The effects of calcium supplementation and exercise on bone density in elderly Chinese women
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
A randomized controlled trial was carried out to determine whether calcium supplementation and load-bearing exercise can increase or maintain bone mass in the elderly. Fifty Chinese women, aged 62–92 years, living in a hostel for the elderly in Hong Kong were randomized to enter one of four treatment groups: (I) calcium supplementation of 800 mg (as calcium lactate gluconate) daily; (II) load-bearing exercise four times a week plus a daily placebo tablet; (III) calcium supplementation daily and load-bearing exercise four times a week; (IV) a placebo tablet daily. The interventions went on for 10 months. The bone mineral density (BMD) was measured at three sites in the hip (femoral neck, Ward's triangle and intertrochanteric area) and the L2–4 level of the spine. The percentage change in BMD in 10 months was used as the main outcome measurement. The parathyroid hormone level and indices of bone metabolism were also measured before and after 10 months of intervention.
The BMD at Ward's triangle and the intertrochanteric area increased significantly in subjects on calcium supplement (p<0.05), but there was no significant change at the spine and femoral neck. Exercise had no effect on bone loss at any site. However, the results of two-way analysis of variance showed a significant joint effect of calcium supplements and exercise at the femoral neck (p<0.05), but not at the other sites. The parathyroid hormone levels fell significantly in subjects on calcium supplements (p<0.01).
Calcium supplement in the form of calcium lactate gluconate was adequately absorbed in elderly Chinese women with a calcium intake of less than 300 mg per day. It was effective in reducing bone loss at the hip, and there may be interaction effects with exercise in maintaining bone density.
- Kanis JA, Passmore R. Calcium supplementation of the diet: not justified by present evidence (I). Br Med J 1989;298:137–40.
- Kanis JA, Passmore R. Calcium supplementation of the diet: not justified by present evidence (II). Br Med J 1989;298:205–8.
- Nordin BEC, Heaney RP. Calcium supplementation of the diet: justified by present evidence. Br Med J 1990;300:1056–60.
- Dawson-Hughes B, Dallal GE, Krall EA, Sadowski L, Sahyoun N, Tannenbaum S. A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women. N Engl J Med 1990;323:878–84.
- Recker RR, Saville PD, Heaney RP. Effect of estrogens and calcium carbonate on bone loss in postmenopausal women. Ann Intern Med 1977;87:649–55.
- Horsman A, Gallagher JC, Simpson M, Nordin BE. Prospective trial of oestrogen and calcium in postmenopausal women. Br Med J 1977;2:789–92.
- Smith EL, Gilligan C, Smith PE, Sempos CT. Calcium supplementation and bone loss in middle-aged women. Am J Clin Nutr 1989;50:833–42.
- Polley KJ, Nordin BE, Baghurst PA, Walker CJ, Chatterton BE. Effect of calcium supplementation on forearm bone mineral content in postmenopausal women: a prospective, sequential controlled trial. J Nutr 1987;117:1929–35.
- Riis B, Thomsen K, Christiansen C. Does Calcium supplementation prevent postmenopausal bone loss? A double-blind, controlled clinical study. N Engl J Med 1987;316:173–7.
- Nilas L, Christiansen C, Rødbro P. Calcium supplementation and postmenopausal bone loss. Br Med J 1984;289:1103–6.
- Ettinger B, Genant HK, Cann Ce. Postmenopausal bone loss is prevented by treatment with low-dosage estrogen with calcium. Ann Intern Med 1987;106:40–5.
- Beverly MC, Rider TA, Evans MJ, Smith R. Local bone mineral response to brief exercise that stresses the skeleton. Br Med J 1989;299:233–5.
- Simkin A, Ayalon J, Leichter I. Increased trabecular bone density due to bone-loading exercises in postmenopausal osteoporotic women. Calcif Tissue Int 1987;40:59–63.
- Smith EL, Smith PE, Ensign CJ, Shea MM. Bone involution decrease in exercising middle-aged women. Calcif Tissue Int 1984;36:129–38.
- Chow R, Harrison JE, Notarius C. Effect of two randomised exercise programmes on bone mass of healthy postmenopausal women. Br Med J 1987;295:1441–4.
