The garage door slams behind me as I hear the echo of my own words returning from the dark and empty halls of my house; "Honey, I'm home!"...(home)...(home). During the following moments of silence, the ritual begins, once again, for another evening of bachelorhood as I instinctively negotiate the unseen obstacles and reach for the light.

When you have lived alone as long as I have, you find ways to entertain yourself and pretend that you are not quite so alone. I'm sure others have their own routines. For me, it means immediately targeting the TV remote, partly for the background noise and partly so that I have someone/something to talk to/at. Fortunately, I have not lived alone so long that I think the TV talks back to me... yet.

On this particular night in February, 2006, one of the national news programs is on as I neatly hang my jacket (okay... I actually toss it on the chair) and wander back into the kitchen to ponder my dinner options. I have my head stuck in the ?fridge listening over my shoulder to the anchor-dude talk about one crisis or another as I am sniffing expiration dates for freshness on packages that are trying to scurry to the back of the shelf. As I reach for the "mystery pot" (a leftover remnant from Thanksgiving... 2004) I hear the unmistakable voice of the anchor-dude projecting well above the subtle sound of the throaty growl emanating from the pot:

" Researchers conclude that calcium supplements have no effect on women with osteoporosis."

BANG! "Ouch!" "What!?!"... (what)...(what)

That was my introduction to the news regarding the widely publicized results on the long-term calcium studies published in the New England Journal of Medicine (Vol. 354, pp. 669-683). Last month, in my article Calcium: Another Perspective - Part 1, I suggested a broader view of the study results. When something is being publicized that does not make sense, it never hurts to step back and try "reading between the lines";. Also, I mentioned two dimensions that can influence a health condition: Lifestyle and Environmental dimensions. The topic of calcium supplementation is an excellent example of the effect of modern influences on a health supplement program.

As I stood in front of the TV rubbing the back of my head, I was growing increasingly frustrated listening to the over-simplified statements being delivered to millions of viewers around the country. I was thinking how remarkably irresponsible it is to take a watered-down piece of the study results and present them as being some sort of proof that calcium does not do any good. At the same time, I was thinking what a wonderful example this will be to show how study results can too often be manipulated to suit some other agenda. And I could just feel it in my bones (no pun intended) that there was much more to this story that was not being shared.

A few days later, after having the opportunity to review the study in detail, some issues became apparent. I know there are many others who had very similar reactions, although, perhaps not while grappling with a new life form in their kitchen.

To repeat a point from Calcium:Part 1, there is no such thing as a magic bullet when it comes to preventing, or reversing, osteoporosis. This is not a trivial problem, and I have become just as frustrated in the past when I heard a "professional" suggesting that the solution to prevent this condition is to supplement a diet with calcium. Both perspectives are equally absurd.

As any problem that is considered complex, there are many factors that affect it. And this is the basic complaint I have about the results of the study as they were publicized. There is no indication suggesting the study coordinators have accounted for numerous Lifestyle and Environmental dimension factors.

I am not going to attempt to cover every factor that could be discussed within either dimension. I will only mention a few of the most compelling points. And if you need a review of the definition of the two dimensions, you can find those in Calcium:Part 1.

We know that for several decades, women have been encouraged to consume additional calcium to prevent osteoporosis, yet the rates of occurrence continue to accelerate. And we know this is an issue mostly affecting modern cultures, especially the U.S. population. We also know,from bone density analysis (actually indicated in the study), that women who *consistently* take their calcium supplements *do* show the benefit of healthier bones. So, what other factors are present to either increase the withdrawal of calcium from the body, or reduce the absorption of calcium being taken into the body?

Within the Lifestyle dimension, well-known negative factors are the consumption of soft drinks (especially diet forms), caffeine, alcohol, diet of excess protein and sugar... basically anything that contributes to an acidic effect on the body. This will cause calcium to be drawn from the bones as a buffering agent. Cigarette smoking should also be mentioned since this has a negative impact on osteoclast/osteoblast cells responsible for maintaining healthy bone mass. It is also worth mentioning that soft drinks are high in phosphorous, raising levels in the blood, and since the body needs to maintain equal levels of calcium and phosphorous in the blood, more calcium will be pulled from the bones to make up the deficit.

Also under Lifestyle, we can mention the importance of weight bearing activities in exercise to help reduce the risks of the body throwing off calcium. The body is quite remarkable in its ability to identify when not to put effort into maintaining some part of itself. We see the effects of muscle atrophy for anyone who has ever been in a cast. But did you also know that when you have a cast on your leg or your arm the bone will start losing calcium? The same thing happens to astronauts in space; the body recognizes it does not need to maintain the same levels of bone density for strength when it is not needed in a weightless environment. This mechanism also encourages the body to build or maintain strong bones when regular exercise is applied.

Under the Environmental dimension, one of the most fundamental factors to consider is the water you drink. Even without taking into consideration the concerns for heavy metal impurities, and fluoride, there is much to be concerned about regarding the acidic quality of water. High quality water should be on the alkaline side of the pH scale. But sadly, all those "specialty" waters that come in their plastic bottles are all acidic, as is water produced by the common Reverse Osmosis water filters. And remember, our body will try to buffer an acidic state with calcium.

So, these are just a few mentions of something that has the ability to skew results in a long-term study. I did not see where these types of habits and environmental factors were accounted for in the results as published. And, of course,the anchor-dude on TV failed to mention these deficiencies in the formula. But millions of people were hearing how all those years they have been taking their supplements might have been for naught.

But wait! There's more!

Even though the news media did not pick up on some of the study subtleties, other groups who scrutinized the results did notice something worth mentioning. It turns out that adherence to a supplementation program is crucial. Apparently, only 59% of the 36,000+ women in the study group actually adhered to the supplement program during the seven years of following the women. In this group, the data does, in fact, show a benefit for calcium/vitamin D supplementation, where they showed a 29% lower number of fractures then those on placebo. This means, that calcium and vitamin D supplements did significantly reduce the risk of hip fractures. But you have to take them consistently.

We will save for another time getting into the pros or cons of popular forms of calcium. My main goal here was to broaden your perspective about news items that sometimes just don't sound right. This was one of those times.

It is true that simply popping a pill may not be adequate to prevent or reverse osteoporosis. It is equally true that taking calcium supplements will help if other factors are taken into consideration. Allow yourself to pause and ponder, when your inner voice tells you something does not add up. Sometimes the only way something you hear makes sense is when you step back to gain a new perspective and read between the lines.

Perhaps then, you too will instinctively negotiate some unseen obstacles as you reach for the light.