Calcium and vitamin D supplementation through fortified dairy products counterbalances seasonal variations of bone metabolism indices: the Postmenopausal Health Study
- 433 Downloads
To assess the effectiveness of a dietary intervention combined with fortified dairy products on bone metabolism and bone mass indices in postmenopausal women.
Forty postmenopausal women (55–65 years old) were equally randomized into a dietary group (DG), receiving daily and for 30 months, 1,200 mg of calcium and 7.5 μg of vitamin D3 for the first 12 months that increased to 22.5 μg for the remaining 18 months of intervention through fortified dairy products; and a control group (CG). Differences in the changes of bone metabolism and bone mass indices were examined with repeated measures ANOVA.
A significant increase was observed for PTH levels only in the CG during the first six winter months of intervention (p = 0.049). After 30 months of intervention, during winter, serum 25(OH)D significantly decreased in the CG while remained in the same high levels as in the summer period in the DG. Serum RANKL levels decreased significantly in the DG compared with the increase in the CG during the 30-month intervention period (p = 0.005). Serum CTx decreased significantly in the DG after six (−0.08; −0.12 to −0.03) and 12 (−0.03; −0.08 to −0.02) months of intervention. Finally, the DG had more favorable changes in total body BMD than the CG (p < 0.001).
Increasing dietary intake of calcium and vitamin D in osteopenic postmenopausal women appears to be effective in producing favorable changes in several bone metabolism and bone mass indices and in counterbalancing seasonal variations in hormonal and biochemical molecules.
KeywordsCalcium and vitamin D RANKL Bone metabolism Postmenopausal women Physiology
The present study was supported with a research grant by Friesland Foods Hellas. The authors would like to thank Eva Grammatikaki, Ioanna Katsaroli, and Paraskevi Kannelou, dietitians, as well as Sofia Tanagra, technician, for their valuable contribution in data collection and processing.
Conflict of interest
YM also works as a science and nutrition consultant for FrieslandCampina Hellas. The study sponsor had no role in the study design; the collection, analysis, or interpretation of the data; the writing of the manuscript; the submission and revision of the paper. None of the other authors had any potential conflict of interest.
- 2.Bonde M, Qvist P, Fledelius C, Riis BJ, Christiansen C (1994) Immunoassay for quantifying type I collagen degradation products in urine evaluated. Clin Chem 40(11 Pt 1):2022–2025Google Scholar
- 6.Hodgson SF, Watts NB, Bilezikian JP, Clarke BL, Gray TK, Harris DW, Johnston CC Jr, Kleerekoper M, Lindsay R, Luckey MM, McClung MR, Petak SM, Recker RR, Anderson RJ, Bergman DA, Bloomgarden ZT, Dickey RA, Palumbo PJ, Peters AL, Rettinger HI, Rodbard HW, Rubenstein HA (2003) American association of clinical endocrinologists medical guidelines for clinical practice for the prevention and treatment of postmenopausal osteoporosis: 2001 edition, with selected updates for 2003. Endocr Pract 9(6):544–564Google Scholar
- 7.Nieves JW (2005) Osteoporosis: the role of micronutrients. Am J Clin Nutr 81(5):1232S–1239SGoogle Scholar
- 12.Vieth R, Chan PC, MacFarlane GD (2001) Efficacy and safety of vitamin D3 intake exceeding the lowest observed adverse effect level. Am J Clin Nutr 73(2):288–294Google Scholar
- 13.Storm D, Eslin R, Porter ES, Musgrave K, Vereault D, Patton C, Kessenich C, Mohan S, Chen T, Holick MF, Rosen CJ (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):3817–3825CrossRefGoogle Scholar