- Lau EMC, Cooper C, Barker DJP, Donnan SPB. Incidence and risk factors for hip fracture in Hong Kong Chinese. In: Christiansen C, Overgaard K, editors. Proceedings of the Third International Symposium on Osteoporosis, vol 1. Copenhagen, Denmark: Department of Clinical Chemistry, Glostrup Hospital, 1990:66–70.
- Pun KK, Chung V. The problem of calcium deficiency in Hong Kong. Hong Kong Practitioner 1989;11:287–94.
- Lau EMC, Donnan SPB, Barker DJP, Cooper C. Physical activity and calcium intake in fracture of the proximal femur in Hong Kong. Br Med J 1988;297:1441–3.
- Woo J, Swaminathan R, Lau E, MacDonald D, Pang CP, Nordin BEC. Biochemical effects of a single oral dose of calcium on bone metabolism in elderly Chinese women. Calcif Tissue Int 1991;48:157–60.
- Hodkinson HM. Evaluation of a mental test score for assessment of mental impairment in the elderly. Age Ageing 1972;1:233–8.
- Food and Agriculture Organization. Food composition table for use in East Asia. Rome: FAO, 1972.
- Marshall DH, Nordin BEC. A comparison of radioactive calcium absorption tests with net calcium absorption. Clin Sci 1981;61:477–81.
- Payne RB, Little AJ, Williams RB, Milner JR. Interpretation of serum calcium in patients with abnormal serum proteins. Br Med J 1973;4:643–6.
- Lanyi E. The first experience using the Norland XR-26 system in Hungary. In: Christiansen C, Overgaard, K editors. Proceedings of the Third International Symposium on Osteoporosis, vol 2. Copenhagen, Denmark: Department of Clinical Chemistry, Glostrup Hospital, 1990:678–81.
- Matkovic V, Kostial K, Simonovic I, Buzina R, Brodarec A, Nordin BE. Bone status and fracture rates in two regions of Yugoslavia. Am J Clin Nutr 1979;32:5240–9.
- Holbrook TL, Barrett-Connor E, Wingard DL. Dietary calcium and risk of hip fracture: 14-year prospective population study. Lancet 1988;2:1046–9.
- Cooper C, Barker DJP, Wickham C. Physical activity, muscle strength, and calcium intake in fracture of the proximal femur in Britain. Br Med J 1988;297:1443–6.
- Riggs BL, Wahner HW, Melton LJ III, Richelson LS, Judd HL, O'Fallon WM. Dietary calcium intake and rates of bone loss in women. J Clin Invest 1987;80:979–82.
- Anderson JJB, Tylavsky FA. Diet and osteopenia in elderly Caucasian women. In: Christiansen C, Arnaud CD, Nordin BEC, Parfitt AM, Peck WA, Riggs BL, editors. Proceedings of the Copenhagen International Symposium on Osteoporosis, vol 1. Copenhagen, Denmark: Department of Clinical Chemistry, Glostrup Hospital, 1984:299–304.
- Lanyon LE. Bone remodelling, mechanical stress, and osteoporosis. In: DeLuca MF, Frust FIM, Jee WSS, Johnston CC Jr, Parfitt AM, editors. Osteoporosis: recent advances in pathogenesis and treatment. Baltimore: University Park Press, 1981:129–38.
- Abramson AS, Delagi EF. Influence of weight-bearing and muscle contraction on disease osteoporosis. Arch Phys Med Rehabil 1961;42:147–51.
- The effects of calcium supplementation and exercise on bone density in elderly Chinese women
Volume 2, Issue 4 , pp 168-173
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Bone loss
- Bone mass
- Calcium supplement
- Load-bearing exercise
- Randomized controlled trial
- Industry Sectors
- Author Affiliations
- 1. Department of Community and Family Medicine, the Chinese University of Hong Kong, China
- 3. Department of Medicine, the Chinese University of Hong Kong, China
- 4. Department of Orthopaedics and Traumatology, the Chinese University of Hong Kong, China
- 5. Department of Chemical Pathology, the Chinese University of Hong Kong, China
- 6. Faculty Statistician, the Chinese University of Hong Kong, China