin D concentrations below 25 nmol/l were excluded.1 This implies that serum concentrations of …

Careful selection of patients along with prophylactic calcium supplementation makes outpatient thyroid surgery safe and cost effective, a new study has shown. It was presented in Toronto this week at the annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery Foundation. Thyroidectomy has traditionally required patients to stay in hospital for days, although many surgeons advocate only overnight observation. Mortality from thyroid surgery carries relatively low risk, but caution is required because of the organ's close proximity to other structures, which can …

A series of 103 early postmenopausal women completed a questionnaire about their dietary calcium intake and were then divided into three groups: those with an intake below 550 mg/day, those with an intake between 550 and 1150 mg/day, and those with an intake above 1150 mg/day. Thereafter they were given a daily supplement of 500 mg calcium for two years and had their bone mineral content measured every three months. Any changes found were taken as an estimate of bone calcium balance. All three groups showed a similar fall in bone mineral content over the two years, indicating that a calcium intake of 1000-2000 g daily is ineffective in preventing bone loss in the early menopause.