Effects of dairy food supplements on bone mineral density in teenage girls Calcium intake influences the association of protein intake with rates of bone loss in elderly men and women. Calcium supplementation provides an extended window of opportunity for bone mass accretion after menarche. Dietary acid load is associated with lower bone mineral density in men with low intake of dietary calcium. Bone mineralization in children and adolescents with a milk allergy. The effect of calcium supplementation and tanner stage on bone density, content and area in teenage women Effect of habitual dietary calcium intake on calcium supplementation in 12-14-y-old girls. Effect of milk and calcium supplementation on bone density and bone turnover in pregnant Chinese women: a randomized controlled trail Treatment with alendronate plus calcium, alendronate alone, or calcium alone for postmenopausal low bone mineral density Calcium-enriched foods and bone mass growth in prepubertal girls: a randomized, double-blind, placebo-controlled trial. Effect of calcium or 25OH vitamin D3 dietary supplementation on bone loss at the hip in men and women over the age of 60. Calcium supplementation and bone mineral density in adolescent girls. Dairy intakes affect bone density in the elderly. Effect of calcium supplementation on bone mineral accretion in gambian children accustomed to a low-calcium diet. Beneficial effect of soy isoflavones on bone mineral content was modified by years since menopause, body weight, and calcium intake: a double-blind, randomized, controlled trial Calcium supplementation and bone mineral density in females from childhood to young adulthood: a randomized controlled trial. Appendicular bone mass in children with a high prevalence of low dietary calcium intakes. A 1-y walking program and increased dietary calcium in postmenopausal women: effects on bone. The effect on behavior and bone mineral density of individualized bone mineral density feedback and educational interventions in premenopausal women: a randomized controlled trial [NCT00273260] Cumulative effects of calcium supplementation and physical activity on bone accretion in premenarchal children: a double-blind randomised placebo-controlled trial. Bone mineral contents and plasma osteocalcin concentrations of Gambian children 12 and 24 mo after the withdrawal of a calcium supplement. Vitamin D Is a Major Determinant of Bone Mineral Density at School Age Vitamin D supplementation and bone mineral density in early postmenopausal women. Randomized controlled trial of calcium supplementation in healthy, nonosteoporotic, older men. Protein intake: effects on bone mineral density and the rate of bone loss in elderly women. Effects of two years' milk supplementation on size-corrected bone mineral density of Chinese girls. Skeletal site-dependent response of bone mineral density and quantitative ultrasound parameters following a 12-month dietary intervention using dairy products fortified with calcium and vitamin D: the Postmenopausal Health Study. Effects of dairy products on bone and body composition in pubertal girls. Calcium supplementation prevents seasonal bone loss and changes in biochemical markers of bone turnover in elderly New England women: a randomized placebo-controlled trial. Calcium supplementation and increases in bone mineral density in children. Bone minerals changes in obese women during a moderate weight loss with and without calcium supplementation. Effect of calcium supplementation on bone loss in postmenopausal women. The effects of a high calcium dairy food on bone health in pre-pubertal children in New Zealand. A co-twin study of the effect of calcium supplementation on bone density during adolescence Dietary calcium intake protects women consuming oral contraceptives from spine and hip bone loss. Effect of calcium supplementation in pregnancy on maternal bone outcomes in women with a low calcium intake123 Effect of training mode and calcium intake on bone mineral density in female master cyclist, runners, and non-athletes. The effects of calcium supplementation and exercise on bone density in elderly Chinese women Does vitamin D supplementation of healthy Danish Caucasian girls affect bone turnover and bone mineralization? Veganism, bone mineral density, and body composition: a study in Buddhist nuns Calcium and Vitamin D Supplementation Increases Spinal BMD in Healthy, Postmenopausal Women
