Increased calcium intake does not completely counteract the effects of increased phosphorus intake on bone: an acute dose-response study in healthy females.
A high dietary P intake is suggested to have negative effects on bone through increased parathyroid hormone secretion, as high serum parathyroid hormone (S-PTH) concentration increases bone resorption. In many countries the P intake is 2- to 3-fold above dietary guidelines, whereas Ca intake is too low. This combination may not be optimal for bone health. In a previous controlled study, we found that dietary P dose-dependently increased S-PTH and bone resorption and decreased bone formation. The aim of the present study was to investigate the dose-response effects of Ca intake on Ca and bone metabolism with a dietary P intake higher than recommended. Each of the twelve healthy female subjects aged 21-40 years attended three 24-h study sessions, which were randomized with regard to a Ca dose of 0 (control day), 600 or 1200 mg, and each subject served as her own control. The meals on each study day provided 1850 mg P and 480 mg Ca. S-PTH concentration decreased (P < 0.001) and serum ionized Ca concentration increased (P < 0.001) with increasing Ca doses. The bone formation marker, serum bone-specific alkaline phosphatase, did not differ significantly (P = 0.4). By contrast, the bone resorption marker, urinary N-terminal telopeptide of collagen type I, decreased significantly with both Ca doses (P = 0.008). When P intake was above current recommendations, increased Ca intake was beneficial for bone, as indicated by decreased S-PTH concentration and bone resorption. However, not even a high Ca intake could affect bone formation when P intake was excessive.
Kemi
Virpi E
VE
Calcium Research Unit, Department of Applied Chemistry and Microbiology, University of Helsinki, Helsinki, Finland.
Kärkkäinen
Merja U M
MU
Karp
Heini J
HJ
Laitinen
Kalevi A E
KA
Lamberg-Allardt
Christel J E
CJ
D000328:Adult; D000704:Analysis of Variance; D015519:Bone Density / Q000187:drug effects*; D001862:Bone Resorption / Q000188:drug therapy*; D002118:Calcium / Q000097:blood; D002136:Calcium, Dietary / Q000008:administration & dosage*; D003404:Creatinine / Q000652:urine; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D009752:Nutritional Status; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D016226:Phosphorus, Dietary / Q000008:administration & dosage / Q000009:adverse effects*
D002136:Calcium, Dietary; D010281:Parathyroid Hormone; D016226:Phosphorus, Dietary; D010758:Phosphorus; D003404:Creatinine; D002118:Calcium