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Key points

• The recommended daily intake of calcium as recommended by Healthy Bones Australia (formerly Osteoporosis Australia) is 1300mg daily for women over the age of 50 and men over the age of 70, and 1000mg daily for other adults. Ideally most of this should be from dietary sources
• Calcium supplements result in a marginal reduction in fracture risk, with evidence considered weak and inconsistent
• The routine use of calcium supplements is not recommended
• Whether calcium supplements lead to an increased risk of cardiovascular disease is unclear; if dietary calcium is inadequate then calcium supplements containing 500-600mg daily can be used
• Calcium citrate is the preferred supplement with co-existent proton pump inhibitor or H2 antagonist use

Background

Osteoporotic fractures are a common problem worldwide and are associated with increased morbidity and mortality. Calcium is a major component of the skeleton and traditionally calcium supplements have been considered an integral part of osteoporosis management. Furthermore, most studies of osteoporosis therapies have been performed with the use of concurrent calcium supplements. In recent years, the role of calcium supplements has been controversial, particularly whether they lead to an increased risk of cardiovascular disease.