New Osteoporosis National Action Plan 2016
A new Osteoporosis National Action Plan, the result of a 12 month collaboration among a national alliance of stakeholder groups, launched on 20 October 2016 - World Osteoporosis Day. The plan presents a joint vision to address this major health issue as a matter of urgency.
The Australian and New Zealand Bone and Mineral Society, Osteoporosis Australia and Endocrine Society of Australia collectively reject the suggestion of Mr Pete Evans (reported on 29 August 2016 in the Sydney Morning Herald1, ABC2 and other media outlets) that “calcium from dairy can remove the calcium from your bones" or that calcium obtained from dairy foods can cause or contribute to osteoporosis.
Ensuring sufficient calcium intake is an important component for bone health across the entire lifespan. Dairy foods are an important and inexpensive source of calcium for many individuals, and most Australians obtain the majority of their calcium intake from dairy sources. Dairy foods also represent an important source of protein and calories for many frail older people.
Men and women with osteopaenia or osteoporosis should be reassured and confident that a good dairy intake does not have adverse effects upon skeletal health.
Prof Emma Duncan
A/Prof Warrick Inder
President, Endocrine Society of Australia
Prof Peter Ebeling
Medical Director, Osteoporosis Australia
Australian and New Zealand Bone and Mineral Society releases widely endorsed Position Paper on Secondary Fracture Prevention: A Call to Action.
On 11 May 2015, the Australian and New Zealand Bone and Mineral Society (ANZBMS) launched its pivotal Position Paper on Secondary Fracture Prevention, calling for radical change in how people who have suffered a fragility fracture are being managed.
Osteoporosis Australia and Garvan Institute of Medical Research launched Know Your Bones on Thursday 16 June. An Australian-first bone health self-assessment tool designed to help consumers understand their bone fracture risk, is now available to all adults, including the 7.5 million Australians living with brittle bones.
TheKnow Your Bonesonline tool helps adults assess their likelihood of fractures, including those diagnosed with osteopenia and osteoporosis – two common bone conditions that, together with fractures, will cost the nation more than $3 billion this year.
Further information: http://www.osteoporosis.org.au/experts-launch-know-your-bones
Information about the launch event: http://www.osteoporosis.org.au/minister-ley-attends-launch
26-29 September 2016
Abstract deadline extended to: 8 July 2016
Updated: 10 September 2010
A recent publication by Bolland et al published in the British Medical Journal suggests that calcium supplements may increase the relative risk of ischaemic heart disease by 30%.1
While it is important to investigate possible harm caused by dietary supplements, it is difficult to know how much weight to put on this meta-analysis for several reasons. Firstly, a similar study – i.e. a pooled analysis of several randomized controlled trials where calcium supplements were given, funded by the American Heart Association did not detect any statistically significant increased risk of cardiovascular disease or other negative effects of calcium supplements.2 Secondly, none of the individual randomized trials analysed reported a statistically significant increased risk of ischaemic heart disease. Thirdly, new data from Lewis et al also reported no increase in atherosclerotic vascular disease related events in elderly women receiving calcium supplements (1200mg per day) followed for a total of 9.5 years (5 years on calcium supplements and a further 4.5 years). Importantly, records in this study, but not in most others, were validated through hospital admission data linkage although data for myocardial infarction events were not reported separately3. Fourthly, previous observational studies examining data from very large numbers of people have shown no adverse effect of high calcium intakes. As pointed out by Bolland et al, the effect of high dietary calcium intakes from diet were not studied in their recent meta-analysis.
While these studies were negative, it is important to recognise that methodological issues in the individual trials would have resulted in lack of power to detect a deleterious effect of calcium supplementation if there really was one present. For example, compliance in most, if not all the large trials, was around 50% so that a deleterious effect of calcium might have been missed. In post hoc analysis, the reduction in sample size when only compliers are examined, reduces the power of the study. Furthermore, none of the trials with calcium supplements were designed to investigate vascular events, so that randomization may have produced an uneven distribution of risk factors for cardiovascular disease, which could produce spurious results in either direction. In most of the studies, the subjects were not dietary calcium deficient, so supplements were given to people who already had adequate calcium intakes from dietary sources. In some studies, total calcium intakes were above 2000mg/day.
Given these uncertainties, ANZBMS recommends achieving a total calcium intake of 1000-1300mg, depending on age and sex, where possible through dietary intake of calcium rich foods. Similar recommendations come from the National Health and Medical Research Council. If dietary intake is not feasible and the treating doctor believes calcium supplements are needed for fracture risk reduction, then calcium supplements in doses of 500-600mg can be considered after a discussion of their benefits vs risks.
1. Bolland MJ, Avenell A, Baron JA, Grey A, MacLennan GS, Gamble GD, Reid IR. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 2010; 341:c3691.
2. Wang L, Manson JE, Song Y, Sesso HD. Systematic review: Vitamin D and calcium supplementation in prevention of cardiovascular events. Ann Intern Med. 2010 Mar 2;152(5):315-23.
3. Lewis JR, Calver J, Zhu K, Flicker L, Prince RL. Calcium supplementation and the risks of atherosclerotic vascular disease in older women: results of a 5-year RCT and a 4.5-year follow-up. J Bone Miner Res. 2010 Jul 7. [Epub ahead of print].
Osteoporosis Australia and ANZMBS jointly released consumer fact sheet:
Consumer Fact Sheet on Bisphosphonates and ONJ (38KB)
ANZMBS published a position statement on ONJ and the use of bisphosphonates.
See: Policies & Position Statements > Jaw osteonecrosis with bisphosphonates
The following interview was conducted between Dr Patrick Meaney and Professor Philip Sambrook on behalf of the Australian Dental Association (ADA) for their audio program, Dental Files, and discusses the use of bisphosphonates.
Audio interview for ADA Dental Files on bisphosphonates* (mp3 file, 15 minutes, 8.37MB)
*This interview is provided courtesy of the Australian Dental Association and was orginally produced for the ADA Dental Files audio magazine, August 2008 edition.
NOTE: If you have a slow internet connection, it may be more convenient if you patiently download and save the MP3 file onto your computer first before trying to listen to it. To do so, "right-click" on the audio link above, select "Save Target As..." from the popup menu and choose a place on your computer to save it.
The ABC's current affairs program, 7:30 Report, ran a story on Osteonecrosis of the Jaw (ONJ) and bisphosphonates on 11 Dec 2007. The story contained numerous errors and misleading information prompting ANZBMS President, Prof Philip Sambrook, to respond in a letter to the Executive Producer requesting urgent correction. The 7:30 Report subsequently aired a follow-up interview with Prof Sambrook and Prof Nordin.