Skip to main content

A prospective study of the effects of 1-year calcium-fortified soy milk supplementation on dietary calcium intake and bone health in Chinese adolescent girls aged 14 to 16

Osteoporosis International volume 16, pages 1907–1916 (2005)Cite this article

Abstract

The Chinese diet is low in calcium, including among adolescent girls, with an average intake around 500 mg per day. In this study, we compared the percentage change in bone mineral density and content of the spine and hip region in a 1-year follow-up study between 104 adolescent girls aged 14 to 16 years receiving 375 ml calcium-fortified soymilk supplementation and 95 girls in the control group. The mean percentage changes of bone mineral density/content (BMD/BMC) and standard deviation (SD) at 1 year for the supplementation and control groups were as follows: neck of the femur BMD 2.7±2.94%, 1.8±3.49% (P =0.08); trochanter BMD 3.3±3.27%, 1.6±2.94% (P ≤<0.001); intertrochanter BMD 3.6±3.05%, 2.32±2.95% (P =0.002); total hip BMD 3.1±2.39%, 2.05±2.22% (P =0.001); total hip BMC 3.8±3.05%, 2.6±2.96% (P =0.006). The percent difference between the percentage of bone changes in the supplementation and control groups [100× (soymilk-control)/control] ranged from 45 to 113%. We observed no differences in the spine BMD/C and no differences in changes of height and weight between the soymilk supplementation and control groups, which yielded similar results. Stepwise multivariate regression analysis including height, weight, growth stage, dietary energy, protein, calcium from usual diet and physical activity also showed that supplementation was significantly associated with a percentage increase in BMD/C at the hip. We conclude that 375 ml calcium-fortified soymilk supplementation, or an equivalent of about two glasses, is among the effective strategies for bone acquisition and the optimization of peak bone mass in adolescent girls.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1

References

  1. Schwartz AV, Kelsey JL, Maggi S, Tuttleman M, Ho S C, Jonsson PV, Poor G, Sisson de Castro JA, Xu, L, Matkin CC, Nelson LM, Heyse SP (1999) International variation in the incidence of hip fractures: cross-national project on osteoporosis for the World Health Organization Program for research on aging. Osteoporosis Int 9:242–253

    Article  Google Scholar 

  2. Ho SC, Lau EMC, Woo J, Sham A, Chan KM, Lee S, Leung PC (1999) The prevalence of osteoporosis in Hong Kong Chinese female population. Maturitas 32:171–178

    Article  PubMed  Google Scholar 

  3. Ho SC (1997) Attainment of peak bone mass and dietary factors in Chinese women. In: Lau MC, Ho SC, Leung S, Woo J (eds) Osteoporosis in Asia: crossing the frontiers. World Scientific Publishing Co PTE Ltd

  4. Ho SC, Leung PC (1995) Determinants of peak bone mass in Chinese and Caucasian populations. HKMJ 1:38–42

    Google Scholar 

  5. Messina V, Setchell K (1994) The simple soybean and your health. Avery, New York

  6. Messina MJ, Persky V, Setchell KDR, Barnes S (1994) Soy intake and cancer risk: a review of the in vitro and in vivo data. Nutr Cancer 21:113–121

    PubMed  Google Scholar 

  7. Anderson JW, Johnstone BM, Cook-Newell ME (1995) Meta-analysis of the effects of soy protein intake on serum lipids. N Engl J Med 333:276–282

    Article  PubMed  Google Scholar 

  8. Potter SM, Baum JA, Teng H, Stillman RJ, Erdman JW Jr (1998) Soy protein and isoflavones: their effects on blood lipids and bone density in postmenopausal women. Am J Clin Nutr 68:1375S–1379S

    PubMed  Google Scholar 

  9. Alekel DL, Germain AS, Peterson CT, Hanson KB, Stewart JW, Toda T (2000) Isoflavone-rich soy protein isolate attenuates bone loss in the lumbar spine of perimenopausal women. Am J Clin Nutr 72:844–852

    PubMed  Google Scholar 

  10. Ho SC, Chan SG, Yi Q, Wong E (2001) Soy intake and the maintenance of peak bone mass in Hong Kong Chinese Women. J Bone Miner Res 16:1363–1369

    PubMed  Google Scholar 

  11. Ho SC, Woo J, Chen YM, Sham A, Lau J (2003) Soy protein consumption and bone mineral density in early postmenopausal Chinese women. Osteoporos Int 14:835–842

