Long-term effects of nutrient intervention on markers of bone remodeling and calciotropic hormones in late-postmenopausal women.
BACKGROUND
Adequate intakes of calcium and vitamin D reduce bone loss and fracture risk in the elderly. Other nutrients also affect bone health, and adequate intakes may influence bone turnover and balance.


OBJECTIVE
We compared the long-term effects on bone turnover markers and calciotropic hormones of a multinutrient supplement, a calcium and vitamin D supplement, and dietary instruction aimed at increasing calcium intake through foods.


METHODS
Ninety-nine healthy postmenopausal women participated in a 3-y, randomized trial, receiving either 1) supplemental calcium (1450 mg/d) and vitamin D [10 microg (400 IU)/d], 2) calcium, vitamin D, and other nutrients (multinutrient supplement), or 3) dietary instruction (dietary control group). Data are from 83 subjects who completed the trial.


RESULTS
Increases over baseline in calcium intakes and serum 25-hydroxyvitamin D concentrations were sustained over 3 y in all treatment groups. Circulating parathyroid hormone concentrations were reduced at year 1 in all treatment groups but trended toward baseline thereafter. Bone turnover markers followed a similar pattern, and none of the changes in biochemical concentrations differed significantly between groups.


CONCLUSIONS
All 3 interventions offer long-term feasibility for increasing calcium intake and serum 25-hydroxyvitamin D concentrations. The dietary addition of micronutrients implicated in skeletal physiology confers no obvious bone-sparing effect in healthy postmenopausal women beyond that of calcium and vitamin D alone. The attenuation over time in suppression of parathyroid hormone and bone turnover might help explain why nutrient intervention tends to have less of a bone-sparing effect than do skeletally active medications such as estrogen or bisphosphonates.
Jensen
Christopher
C
University of California, Berkeley, School of Public Health, Department of Epidemiology, USA.
Holloway
Leah
L
Block
Gladys
G
Spiller
Gene
G
Gildengorin
Ginny
G
Gunderson
Erica
E
Butterfield
Gail
G
Marcus
Robert
R
D000368:Aged; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D016723:Bone Remodeling / Q000187:drug effects* / Q000502:physiology; D002118:Calcium / Q000097:blood; D002136:Calcium, Dietary / Q000008:administration & dosage* / Q000378:metabolism; D004032:Diet; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000503:physiopathology / Q000517:prevention & control*; D010281:Parathyroid Hormone / Q000378:metabolism*; D010349:Patient Compliance; D017698:Postmenopause / Q000097:blood*; D014807:Vitamin D / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000097:blood / Q000378:metabolism
D002136:Calcium, Dietary; D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D002118:Calcium