Abstract
Background
Low vitamin D intake and levels have been associated with increased joint symptoms
in some observational studies but the findings are mixed and evidence from randomized
trials sparse.
Objective
To evaluate the influence of supplemental calcium and vitamin D on joint symptoms
in the Women’s Health Initiative randomized, placebo-controlled, clinical trial.
Design
In post hoc analyses, the results of the Women’s Health Initiative randomized clinical
trial in which 36,282 postmenopausal women were randomized to receive calcium carbonate
(1,000 mg as elemental calcium) with vitamin D-3 (400 IU) daily or placebo were examined
in the 6% subgroup of 1,911 participants, oversampled for minorities, who had serial
joint symptom assessment. Qualitative information on joint pain and joint swelling
was collected by questionnaire before entry and 2 years after randomization. Logistic
regression models were used to compare the occurrence and severity of joint symptoms
across randomization groups.
Results
At baseline, total calcium and vitamin D intakes from diet and supplements were similar
in the two randomization groups. In addition, both joint pain (reported by 73%) and
joint swelling (reported by 34%) were commonly reported and comparable in the supplement
and placebo groups. Two years after randomization, no statistically significant differences
between supplement and placebo groups were seen for joint pain frequency (74.6% compared
with 75.1% [P=0.79] for supplement and placebo groups, respectively) or joint swelling frequency
(34.6% compared with 32.4% [P=0.29], respectively) or in severity scores for either outcome. Subgroup analyses
suggested study participants also using nonprotocol calcium supplements at study entry
may have less joint pain with supplement group randomization (interaction P=0.02).
Conclusions
Joint symptoms are relatively common in postmenopausal women. However, daily supplementation
with 1,000 mg calcium carbonate and 400 IU vitamin D-3 in a randomized, placebo-controlled
clinical trial setting did not reduce the self-reported frequency or severity of joint
symptoms.
Keywords
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Biography
R. T. Chlebowski is a professor of medicine, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA.
Biography
M. Pettinger is a senior statistician, Fred Hutchinson Cancer Research Center, Seattle, WA.
Biography
C. L. Kooperberg is an affiliate professor, Fred Hutchinson Cancer Research Center, Seattle, WA.
Biography
K. C. Johnson is a professor and interim chair, University of Tennessee Health Science Center, Department of Preventive Medicine, Memphis.
Biography
R. Wallace is a professor, University of Iowa College of Public Health, Iowa City.
Biography
C. Womack is an associate professor of medicine, Veterans Affairs Medical Center, Memphis, and University of Tennesee Health Science Center, Memphis.
Biography
L. Carbone is a professor of medicine, Veterans Affairs Medical Center, Memphis, and University of Tennesee Health Science Center, Memphis.
Biography
Y. Mossavar-Rahmani is an associate professor of clinical epidemiology and population health, Albert Einstein College of Medicine, Bronx, NY.
Biography
M. Stefanick is a professor of medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA.
Biography
J. Wactawski-Wende is a professor and associate chair, The State University of New York, Buffalo.
Biography
B. Lu is an assistant professor, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Biography
C. Eaton is a professor of family medicine and epidemiology, Brown University, Providence, RI.
Biography
B. Walitt is an associate professor of medicine, Georgetown University Medical Center, Washington, DC.
Article info
Publication history
Published online: August 19, 2013
Accepted:
June 5,
2013
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, US Department of Health and Human Services, through contracts N01WH22110, 24152, 32100-2, 32105-6, 32108-9, 32111-13, 32115, 32118-32119, 32122, 42107-26, 42129-32, and 44221.
Identification
Copyright
© 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