    Article  PubMed  Google Scholar 

  12. Chen YM, Ho SC, Lam SSH, Ho SSS, Woo JLF (2003) Soy isoflavones have a favorable effect on bone loss in Chinese postmenopausal women with lower bone mass: a double-blind randomized-controlled trial. J Clin Endoc Metab 88:4740–4747

    Article  Google Scholar 

  13. Anderson JJ, Chen X, Boass A, Symons M, Kohlmeier M, Renner JB, Garner SC (2002) Soy isoflavones: no effects on bone mineral content and bone mineral density in healthy, menstruating young adult women after one year. J Am Coll Nutr 21:388–393

    PubMed  Google Scholar 

  14. Ho SC, Leung PC, Swaminathan R, Chan C, Chan SG, Lindsay R (1994) Determinants of bone mass in Chinese women aged 21–40. II. Pattern of dietary calcium intake and association with bone mineral density. Osteoporosis Int 4:167–175

    Article  Google Scholar 

  15. Ho SC, Eric Wong, Chan SG, Lau J, Chan C, Leung P.C (1997) Determinants of peak bone mass in Chinese women aged 21–40 years. III. Physical activity and bone mineral density. J Bone Miner Res 12:1262–1271

    PubMed  Google Scholar 

  16. McArdle WD, Katch FI, Katch VI (1981) Exercise physiology. Lea and Febiger, Philadephia, pp 486–493

  17. Bollen AMA (2000) A prospective longitudinal study of urinary excretion of a bone resorption marker in adolescents. Ann Hum Biol 27:199–211

    Article  PubMed  Google Scholar 

  18. Lydeking-Olsen E, Jensen JEB, Setchell KDR, Damhus M, Jensen TH (2002) Isoflavone-rich soymilk prevents bone loss in the lumbar spine of postmenopausal women: a 2-year study. J Nutr 132:581S (abstract)

    Google Scholar 

  19. Petrakis N, Barnes S, King EB, Lowenstain J, Wiencke J, Lee MM, et al (1996). Stimulatory influence of soy protein isolate on breast secretion in pre- and postmenopausal women. Cancer Epidemiol Biomarkers Prev 5:785–794

    PubMed  Google Scholar 

  20. Nagata C, Takatsuka N, Inaba S, Kawakami N, Shimizu H (1998) Effect of soymilk consumption on serum estrogen concentrations in premenopausal Japanese women. J Nat Cancer I 90:1830–1835

    Article  Google Scholar 

  21. Verkasalo PK, Appleby PN, Davey GK, Key TJ (2001) Soy milk intake and plasma sex hormones: a cross-sectional study in pre- and postmenopausal women (EPIC-Oxford). Nutr Cancer 40:79–86

    Article  PubMed  Google Scholar 

  22. Anderson JJB, Miller CP (1998) Lower lifetime estrogen exposure among vegetarians as a possible risk factor for osteoporosis: a hypothesis. Vegetarian Nutr 2:4–12

    Google Scholar 

  23. Arjmandi BH, Getlinger MJ, Goyal NV, Alekel L, Hasler CM, Juma S, Drum ML, Hollis BW, Kukreja SC (1998) Role of soy protein with normal or reduced isoflavone content in reversing bone loss induced by ovarian hormone deficiency in rats. Am J Clin Nutr 68:1358S–63S

    PubMed  Google Scholar 

  24. Anderson JJB, Thomsen K, Christiansen C (1987) High protein meals, insular hormones and urinary calcium excretion in human subjects. In: Christiansen C, Johansen JS, Riis BJ (eds) Osteoporosis. Nørhaven A/S, Viborg, Denmark, pp 240–245

  25. Arjmandi BH, Khalil DA, Smith BJ, Lucas EA, Juma S, Payton ME, Wild RA (2003) Soy protein has a greater effect on bone in postmenopausal women not on hormone replacement therapy, as evidenced by reducing bone resorption and urinary calcium excretion. J Clin Endocrinol Metab 88:1048–1054

    Article  PubMed  Google Scholar 

  26. Boonen S, Lesaffre E, Dequeker J, Aerssens J, Nijs J, Pelemans W, Bouillon R (1996) Relationship between baseline insulin-like growth factor-I (IGF-I) and femoral bone density in women aged over 70 years: potential implications for the prevention of age-related bone loss. J Am Geriatr Soc 44:1301–1306

