title: Effects of a multi-component exercise program and calcium-vitamin-D3-fortified milk on bone mineral density in older men: a randomised controlled trial.
abstract: CONCLUSIONS
  We examined the independent and combined effects of a multi-component exercise program and calcium-vitamin-D(3)-fortified milk on bone mineral density (BMD) in older men. Exercise resulted in a 1.8% net gain in femoral neck BMD, but additional calcium-vitamin D(3) did not enhance the response in this group of older well-nourished men.
  
  
  BACKGROUND
  This 12-month randomised controlled trial assessed whether calcium-vitamin-D(3)-fortified milk could enhance the effects of a multi-component exercise program on BMD in older men.
  
  
  METHODS
  Men (n = 180) aged 50-79 years were randomised into: (1) exercise + fortified milk; (2) exercise; (3) fortified milk; or (4) controls. Exercise consisted of high intensity progressive resistance training with weight-bearing impact exercise. Men assigned to fortified milk consumed 400 mL/day of low fat milk providing an additional 1,000 mg/day calcium and 800 IU/day vitamin D(3). Femoral neck (FN), total hip, lumbar spine and trochanter BMD and body composition (DXA), muscle strength 25-hydroxyvitamin D and parathyroid hormone (PTH) were assessed.
  
  
  RESULTS
  There were no exercise-by-fortified milk interactions at any skeletal site. Exercise resulted in a 1.8% net gain in FN BMD relative to no-exercise (p < 0.001); lean mass (0.6 kg, p < 0.05) and muscle strength (20-52%, p < 0.001) also increased in response to exercise. For lumbar spine BMD, there was a net 1.4-1.5% increase in all treatment groups relative to controls (all p < 0.01). There were no main effects of fortified milk at any skeletal site.
  
  
  CONCLUSIONS
  A multi-component community-based exercise program was effective for increasing FN BMD in older men, but additional calcium-vitamin D(3) did not enhance the osteogenic response.
authors.affiliation: Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Kukuljan
authors.forename: C A
authors.initials: CA
authors.lastname: Nowson
authors.forename: S L
authors.initials: SL
authors.lastname: Bass
authors.forename: K
authors.initials: K
authors.lastname: Sanders
authors.forename: G C
authors.initials: GC
authors.lastname: Nicholson
authors.forename: M J
authors.initials: MJ
authors.lastname: Seibel
authors.forename: J
authors.initials: J
authors.lastname: Salmon
authors.forename: R M
authors.initials: RM
authors.lastname: Daly
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000818:Animals; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D002136:Calcium, Dietary / Q000008:administration & dosage*; D002762:Cholecalciferol / Q000008:administration & dosage*; D015444:Exercise; D005081:Exercise Therapy; D005269:Femur / Q000000981:diagnostic imaging; D005272:Femur Neck / Q000000981:diagnostic imaging; D005527:Food, Fortified; D006621:Hip Joint / Q000000981:diagnostic imaging; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D008892:Milk; D053580:Muscle Strength / Q000502:physiology; D018482:Muscle, Skeletal / Q000187:drug effects / Q000502:physiology; D010281:Parathyroid Hormone / Q000097:blood; D016896:Treatment Outcome; D014739:Victoria; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
chemical_list: D002136:Calcium, Dietary; D010281:Parathyroid Hormone; D014807:Vitamin D; D002762:Cholecalciferol; C104450:25-hydroxyvitamin D