Abstract

Bischoff-Ferrari et al conclude that “calcium intake was not significantly associated with hip fracture risk in men and women.” And while many issues need to be addressed and many have already been addressed by the authors of the manuscript and the accompanying editorial, some of the following issues need re-emphasis: focusing on the lifelong daily calcium and vitamin D intake as opposed to just intake at the time of enrollment; measuring the bioavailability of calcium from supplements and food; taking into account the effect of calcium supplements and food on bioavailability; realizing that calcium supplements cannot be expected to have any effect on skeletal mass or fracture risk of people who already have an adequate daily intake of calcium; remembering that vitamin D plays an important role in overall bone health; and, finally, avoiding the isolation of calcium from the intake of vitamin D and overall nutritional intake.