Effect of withdrawal of calcium and vitamin D supplements on bone mass in elderly men and women.
BACKGROUND
Supplementation with calcium and vitamin D reduces bone loss and prevents fractures in elderly people, but it is not known whether any lasting benefit remains if the supplements are discontinued.


OBJECTIVE
The objective was to determine whether gains in bone mineral density (BMD) induced by calcium and vitamin D supplementation persist after supplement withdrawal.


METHODS
Two-hundred ninety-five healthy, elderly men and women (aged >/=68 y) who had completed a 3-y randomized, placebo-controlled trial of calcium and vitamin D supplementation were followed for an additional 2 y during which no study supplements were given. BMD was measured by dual-energy X-ray absorptiometry, and biochemical variables related to calcium metabolism and bone turnover were measured.


RESULTS
In the 128 men, supplement-induced increases in spinal and femoral neck BMD were lost within 2 y of supplement discontinuation, but small benefits in total-body BMD remained. In the 167 women, there were no lasting benefits in total-body BMD or at any bone site. Consistent with the observations on BMD, the bone turnover rates in both men and women (as measured by serum osteocalcin concentrations) returned to their original higher concentrations within the same 2-y period.


CONCLUSIONS
Discontinued calcium and vitamin D supplementation has limited cumulative effect on bone mass in men and women aged >/=68 y.
Dawson-Hughes
B
B
Calcium and Bone Metabolism Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston 02111, USA. hughesb@hnrc.tufts.edu
Harris
S S
SS
Krall
E A
EA
Dallal
G E
GE
D015502:Absorptiometry, Photon; D000368:Aged; D015519:Bone Density / Q000187:drug effects*; D016723:Bone Remodeling; D002118:Calcium / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D005272:Femur Neck / Q000187:drug effects; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000517:prevention & control; D006801:Humans; D008297:Male; D009994:Osmolar Concentration; D015675:Osteocalcin / Q000097:blood; D013131:Spine / Q000187:drug effects; D014807:Vitamin D / Q000008:administration & dosage* / Q000627:therapeutic use
D015675:Osteocalcin; D014807:Vitamin D; D002118:Calcium