    PubMed  Google Scholar 

  27. Sugimoto T, Nishiyama K, Kuribayashi F, Chihara K (1997) Serum levels of insulin-like growth factor (IGF) I, IGF-binding protein (IGFBP)-2, and IGFBP-3 in osteoporotic patients with and without spinal fractures. J Bone Miner Res 12:1272–1279

    PubMed  Google Scholar 

  28. Cadogan J, Eastell R, Jones N, Barker ME (1997) Milk intake and bone mineral acquisition in adolescent girls: randomized, controlled intervention trial. BMJ 315:1255–1260

    PubMed  Google Scholar 

  29. China Nutrition Association (2000) Reference dietary intake of nutrients of a Chinese population. Beijing. China Light Industry Press

  30. Kristinsson JO, Valdimarsson O, Steingrimsdottir L, Sigurdsson G (1994). Relation between calcium intake, grip strength and bone mineral density in the forearms of girls aged 13 and 15. J Int Med 236:385–390

    Google Scholar 

  31. Lee WTK, Leung SSF, Leung DMY, Tsang HSY, Lau J, Cheng JCY (1995) A randomized double-blind controlled calcium supplementation trial, and bone and height acquisition in children. Brit J Nutr 74:125–139

    Article  PubMed  Google Scholar 

  32. Lee WTK, Leung SSF, Wang SH, Xu YC, Zang WP, Lau J, Oppenheimer SJ, Cheng JCY (1994) Double-blind, controlled calcium supplementation and bone mineral accretion in children accustomed to a low-calcium diet. Am J Clin Nutr 60:744–750

    PubMed  Google Scholar 

  33. Nowson CA, Green RM, Hopper JL, et al. (1997) A co-twin study of the effect of calcium supplementation on bone density during adolescence. Osteoporos Int 7:219–225

    Article  PubMed  Google Scholar 

  34. Heaney RP (2000) Calcium, dairy products and osteoporosis. J Am Coll Nutr 19:83S–99S

    PubMed  Google Scholar 

  35. Chan GM, Hoffman K, McMurry M (1995) Effects of dairy products on bone and body composition in pubertal girls. J Pediatr 126:551–556

    PubMed  Google Scholar 

  36. Renner E, Hermes M, Stracke H (1998) Bone mineral density of adolescents as affected by calcium intake through milk and milk products. Int Dairy J 8:759–764

    Article  Google Scholar 

  37. Blumsohn A. Hannon RA, Wrate R, Barton J, al-Dehaimi AW, Colwell A, Eastell R (1994). Biochemical markers of bone turnover in girls during puberty. Clin Endocrinol 40:663–670

    Google Scholar 

  38. Lu LJW, Anderson KE (1998) Sex and long-term soy diets affect the metabolism and excretion of soy isoflavones in humans. Am J Clin Nutr [Suppl] 68:1500S–1504S

    Google Scholar 

  39. Anderson JJB (1999). Plant-based diets and bone health: nutritional implications. Am J Clin Nutr [Suppl] 70:539S–5342S

    Google Scholar 

Download references

Acknowledgements

Calcium-fortified soymilk (Calciplus) was supplied by Vitasoy International Holdings (Ltd.).

Author information

Authors and Affiliations

  1. Department of Community and Family Medicine, Centre of Research and Promotion of Women’s Health, School of Public Health, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong SAR

    Suzanne C. Ho, Ruby Yu & Aprille Sham

  2. Food and Nutritional Sciences Program, Department of Biochemistry, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong SAR

    Georgia S. Guldan & Mandy M. Tse

  3. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong SAR

    Jean Woo

  4. Department of Orthopedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin NT, Hong Kong SAR

    Jack Cheng

Authors
  1. Suzanne C. Ho
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Georgia S. Guldan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jean Woo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ruby Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mandy M. Tse
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Aprille Sham
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jack Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Suzanne C. Ho.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Ho, S.C., Guldan, G.S., Woo, J. et al. A prospective study of the effects of 1-year calcium-fortified soy milk supplementation on dietary calcium intake and bone health in Chinese adolescent girls aged 14 to 16. Osteoporos Int 16, 1907–1916 (2005). https://doi.org/10.1007/s00198-005-1963-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-005-1963-8

Keywords

  • Adolescent girls
  • Bone mass
  • Soy milk