 Determinants of bone mineral density in older men. Effect of calcium plus vitamin D supplementation during pregnancy in Brazilian adolescent mothers: a randomized, placebo-controlled trial. Prevalence of osteoporosis in ambulatory postmenopausal women from a semiurban region in Southern India: relationship to calcium nutrition and vitamin D status. [Calcium supplementation and bone absorptiometry in girls]. The skeletal benefits of calcium- and vitamin D3-fortified milk are sustained in older men after withdrawal of supplementation: an 18-mo follow-up study. Identification of a dietary pattern prospectively associated with bone mass in Australian young adults. Bone mass and density response to a 12-month trial of calcium and vitamin D supplement in preadolescent girls. The efficacy of calcium supplementation alone in elderly Thai women over a 2-year period: a randomized controlled trial Maternal calcium supplementation and fetal bone mineralization. A two-year program of aerobics and weight training enhances bone mineral density of young women. Bone turnover and density in obese premenopausal women during moderate weight loss and calcium supplementation. Associations of dietary calcium, vitamin D, milk intakes, and 25-hydroxyvitamin D with bone mass in Spanish adolescents: the HELENA study. Long-term effects of calcium supplementation on bone loss and fractures in postmenopausal women: a randomized controlled trial. [Effects of calcium supplementation on bone mineral accretion in adolescents]. Effect of withdrawal of calcium and vitamin D supplements on bone mass in elderly men and women. Benefits of milk powder supplementation on bone accretion in Chinese children Calcium supplementation suppresses bone turnover during weight reduction in postmenopausal women. The Effect of a Whey Protein Supplement on Bone Mass in Older Caucasian Adults. Physical activity and dietary constituents as predictors of forearm cortical and trabecular bone gain in healthy children and adolescents: a prospective study
Summary Background Bone mineral density ( BMD ) is largely genetically determined and this influence is most powerful in the period of rapid skeletal development in childhood and late adolescence but environmental factors such as exercise and dietary calcium intake may influence up to 20 % . Aims of the study The aims of the study were to examine healthy late adolescent females for the effects and benefits of a high calcium intake from dairy product foods on bone mineral density , body composition , lipids and biochemistry . The secondary aim is determine whether a high intake of dairy product foods in the diet is acceptable for this age group long term . Methods Ninety-one teenage girls who participated in a two-year r and omised controlled study on the effect of dairy food supplementation on dietary patterns , body composition and bone density in post-pubertal teenage girls were approached one year after the cessation of the study to determine the effects of the cessation of dairy supplements on bone mineral density , dietary habits , biochemical markers , body composition and blood lipids . Bone mineral density and bone mineral content were assessed at the hip , spine and total body . Anthropometric data were collected , and exercise , Tanner , dietary assessment , preference and compliance question naires were administered . Lipid profiles , hydroxyproline excretion and urinary calcium and sodium excretion measurements were performed . Results There were no significant differences between the 2 groups for height , weight , lean and fat mass . The supplemented group had significantly higher calcium , phosphorus and protein intake during the supplementation period ( p<0.001 ) . No differences were seen between the groups 12 months after supplementation finished . There were no significant differences in exercise level , preference or acceptability of dairy products or in the lipids and bone markers between baseline the end of supplementation and 1 year follow-up . There was a significant increase in trochanter ( 4.6 % ) , lumbar spine ( 1.5 % ) and femoral neck ( 4.8 % ) BMD ( p<0.05 ) in the high calcium group at the end of supplementation . There was an increase in bone mineral content at the trochanter ( p<0.05 ) and lumbar spine ; however the latter was not statistically significant , in the high calcium group at the end of supplementation . There was no difference in vertebral height or width at any stage of the study , indicating no influence on bone size . Conclusions In this 3 year study ( 2 years of supplementation , 1 year follow-up ) , teenage girls , aged 15–18 years , were able to significantly increase their BMD at the trochanter , femoral neck and lumbar spine when supplemented with dairy product foods to a mean calcium intake of 1160 mg/d . There was also an effect seen on the BMC particularly at the trochanter and to a lesser extent at the lumbar spine . The dietary calcium intake achieved did not adversely affect body weight , fat and lean mass or blood lipid profiles . Twelve months after the supplementation finished the girls had returned to their baseline diet , indicating self- selection of a high dairy product diet may be hard to achieve BACKGROUND