Use of calcium or calcuim in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis

Background:  Whether calcium supplementation can reduce osteoporotic fractures is uncertain. We did a meta-analysis to include all the randomised trials in which calcium, or calcium in combination with vitamin D, was used to prevent fracture and osteoporotic bone loss.

Methods:  We identified 29 randomised trials (n=63 897) using electronic databases, supplemented by a hand-search of reference lists, review articles, and conference abstracts. All randomised trials that recruited people aged 50 years or older were eligible. The main outcomes were fractures of all types and percentage change of bone-mineral density from baseline. Data were pooled by use of a random-effect model.

Findings:  In trials that reported fracture as an outcome (17 trials, n=52 625), treatment was associated with a 12% risk reduction in fractures of all types (risk ratio 0·88, 95% CI 0·83–0·95; p=0·0004). In trials that reported bone-mineral density as an outcome (23 trials, n=41 419), the treatment was associated with a reduced rate of bone loss of 0·54% (0·35–0·73; p<0·0001) at the hip and 1·19% (0·76–1·61%; p<0·0001) in the spine. The fracture risk reduction was significantly greater (24%) in trials in which the compliance rate was high (p<0·0001). The treatment effect was better with calcium doses of 1200 mg or more than with doses less than 1200 mg (0·80 vs 0·94; p=0·006), and with vitamin D doses of 800 IU or more than with doses less than 800 IU (0·84 vs 0·87; p=0·03).

Interpretation:  Evidence supports the use of calcium, or calcium in combination with vitamin D supplementation, in the preventive treatment of osteoporosis in people aged 50 years or older. For best therapeutic effect, we recommend minimum doses of 1200 mg of calcium, and 800 IU of vitamin D (for combined calcium plus vitamin D supplementation).

Is a healthy diet affordable and accessible in the city of Yarra, Victoria Australia? An analysis of cost disparity and nutritional choices

This study aimed to examine cost disparity and nutritional choices within the
City of Yarra (Yarra), targeting three suburbs that have low- and high-rise
estates: Richmond, Fitzroy, and Collingwood. The healthy food basket
(HFB) was modeled on the Queensland Healthy Food Access Basket for a
six-person family for a fortnight and was constructed to include food items
that are common to ethnic groups living in Yarra. The HFB food item costs
were sampled across 29 food outlets in Yarra. The average cost of HFB per fortnight
for a family of six was significantly lower in Richmond (Mean = $419.26)
than in Collingwood (Mean = $519.28) and in Fitzroy (Mean = $433.98). While
costs for cereal groups, dairy, meats and alternatives, and non-core were
comparable across the suburbs, significant differences were noticed for fruit,
legumes and vegetables. Geographic location alone explained 54% of the
variance in HFB price (F_2,26 = 15.23, p < 0.001) and 32.7% in the variance of
fruit, vegetable and legumes (F_2,26 = 7.72, p < 0.001). The effect of geographic
location remained consistent after controlling for the type of food
outlets. The type of food outlets had a non-significant effect on the variance
of prices. Richmond had a greater number variety of fruit, vegetables, and
legumes (F_{2, 26} = 5.7, p < 0.01) and an overall lower number of missing items
(F_{2, 26} = 3.9, p < 0.05) than Collingwood and Fitzroy. The diversity of food
available in the three suburbs was more likely to reflect the Vietnamese,
Chinese and East-Timorese shopping pattern than the rest of other ethnic

Algae from Ceylon, Friendly Islands and Australia : collected during the years 1852, '53, '54 and '55

Algae specimens mounted on 133 leaves preceded by printed pages with caption title: (1) List of Dr. Harvey's duplicate Ceylon algae ; (2) List of Dr. Harvey's duplicate Friendly Island Algae ; (3) List of Dr. Harvey's duplicate Australian algae.