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, Gabriel Sanfélix‐Gimeno Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC)Spain Division of Pharmacoepidemiology and PharmacoeconomicsBrigham and Women's Hospital and Harvard Medical SchoolBostonMAUSA Department of EpidemiologyHarvard School of Public HealthBostonMAUSA Center for Public Health Research (CSISP)Fundación para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO)ValenciaSpain Search for other works by this author on: Oxford Academic José Sanfélix‐Genovés Fundación de Investigación del Hospital Clínico Universitario‐Instituto de Investigación Sanitaria INCLIVAValenciaSpain Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC)Spain Center for Public Health Research (CSISP)Fundación para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO)ValenciaSpain Search for other works by this author on: Oxford Academic Clara L Rodriguez‐Bernal Ciber en Epidemiología y Salud Pública (CIBERESP)MadridSpain Center for Public Health Research (CSISP)Fundación para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO)ValenciaSpain Search for other works by this author on: Oxford Academic Salvador Peiró Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC)Spain Center for Public Health Research (CSISP)Fundación para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO)ValenciaSpain Search for other works by this author on: Oxford Academic Isabel Hurtado Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC)Spain Center for Public Health Research (CSISP)Fundación para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO)ValenciaSpain Search for other works by this author on: Oxford Academic
Journal of Bone and Mineral Research, Volume 28, Issue 11, 1 November 2013, Pages 2286–2294, https://doi.org/10.1002/jbmr.1977
Published:
09 May 2013
Article history
Received:
21 January 2013
Revision received:
16 April 2013
Accepted:
26 April 2013
Published:
09 May 2013
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Gabriel Sanfélix‐Gimeno, José Sanfélix‐Genovés, Clara L Rodriguez‐Bernal, Salvador Peiró, Isabel Hurtado, Prevalence, determinants, and inappropriateness of calcium supplementation among men and women in a Spanish Mediterranean area: Cross‐sectional data from the ESOSVAL cohort, Journal of Bone and Mineral Research, Volume 28, Issue 11, 1 November 2013, Pages 2286–2294, https://doi.org/10.1002/jbmr.1977
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ABSTRACT
Recently, safety concerns about calcium supplementation have arisen. In this situation, ensuring appropriateness of use is highly important. We aimed to describe the use of calcium and vitamin D supplements, the factors related to it, and to assess the appropriateness of calcium prescription among men and women aged 50 years or older. We performed a cross‐sectional study in 2009–2010 including 11,035 adults who belong to the ESOSVAL cohort and attend 272 primary healthcare centers in the Valencia region of Spain. Criteria for the inappropriateness of calcium prescription, based on guidelines and recent evidence, were: excessive or insufficient daily total intake (diet plus supplements), excessive single doses of supplements, excessive or insufficient association with vitamin D, and overall inappropriateness. Calcium and/or vitamin D were prescribed to about 17% of the population. Older age, antiosteoporotic treatment, use of glucocorticoids, and a diagnosis of osteoporosis were related to prescription. The presence of other secondary causes of osteoporosis determined supplementation only in men. Calcium dietary intake was not related to the prescription of supplements. Among calcium users, 85.8% met at least one criterion of inappropriate prescription; 29% had an inappropriate daily total intake mainly resulting from excessive consumption (>2000 mg/day); 53.8% of patients were given calcium supplements in quantities higher than 500 mg per dose; and 38.9% of individuals receiving calcium supplements had inappropriate (absent or below 800 UI/day) vitamin D supplementation (all of them at high risk). In conclusion, we found high inappropriateness of calcium supplementation, mainly because of calcium overdosing, and also to undertreatment and underdosing of vitamin D in high‐risk patients. Physicians should be encouraged to assess calcium dietary intakes before supplementation, recommending intake from food whenever possible, and to prescribe low calcium doses and high vitamin D doses when given in fixed‐dose combinations, or vitamin D alone when calcium is not necessary. © 2013 American Society for Bone and Mineral Research
CALCIUM, VITAMIN D, OSTEOPOROTIC FRACTURE, OSTEOPOROSIS, INAPPROPRIATENESS
© 2013 American Society for Bone and Mineral Research
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)
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