There is currently no consensus on the effect of dietary protein intake on the skeleton , but there is some indication that low calcium intakes adversely influence the effect of dietary protein on fracture risk . OBJECTIVE The objective of the present study was to determine whether supplemental calcium citrate malate and vitamin D influence any associations between  protein intake and change in bone mineral density ( BMD ) . DESIGN Associations between protein intake and change in BMD were examined in 342 healthy men and women ( aged > or = 65 y ) who had completed a 3-y , r and omized , placebo-controlled trial of calcium and vitamin D supplementation . Protein intake was assessed at the midpoint of the study with the use of a food-frequency question naire and  BMD  was assessed every 6 mo by dual-energy X-ray absorptiometry . RESULTS The mean ( + /-SD ) protein intake of all subjects was 79.1 + /- 25.6 g/d and the mean total calcium intakes of the supplemented and placebo groups were 1346 + /- 358 and 871 + /- 413 mg/d , respectively . Higher protein intake was significantly associated with a favorable 3-y change in total-body BMD in the supplemented group ( in a model containing terms for age , sex , weight , total energy intake , and dietary calcium intake ) but not in the placebo group . The pattern of change in femoral neck BMD with increasing protein intake in the supplemented group was similar to that for the total body . CONCLUSION Increasing protein intake may have a favorable effect on change in BMD in elderly subjects supplemented with calcium citrate malate and vitamin BACKGROUND High calcium intakes during adolescence may increase bone acquisition . The magnitude of the effect of dietary calcium supplementation and the timing of its administration to achieve significant effects on bone health are still incompletely defined . OBJECTIVE The objective of this study was to assess the effect of calcium supplementation on bone mass accretion in postmenarcheal adolescent girls with low calcium intakes . DESIGN A double-blind , placebo-controlled calcium supplementation study was implemented . One hundred girls with a mean ( + /- SD ) age of 14 + /- 0.5 y with habitual calcium intakes < 800 mg/d completed a 12-mo protocol . The treatment group received a daily supplement containing 1000 mg elemental calcium .  Bone mineral density ( BMD ) and bone mineral content ( BMC ) of the total body , lumbar spine , and femoral neck were determined at inclusion , 6 mo , and 12 mo . Also measured were serum concentrations of biochemical markers of bone turnover ( osteocalcin and deoxypyridinoline ) , parathyroid hormone , and vitamin D. RESULTS The calcium-supplemented group had greater accretion of total-body BMD and lumbar spine BMD but not BMC than did the control group . Calcium supplementation appeared selectively beneficial for girls who were 2 y postmenarcheal . Calcium supplementation significantly decreased bone turnover and decreased serum parathyroid hormone concentrations . CONCLUSION Calcium supplementation of postmenarcheal girls with low calcium intakes enhances bone mineral acquisition , especially in girls > 2 y past the onset of menarche High dietary acid load ( DAL ) may be detrimental to bone mineral density ( BMD ) . The objectives of the study were to : ( 1 ) evaluate the cross-sectional relation between DAL and BMD ; and ( 2 ) determine whether calcium intake modifies this association . Men ( n = 1218 ) and women ( n = 907 ) aged ≥60 years were included from the National Health and Nutrition Examination Survey 2005 - 2008 .  Nutrient intake from 2 , 24-hour recalls was used to calculate net endogenous acid production ( NEAP ) and potential renal acid load  ( PRAL ) ( mEq/d ) . PRAL was calculated from dietary calcium ( PRALdiet ) and diet + supplemental calcium ( PRALtotal ) . Tests for linear trend in adjusted mean BMD of the hip and lumbar spine were performed across energy-adjusted NEAP and PRAL quartiles . Modification by calcium intake ( dietary or total ) above or below 800 mg/d was assessed by interaction terms . Overall , mean age was 69 ± 0.3 years . Among women , there was no association between NEAP and BMD  . PRALdiet was positively associated with proximal femur BMD ( p trend = 0.04 ) . No associations were observed with PRALtotal at any BMD site ( p range , 0.38 - 0.82 ) . Among men , no significant associations were observed between BMD and NEAP or PRAL . However , an interaction between PRALdiet and calcium intake was observed with proximal femur BMD ( p = 0.08 ) . An inverse association between PRALdiet and proximal femur BMD was detected among men with < 800 mg/d dietary calcium ( p = 0.02 ) ; no associations were found among men with ≥800 mg/d ( p = 0.98 ) . A significant interaction with PRALtotal was not observed . In