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High doses of vitamin C plus E reduce strength training-induced improvements in areal bone mineral density in elderly men



Resistance training is beneficial for maintaining bone mass. We aimed to investigate the skeletal effects of high doses of antioxidants [vitamin C + E (α-tocopherol)] supplementation during 12-week supervised strength training in healthy, elderly men


Design: double-blinded randomized placebo-controlled study. Participants followed a supervised, undulating periodic exercise program with weekly adjusted load: 3 sessions/week and 3–15 repetitions maximum (RM) sets/exercise. The control group (CG, n = 17, 67 ± 5 years) received placebo and the antioxidant group (AO, n = 16, 70 ± 7 years) 1000 mg vitamin C + 235 mg vitamin E, daily. Areal bone mineral density (aBMD) at whole body, lumbar spine (L1–L4), total hip, and femoral neck were measured by dual energy X-ray absorptiometry and muscle strength by 1RM. Serum analyses of bone-related factors and adipokines were performed.


In the CG, total hip aBMD increased by 1.0% (CI: 0.3–1.7) versus pretest and lumbar spine aBMD increased by 0.9% (CI: −0.2 to 2.0) compared to the AO. In the CG, there was an increase in serum concentrations of insulin-like growth factor 1 [+27.3% (CI: −0.3 to 54.9)] and leptin [+31.2% (CI: 9.8–52.6)) versus pretest, and a decrease in sclerostin [−9.9% (CI: 4.4–15.3)] versus pretest and versus AO. Serum bone formation markers P1NP and osteocalcin increased in both groups, while the bone resorption marker CTX-1 remained unchanged.


High doses of antioxidant supplementations may constrain the favorable skeletal benefits of 12 weeks of resistance exercise in healthy elderly men.

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Fig. 1



One repetition maximum


Areal bone mineral density


Analysis of covariance


Antioxidant group


Bone mineral content


Bone mineral density


Body mass index (m/h2)


Control group


95% confidence interval


C-terminal telopeptide from type 1 collagen


Coefficient of variation


Dickkopf-related protein protein 1


Dual energy X-ray absorptiometry


Growth hormone

IGF-1 :

Insulin`-like growth factor 1


Interquartile range






Procollagen type 1 N-terminal propeptide


Parathyroid hormone


Receptor activator for nuclear factor κB ligand


Repetition maximum


Reactive oxygen species


Standard deviation

TNF-α :

Tumor necrosis factor α


25-hydroxy vitamin D3


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This work has been supported by grants from the Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology (NTNU), Regional Research Funds, Agder, Norway and The Smartfish Company, Norway. The authors would like to thank Prof. Lene Frost Andersen for analysis of dietary registrations, Hanne Vestaby for conducting the DXA measurements, and the participants for their dedication.

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Correspondence to Astrid Kamilla Stunes.

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Author contributions

The project was performed at the Department of Public Health, Sport and Nutrition, University of Agder, Norway and at the Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, (NTNU), Trondheim, Norway. Study design: SB, THS, KJH, and HLS. Study conduct: SB, THS, KJH, HLS, GH, and TB. Data collection: AKS, SB, THS, KJH, HLS, GH, and TB. Data analyses: AKS, TB, and THS. Data interpretation: AKS, MPM, TB, and US. Drafting manuscript: AKS. Revising manuscript: AKS, US, MPM, GH, TB, SB, THS, KJH, HLS, TR, and GP. Approved the final version of the manuscript: AKS, US, MPM, GH, TB, SB, THS, KJH, HLS, TR, and GP.

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Communicated by William J. Kraemer.

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Stunes, A.K., Syversen, U., Berntsen, S. et al. High doses of vitamin C plus E reduce strength training-induced improvements in areal bone mineral density in elderly men. Eur J Appl Physiol 117, 1073–1084 (2017).

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