Calcium Plus Vitamin D Supplementation and Joint Symptoms in Postmenopausal Women in the Women's Health Initiative Randomized Trial

Rowan T. Chlebowski, Mary Pettinger, Karen C. Johnson, Robert Wallace, Catherine Womack, Yasmin Mossavar-Rahmani, Marcia Stefanick, Jean Wactawski-Wende, Laura D Carbone, Bing Lu, Charles Eaton, Brian Walitt, Charles L. Kooperberg

Research output: Contribution to journalArticle

11 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1302-1310
Number of pages9
JournalJournal of the Academy of Nutrition and Dietetics
Volume113
Issue number10
DOIs
Publication statusPublished - Oct 1 2013
Externally publishedYes

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Keywords

  • Calcium
  • Joint symptoms
  • Vitamin D

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics

Cite this

Chlebowski, R. T., Pettinger, M., Johnson, K. C., Wallace, R., Womack, C., Mossavar-Rahmani, Y., ... Kooperberg, C. L. (2013). Calcium Plus Vitamin D Supplementation and Joint Symptoms in Postmenopausal Women in the Women's Health Initiative Randomized Trial. Journal of the Academy of Nutrition and Dietetics, 113(10), 1302-1310. https://doi.org/10.1016/j.jand.2013.06.007