conclusion , when supplemental calcium is considered , there is no association between DAL and  BMD among adults . Men with low dietary calcium showed an inverse relation with PRAL at the proximal femur ; in women no interaction was observed . This study highlights the importance of calcium intake in counteracting the adverse effect of DAL on bone health . Further research should determine the relation between DAL and change in BMD with very low calcium intake To evaluate the correlation between dietary calcium intake and mineralization of the immature skeleton 55 children and adolescents aged 5 - 14 years ( mean , 9.5 years ) with a positive radioallergosorbent test ( RAST ) for serum antibodies to cow 's milk protein were evaluated .  Bone mineral density ( BMD ) in the lumbar spine and proximal femurs were measured by dual energy X-ray absorptiometry . BMD at each site for each subject was converted to an age-adjusted Z score based on our own series of 95 normal pediatric controls .  Calcium intake was determined using a detailed food frequency question naire administered by a nutritionist during a 30 - 40-min interview . Dietary adjustments to the condition varied and result ed in a wide range of calcium intakes . Calcium supplements were taken by 22 % of the subjects and were included in the determination of daily calcium intake . The group of 55 subjects was divided into quartiles based on calcium intake ( mean + /- S.E mg calcium/day ) : Group 1 , 409 + /- 21 , Group 2 , 663 + /- 16 , Group 3 , 950 + /- 32 , Group 4 , 1437 + /- 124 . Bone density Z scores in the proximal femur serially increased across the calcium intake groups ( mean + /- S.E. ) : Group 1 , -0.16 + /- 0.31 ; Group 2 , 0.05 + /- 0.33 ; Group 3 , 0.44 + /- 0.24 ; Group 4 , 0.79 + /- 0.41 ( P = 0.03 ) . A similar pattern was found with lumbar spine BMD Z scores : Group 1 , -0.16 + /- 0.27 ; Group 2 , 0.10 + /- 0.21 ; Group 3 , 0.18 + /- 0.20 ; Group 4 , 0.30 + /- 0.25 ( P = 0.05 ) . These data add further to the evidence that dietary calcium intake is important for optimal mineralization of the growing skeleton One hundred and twelve Caucasian girls , 11.9±0.5 years of age at entry , were r and omized into a 24-month , double-masked , placebo-controlled trial to determine the effect of calcium supplementation on bone mineral content , bone area and bone density . Supplementation was 500 mg calcium as calcium citrate malate ( CCM ) per day . Controls received placebo pills , and compliance of both groups averaged 72 % . Bone mineral content , bone mineral area and bone mineral density of the lumbar spine and total body were measured by dual energy X-ray absorptiometry ( DXA ) . Calcium intake from dietary sources averaged 983 mg/day for the entire study group . The supplemented group received , on average , an additional 360 mg calcium/day from CCM . At baseline and after 24 months , the two groups did not differ with respect to anthropometric measurements , urinary reproductive hormone levels or any measurement of pubertal progression . The supplemented group had greater increases of total body bone measures : content 39.9 % versus 35.7 % ( p=0.01 ) , area 24.2 % versus 22.5 % ( p=0.15 ) and density 12.2 % versus 10.1 % ( p=0.005 ) . Region-of-interest analyses showed that the supplemented group had greater gains compared with the control group for bone mineral density , content and area . In particular , in the lumbar spine and pelvis , the gains made by the supplemented group were 12%–24 % greater than the increases made by the control group . Bone acquisition rates in the two study groups were further compared by subdividing the groups into those with below- or above-median values for Tanner score and dietary calcium intake . In subjects with below-median Tanner scores , bone acquisition was not affected by calcium supplementation or dietary calicum level . However , the calcium supplemented subjects with above-median Tanner had higher bone acqusition rates than the placebo group with above-median Tanner scores . Relative to the placebo group , the supplemented group had increased yearly gains of bone content , area and density which represented about 1.5 % of adult female values . Such increases , if held to adult skeletal maturity , could provide protection against future risk of osteoporotic fractures BACKGROUND There is no agreement on how much calcium young girls need for optimal bone mineralization . OBJECTIVE We evaluated whether the effect of calcium supplementation on whole-body bone mineral accretion depends on habitual calcium intake . DESIGN This was a r and omized , double-blind , placebo-controlled , 1-y calcium intervention study of girls aged 12 - 14 y selected from a larger group according to habitual calcium intake : subgroup A ( n = 60 ) habitually consumed 1000 - 1307 mg/d ( 40th-60th percentile ) , and subgroup B ( n = 53 ) habitually consumed < 713 mg/d ( < 20th percentile ) . The girls from each subgroup were r and omly assigned to receive either 500 mg Ca/d or placebo .  