title: Long-term effects of nutrient intervention on markers of bone remodeling and calciotropic hormones in late-postmenopausal women.
abstract: 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.
authors.affiliation: University of California, Berkeley, School of Public Health, Department of Epidemiology, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Jensen
authors.forename: Leah
authors.initials: L
authors.lastname: Holloway
authors.forename: Gladys
authors.initials: G
authors.lastname: Block
authors.forename: Gene
authors.initials: G
authors.lastname: Spiller
authors.forename: Ginny
authors.initials: G
authors.lastname: Gildengorin
authors.forename: Erica
authors.initials: E
authors.lastname: Gunderson
authors.forename: Gail
authors.initials: G
authors.lastname: Butterfield
authors.forename: Robert
authors.initials: R
authors.lastname: Marcus
mesh_terms: 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
chemical_list: D002136:Calcium, Dietary; D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D002118:Calcium