Effects of calcium, dairy product, and vitamin D supplementation on bone mass accrual and body composition in 10-12-y-old girls: a 2-y randomized trial.
BACKGROUND
Little is known about the relative effectiveness of calcium supplementation from food or pills with or without vitamin D supplementation for bone mass accrual during the rapid growth period.


OBJECTIVE
The purpose was to examine the effects of both food-based and pill supplements of calcium and vitamin D on bone mass and body composition in girls aged 10-12 y.


METHODS
This placebo-controlled intervention trial randomly assigned 195 healthy girls at Tanner stage I-II, aged 10-12 y, with dietary calcium intakes <900 mg/d to 1 of 4 groups: calcium (1000 mg) + vitamin D3 (200 IU), calcium (1000 mg), cheese (1000 mg calcium), and placebo. Primary outcomes were bone indexes of the hip, spine, and whole body by dual-energy X-ray absorptiometry and of the radius and tibia by peripheral quantitative computed tomography.


RESULTS
With the use of intention-to-treat or efficacy analysis, calcium supplementation with cheese resulted in a higher percentage change in cortical thickness of the tibia than did placebo, calcium, or calcium + vitamin D treatment (P = 0.01, 0.038, and 0.004, respectively) and in higher whole-body bone mineral density than did placebo treatment (P = 0.044) when compliance was >50%. With the use of a hierarchical linear model with random effects to control for growth velocity, these differences disappeared.


CONCLUSIONS
Increasing calcium intake by consuming cheese appears to be more beneficial for cortical bone mass accrual than the consumption of tablets containing a similar amount of calcium. Diverse patterns of growth velocity may mask the efficacy of supplementation in a short-term trial of children transiting through puberty.
Cheng
Sulin
S
Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland. cheng@sport.jyu.fi
Lyytikäinen
Arja
A
Kröger
Heikki
H
Lamberg-Allardt
Christel
C
Alén
Markku
M
Koistinen
Arvo
A
Wang
Qing Ju
QJ
Suuriniemi
Miia
M
Suominen
Harri
H
Mahonen
Anitta
A
Nicholson
Patrick H F
PH
Ivaska
Kaisa K
KK
Korpela
Riitta
R
Ohlsson
Claes
C
Väänänen
Kalervo H
KH
Tylavsky
Frances
F
D015502:Absorptiometry, Photon; D000704:Analysis of Variance; D001823:Body Composition / Q000187:drug effects* / Q000502:physiology; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000494:pharmacology*; D001846:Bone Development / Q000187:drug effects* / Q000502:physiology; D016723:Bone Remodeling; D002136:Calcium, Dietary / Q000494:pharmacology*; D002611:Cheese; D002648:Child; D003611:Dairy Products; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D016014:Linear Models; D008572:Menarche / Q000502:physiology; D010349:Patient Compliance; D011627:Puberty / Q000502:physiology; D011884:Radius / Q000000981:diagnostic imaging; D013977:Tibia / Q000000981:diagnostic imaging; D014807:Vitamin D / Q000494:pharmacology*
D050071:Bone Density Conservation Agents; D002136:Calcium, Dietary; D014807:Vitamin D