Whole-body bone mineral content ( BMC ) , bone area ( BA ) , bone mineral density ( BMD ) , and BMC adjusted for BA , height , and weight ( size-adjusted BMC ) were measured at baseline and after 1 y. RESULTS There was no significant effect modification of baseline habitual calcium intake on the relation between calcium supplementation and height , weight , BMC , size-adjusted BMC , BA , BMD , or alkaline phosphatase .  Calcium supplementation had an effect on BMD ( 0.8 % ; P = 0.049 ) and tended to show signs of an effect on size-adjusted BMC ( 0.5 % ; P = 0.08 ) . CONCLUSION A modest effect of calcium supplementation on BMD was shown . However , the effect was independent of habitual calcium intake Objective Calcium dem and is increased during pregnancy . However , few r and omized controlled trials examined the effects of calcium supplementation on bone mass during pregnancy . This study determined effects of calcium and milk supplementation on maternal bone mineral density ( BMD ) and bone turnover in pregnant Chinese women with habitual low calcium intake . Methods In this r and omized controlled trial , 36 Chinese pregnant women ( 24–31 years , 18 gestational weeks ) were r and omly assigned to the following three arms ( 12 each ) : I , usual diet ; II , “ I ” + 45 g milk powder ( containing 350 mg calcium ) ; or III , “ II ” + 600 mg calcium/day from gestational age of 20 weeks to 6 weeks post-partum ( PP ) . BMD was measured post-treatment using dual-energy X-ray absorptiometry . Dietary intakes , 24-h urinary calcium , bone resorption ( urinary hydroxyproline ) and formation ( serum osteocalcin ) biomarkers were examined at the gestational age of 20 and 34 weeks , and 6 weeks PP . Results A dose-dependent relationship was observed between calcium intake and BMDs . The BMD values were significantly higher in subjects with calcium and milk supplementation  than those in the controls at the whole body and spine ( p < 0.05 ) but not at the hip sites . We found significant decreases in changes of urinary hydroxyproline , and significant increases in serum osteocalcin during the intervention period in the calcium/milk intervention groups than those in the control group ( all p < 0.05 ) . Conclusion Calcium/milk supplementation during pregnancy is associated with greater BMD at the spine and whole body and suppresses bone resorption in Chinese women with habitual low calcium intake ABSTRACT Objective : Bisphosphonates such as alendronate are widely used for postmenopausal osteoporosis . Supplemental calcium is also generally recommended . This trial directly compares alendronate to supplemental calcium and examines the effect of calcium supplementation on alendronate treatment . Methods : This 2-year , r and omized , double-blind , multicenter trial enrolled healthy , postmenopausal women with low bone mineral density ( BMD ) . Patients with a dietary calcium intake ≥ 800 mg/day received daily vitamin D 400 IU and alendronate 10 mg/calcium-placebo , alendronate 10 mg/elemental calcium 1000 mg , or alendronate-placebo/calcium 1000 mg ( 2:2:1 ) . Endpoints included BMD , bone turnover markers ( BTMs ) , and adverse events . Results : R and omized patients ( N = 701 ) were an average of 20.4 years postmenopausal . After 24 months , increases in lumbar spine BMD differed significantly between patients receiving calcium alone ( 0.8 % ) and either alendronate alone ( 5.6 % ) or alendronate + calcium ( 6.0 % ) ( p < 0.001 ) . Significant differences were also seen at the trochanter and femoral neck ( p < 0.001 ) . BTMs were significantly lower with alendronate-containing treatments than calcium alone ( p < 0.001 ) . Addition of calcium supplementation to alendronate did not significantly increase BMD  compared to alendronate alone ( p = 0.29 to 0.97 ) , but did result in a statistically significant , though small , additional reduction in urinary NTx . Adverse events were similar among treatment groups . Limitations include no assessment of vitamin D levels and a discontinuation rate of approximately 30 % , although discontinuation rates were similar among treatment groups . Conclusions : In postmenopausal women with a daily intake of ≥ 800 mg calcium and 400 IU vitamin D , 24-month treatment with alendronate 10 mg daily with or without calcium 1000 mg result ed in significantly greater increases in BMD and reduction of bone turnover than supplemental calcium alone . Addition of supplemental calcium to alendronate treatment had no effect on BMD and result ed in a small , though statistically significant , additional reduction in NTx High calcium intake during childhood