- 15.Manios Y, Moschonis G, Trovas G, Lyritis GP (2007) Changes in biochemical indexes of bone metabolism and bone mineral density after a 12-mo dietary intervention program: the postmenopausal health study. Am J Clin Nutr 86(3):781–789Google Scholar
- 16.University of Crete (1991) Food composition tables. Nutrition.Med.Uoc.Gr/greektablesGoogle Scholar
- 17.Trichopoulou A (2004) Composition tables of foods and Greek dishes. School of medicine: department of hygiene and epidemiology, GreeceGoogle Scholar
- 18.Groothausen J, Siemer H, Kemper HCG, Twisk J, Welten DC (1997) Influence of peak strain on lumbar bone mineral density: an analysis of 15-year physical activity in young males and females. Pediatr Exerc Sci 9(2):159–173Google Scholar
- 19.Institute of Medicine Food and Nutrition Board (2001) Dietary reference intakes: applications in dietary assessment. National Academy Press, DCGoogle Scholar
- 20.Calvo MS, Whiting SJ, Barton CN (2005) Vitamin D intake: a global perspective of current status. J Nutr 135(2):310–316Google Scholar
- 21.Souberbielle JC, Body JJ, Lappe JM, Plebani M, Shoenfeld Y, Wang TJ, Bischoff-Ferrari HA, Cavalier E, Ebeling PR, Fardellone P, Gandini S, Gruson D, Guerin AP, Heickendorff L, Hollis BW, Ish-Shalom S, Jean G, von Landenberg P, Largura A, Olsson T, Pierrot-Deseilligny C, Pilz S, Tincani A, Valcour A, Zittermann A (2010) Vitamin D and musculoskeletal health, cardiovascular disease, autoimmunity and cancer: recommendations for clinical practice. Autoimmun Rev 9(11):709–715CrossRefGoogle Scholar
- 23.Schurch MA, Rizzoli R, Slosman D, Vadas L, Vergnaud P, Bonjour JP (1998) Protein supplements increase serum insulin-like growth factor-I levels and attenuate proximal femur bone loss in patients with recent hip fracture. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 128(10):801–809Google Scholar
- 24.Heaney RP, Davies KM, Chen TC, Holick MF, Barger-Lux MJ (2003) Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr 77(1):204–210Google Scholar
- 25.Aloia JF, Patel M, Dimaano R, Li-Ng M, Talwar SA, Mikhail M, Pollack S, Yeh JK (2008) Vitamin d intake to attain a desired serum 25-hydroxy vitamin D concentration. Am J Clin Nutr 87(6):1952–1958Google Scholar
- 26.Hamdy NA (2007) Targeting the rank/rankl/opg signaling pathway: a novel approach in the management of osteoporosis. Curr Opin Investig Drugs 8(4):299–303Google Scholar
- 28.Marini H, Minutoli L, Polito F, Bitto A, Altavilla D, Atteritano M, Gaudio A, Mazzaferro S, Frisina A, Frisina N, Lubrano C, Bonaiuto M, D’Anna R, Cannata ML, Corrado F, Cancellieri F, Faraci M, Marini R, Adamo EB, Wilson S, Squadrito F (2008) Opg and srankl serum concentrations in osteopenic, postmenopausal women after 2-year genistein administration. J Bone Miner Res 23(5):715–720. doi:10.1359/jbmr.080201 CrossRefGoogle Scholar
- 30.Hunter D, Major P, Arden N, Swaminathan R, Andrew T, MacGregor AJ, Keen R, Snieder H, Spector TD (2000) A randomized controlled trial of vitamin d supplementation on preventing postmenopausal bone loss and modifying bone metabolism using identical twin pairs. J Bone Miner Res 15(11):2276–2283CrossRefGoogle Scholar
- 34.Bergman GJ, Fan T, McFetridge JT, Sen SS (2010) Efficacy of vitamin d3 supplementation in preventing fractures in elderly women: a meta-analysis. Curr Med Res Opin 26(5):1193–1201Google Scholar
- 36.Wang L, Manson JE, Song Y, Sesso HD (2010) Systematic review: vitamin d and calcium supplementation in prevention of cardiovascular events. Ann Intern Med 152(5):315–323Google Scholar