Calcium builds and maintains healthy bones and vitamin D assists with absorption and increased uptake.

Alarmingly, 90 percent of women in the US are deficient in calcium and 50 to 90 percent are deficient in vitamin D. These numbers are even higher among minorities, including Hispanics and African-Americans. Even among children, 30 to 40 percent are already deficient in calcium and vitamin D. Furthermore, about 50 percent of women and 20 percent of men aged 50 and older will have a fracture as a result of osteoporosis.

Clinicians and patients have become concerned about the possible, but unproven links between calcium supplements and heart attacks. In an editorial published in the recent issue of the Journal of Cardiovascular Pharmacology and Therapeutics, E. Joan Barice, affiliate associate professor, and Charles H. Hennekens, first Sir Richard Doll professor and senior academic advisor to the dean in the Charles E. Schmidt College of Medicine at Florida Atlantic University, provide reassurances to clinicians and their patients about calcium and vitamin D supplements and cardiovascular disease.

The authors emphasize that the benefits of calcium and vitamin D supplements on bone health are conclusive, and that the totality of evidence is reassuring on cardiovascular disease. The totality of evidence includes all sources of information whether basic or clinical research, especially studies designed to test the question. Previous concerns were based largely on over-interpretation of results from studies not designed to test the question as well as overreliance on a few sub-groups of individual studies rather than looking at the totality of evidence.

To decrease disability and death from osteoporosis, many guidelines recommend daily intakes of 1,200 mg of calcium and 600 IU (international units) of vitamin D.

Hennekens and Barice conclude that it would be unfortunate if clinicians failed to prescribe the combination of calcium and vitamin D supplements as adjuncts to therapeutic lifestyles changes of proven benefit, especially regular physical activity, to the very large number of patients in whom the benefit-to-risk ratio in clearly favorable.

“While drugs to prevent and treat osteoporosis serve as bricks in strengthening bones and preventing bone loss, calcium and vitamin D serve as mortar,” said Hennekens. “Without adequate intake of this combination, as recommended by most guidelines, we can neither achieve nor maintain healthy bone structure.”

Barice has been a national leader in women’s health as well as addiction medicine. She established the Florida Society of Addiction Medicine and achieved designation of the specialty by the Florida Medical Association and subsequent recognition by the American Medical Association. Her numerous other accomplishments benefiting public health include chronic pain management and the appropriate use of alternative and complementary medicines.