Abstract
The objective of this study is to examine the effect of milk powder supplementation with different calcium contents on bone mineral density (BMD) in postmenopausal Chinese women, and to determine a more appropriate dose of calcium supplementation. A 2-year, randomized controlled double-blind trial. Postmenopausal women (n = 210) aged 50–65 years were recruited and assigned randomly into three calcium supplementation groups. All participants received milk powder supplementation with different calcium contents (300, 600, and 900 mg per day for groups A, B, and C, respectively) and all groups received 800 IU of vitamin D per day. During the follow-up period, BMD of the left hip and lumbar spine (as the main indicator) was measured using dual-energy X-ray absorptiometry at the baseline, 1 and 2 years. Both three BMD measures and the changes of BMD over 2 years were used to analyze. Before adjusting for covariates, BMD in group A of the lumbar spine and groups A and B of greater trochanter decreased significantly from the baseline over time but increased significantly in the rest groups of the lumbar spine and greater trochanter and in three groups of Ward’s triangle. There were significant differences across the three groups for changes of BMD in the greater trochanter and Ward’s triangle. When adjusting for covariates, there were significant decreases with time in group A of the spine (P = 0.001), groups A and B of greater trochanter (P = 0.0002 and P = 0.04, respectively) and increases in groups B and C of Ward’s triangle (P = 0.03 and P = 0.004, respectively). BMD change in the greater trochanter was significantly different among three groups. For healthy postmenopausal women, high calcium milk powder supplementation was better in retarding bone loss than medium and low calcium in the greater trochanter. Considering the dietary calcium intake of postmenopausal women in north of China, a dose of 900 mg/day is considered as the most appropriate calcium supplementation for greater trochanter but not for other sites.
Similar content being viewed by others
References
Ho SC, Chen YM, Woo JL, Lam SS (2004) High habitual calcium intake attenuates bone loss in early postmenopausal Chinese women: an 18-month follow-up study. J Clin Endocrinol Metab 89(5):2166–2170. doi:10.1210/jc.2003-031338
Nordin BE (2009) The effect of calcium supplementation on bone loss in 32 controlled trials in postmenopausal women. Osteoporos Int 20(12):2135–2143. doi:10.1007/s00198-009-0926-x
Shea B, Wells G, Cranney A, Zytaruk N, Robinson V et al (2006) WITHDRAWN: calcium supplementation on bone loss in postmenopausal women. Cochrane Database Syst Rev 1:CD004526. doi:10.1002/14651858.CD004526.pub3
Cooper L, Clifton-Bligh PB, Nery ML, Figtree G, Twigg S et al (2003) Vitamin D supplementation and bone mineral density in early postmenopausal women. Am J Clin Nutr 77(5):1324–1329
Storm D, Eslin R, Porter ES, Musgrave K, Vereault D et al (1998) Calcium supplementation prevents seasonal bone loss and changes in biochemical markers of bone turnover in elderly New England women: a randomized placebo-controlled trial. J Clin Endocrinol Metab 83(11):3817–3825. doi:10.1210/jcem.83.11.5289
Lau E, Woo J, Lam V, Hong A (2001) Milk supplementation of the diet of postmenopausal Chinese women on a low calcium intake retards bone loss. J Bone Miner Res 16(9):1704–1709
Chee W, Suriah A, Chan S, Zaitun Y, Chan Y (2003) The effect of milk supplementation on bone mineral density in postmenopausal Chinese women in Malaysia. Osteoporos Int 14(10):828–834
Jackson RD, LaCroix AZ, Gass M, Wallace RB, Robbins J et al (2006) Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med 354(7):669–683. doi:10.1056/NEJMoa055218
Spangler M, Phillips BB, Ross MB, Moores KG (2011) Calcium supplementation in postmenopausal women to reduce the risk of osteoporotic fractures. Am J Health Syst Pharm 68(4):309–318
Tang BM, Eslick GD, Nowson C, Smith C, Bensoussan A (2007) Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet 370(9588):657–666. doi:10.1016/S0140-6736(07)61342-7
Prince RL, Devine A, Dhaliwal SS, Dick IM (2006) Effects of calcium supplementation on clinical fracture and bone structure: results of a 5-year, double-blind, placebo-controlled trial in elderly women. Arch Intern Med 166(8):869–875. doi:10.1001/archinte.166.8.869
Spangler M, Phillips BB, Ross MB, Moores KG (2011) Calcium supplementation in postmenopausal women to reduce the risk of osteoporotic fractures. Am J Health Syst Pharm 68(4):309–318. doi:10.2146/ajhp070175
Li S, Na L, Li Y, Gong L, Yuan F et al (2013) Long-term calcium supplementation may have adverse effects on serum cholesterol and carotid intima-media thickness in postmenopausal women: a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr 98(5):1353–1359. doi:10.3945/ajcn.113.062844
Zittermann A, Pilz S, Borgermann J, Gummert JF (2011) Calcium supplementation and vitamin D: a trigger for adverse cardiovascular events? Future Cardiol 7(6):725–727. doi:10.2217/fca.11.65
Bolland MJ, Barber PA, Doughty RN, Mason B, Horne A et al (2008) Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial. BMJ 336(7638):262–266. doi:10.1136/bmj.39440.525752.BE
Pentti K, Tuppurainen MT, Honkanen R, Sandini L, Kroger H et al (2009) Use of calcium supplements and the risk of coronary heart disease in 52-62-year-old women: the Kuopio Osteoporosis Risk Factor and Prevention Study. Maturitas 63(1):73–78. doi:10.1016/j.maturitas.2009.03.006
Bolland MJ, Grey A, Avenell A, Gamble GD, Reid IR (2011) Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women’s Health Initiative limited access dataset and meta-analysis. BMJ 342:d2040. doi:10.1136/bmj.d2040
Bolland MJ, Avenell A, Baron JA, Grey A, MacLennan GS et al (2010) Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 341:c3691. doi:10.1136/bmj.c3691
Prince R, Devine A, Dick I, Criddle A, Kerr D et al (1995) The effects of calcium supplementation (milk powder or tablets) and exercise on bone density in postmenopausal women. J Bone Miner Res 10(7):1068–1075. doi:10.1002/jbmr.5650100711
Reid IR, Mason B, Horne A, Ames R, Reid HE et al (2006) Randomized controlled trial of calcium in healthy older women. Am J Med 119(9):777–785. doi:10.1016/j.amjmed.2006.02.038
Acknowledgments
This work was supported by the National Natural Science Foundation of China [81273183].
Author information
Authors and Affiliations
Corresponding authors
Ethics declarations
Conflict of Interest
Yongjie Chen, Yaming Xiao, Biao Xie, Qiao Zhang, Xianfu Ma, Ning Li, Meina Liu, and Qiuju Zhang declare that they have no conflict of interest.
Ethical approval
All procedures performed in study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Additional information
Meina Liu and Qiuju Zhang have contributed equally to this work.
Rights and permissions
About this article
Cite this article
Chen, Y., Xiao, Y., Xie, B. et al. Effect of Milk Powder Supplementation with Different Calcium Contents on Bone Mineral Density of Postmenopausal Women in Northern China: A Randomized Controlled Double-Blind Trial. Calcif Tissue Int 98, 60–66 (2016). https://doi.org/10.1007/s00223-015-0065-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00223-015-0065-7