There was no effect of calcium supplements on any fracture outcome in the largest trials at lowest risk of bias. Only one trial in frail elderly women in residential care with low dietary calcium intake and vitamin D concentrations showed significant reductions in fracture risk.
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- The characters are flawed and complex Full article. Both 32 bit and 64 bit versions of Macrium Reflect available to download here., for example Bummi, the immigrant parent who would rather her child did anything but bring home a white partner; and later, an affair that perhaps represents the worst way one woman can betray another.
- From finding family through DNA testing, to wanting to mentor other women of colour, to the possibilities offered by safe spaces – by the novel’s close, Evaristo has illustrated the drive for togetherness.
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There was no evidence of a difference in the results between the subgroups of calcium monotherapy or CaD, or between the subgroups based on residential status and baseline dietary calcium intake for total, vertebral or forearm fracture. Tables 3-5 and tables E-F in appendix 3 summarise the results of these cohort studies⇓ ⇓ ⇓. Thus, 43 of the 58 (74%) reported associations between dietary calcium intake and fracture outcomes were neutral. When relations were reported, they were usually inverse (13/15 associations), with one study describing a positive relation and one study a U shaped relation.
From each study we extracted information on characteristics of participants, study design, funding source and conflicts of interest, and numbers of participants with total, hip, forearm, and vertebral fractures. When data were reported for non-vertebral fracture but not total fracture, we treated non-vertebral fractures as total fractures. A single author extracted data, which were checked by a second author .
These results suggest that widespread untargeted use of calcium supplements in older individuals is unlikely to result in meaningful reductions in incidence of fracture. Table 2⇑ and table C in appendix 3 show the study design and selected characteristics of the 11 cohort studies that reported associations between calcium supplements and fracture outcomes. Most studies reported no association between calcium use and fracture . Of the 20 reported associations, 13 were neutral, five were positive, and two were inverse. Table 6⇓ shows the results of the prespecified subgroup analyses.
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Risk of bias was assessed as recommended in the Cochrane Handbook,12 and we planned a subgroup analysis for each fracture outcome stratified by risk of bias. Design Systematic review of randomised controlled trials and observational studies of calcium intake with fracture as an endpoint. Results from trials were pooled with random effects meta-analyses.
Funnel plots were also asymmetric with more small-moderate sized studies than expected reporting risk reductions in total, vertebral, and forearm fracture with calcium supplements, raising the possibility of publication bias. Results from randomised controlled trials of calcium monotherapy were similar to those with CaD, with no evidence of additional benefit of vitamin D on risk.
Robert De Niro stars in the family movie as an aging dad who reluctantly moves in with his adult daughter Uma Thurman’s family much to the dismay of his grandson who is forced to give up his room. We do this by employing experienced expert reviewers, who thoroughly test everything they recommend, to explain what’s best for most people. In 26 randomised controlled trials, calcium supplements reduced the risk of total fracture by 11% and vertebral fracture by 14% but had no effect on forearm or hip fracture.