has been suggested to increase bone mass accrual , potentially result ing in a greater peak bone mass . Whether the effects of calcium supplementation on bone mass accrual vary from one skeletal region to another , and to what extent the level of spontaneous calcium intake may affect the magnitude of the response has , however , not yet been clearly established . In a double-blind , placebo-controlled study , 149 healthy prepubertal girls aged 7.9+/-0.1 yr ( mean+/-SEM ) were either allocated two food products containing 850 mg of calcium ( Ca-suppl . ) or not ( placebo ) on a daily basis for 1 yr . Areal bone mineral density ( BMD ) , bone mineral content ( BMC ) , and bone size were determined at six sites by dual-energy x-ray absorptiometry . The difference in BMD gain between calcium-supplemented ( Ca-suppl . ) and placebo was greater at radial ( metaphysis and diaphysis ) and femoral ( neck , trochanter , and diaphyses ) sites ( 7 - 12 mg/cm2 per yr ) than in the lumbar spine ( 2 mg/cm2 per yr ) . The difference in BMD gains between Ca-suppl . and placebo was greatest in girls with a spontaneous calcium intake below the median of 880 mg/d . The increase in mean BMD of the 6 sites in the low-calcium consumers was accompanied by increased gains in mean BMC , bone size , and statural height . These results suggest a possible positive effect of calcium supplementation on skeletal growth at that age . In conclusion , calcium-enriched foods significantly increased bone mass accrual in prepubertal girls , with a preferential effect in the appendicular skeleton , and greater benefit at lower spontaneous calcium intake Dietary supplements that prevent bone loss at the hip and that can be applied safely in the elderly are likely to reduce hip fractures . A daily dietary supplement of 750 mg calcium or 15 microg 25OH vitamin D3 on bone loss at the hip and other sites , bone turnover and calcium-regulating hormones were studied over 4 yr in elderly volunteers using a r and omized , double-blind , placebo-controlled trial . Bone mineral density ( BMD ) was measured by dual x-ray absorptiometry and bone structure by radiographs . Calcium biochemistry and bone turnover markers were measured in blood and urine . The 316 women entering the trial had a mean age of 73.7 yr and the 122 men of 75.9 yr . Baseline median calcium intake was 546 mg/day , and median serum 25OH vitamin D3 was 59 nmol/L. On placebo , loss of BMD at total hip was 2 % and femoral medulla expansion was 3 % over 4 yr . Calcium reduced bone loss , secondary hyperparathyroidism , and bone turnover . 25OH vitamin D3 was intermediate between placebo and calcium . Fracture rates and drop-out rates were similar among groups , and there were no serious adverse events with either supplement . A calcium supplement of 750 mg/day prevents loss of BMD , reduces femoral medullary expansion , secondary hyperparathyroidism , and high bone turnover . A supplement of 15 microg/day 25OH vitamin D3 is less effective , and because its effects are seen only at low calcium intakes , suggests that its beneficial effect is to reverse calcium insufficiency OBJECTIVE To evaluate the effect of calcium supplementation on bone acquisition in adolescent white girls . DESIGN A r and omized , double-blind , placebo-controlled trial of the effect of 18 months of calcium supplementation on bone density and bone mass . SUBJECTS Ninety-four girls with a mean age of 11.9 + 0.5 years at study entry . SETTING University hospital in a small town . INTERVENTIONS Calcium supplementation , 500 mg/d calcium as calcium citrate malate ; controls received placebo pills . MAIN OUTCOME MEASURES Bone mineral density and bone mineral content of the lumbar spine and total body were measured by dual-energy x-ray absorptiometry and calcium excretion from 24-hour urine specimens . RESULTS Calcium intake from dietary sources averaged 960 mg/d for the entire study group . The supplemented group received , on average , an additional 354 mg/d of calcium . The supplemented group compared with the placebo group had greater increases of lumbar spine bone density ( 18.7 % vs 15.8 % ; P = .03 ) , lumbar spine bone mineral content ( 39.4 % vs 34.7 % ; P = .06 ) , total body bone mineral density ( 9.6 % vs 8.3 % ; P = .05 ) , and 24-hour urinary calcium excretion ( 90.4 vs 72.9 mg/d ; P = .02 ) , respectively . CONCLUSIONS Increasing daily calcium intake from 80 % of the recommended daily allowance to 110 % via supplementation with calcium citrate malate result ed in significant increases in total body and spinal bone density in adolescent girls . The increase of 24 g of bone gain per year among the supplemented group translates to an additional 1.3 % skeletal mass per year during adolescent growth , which may provide protection against future osteoporotic fracture BACKGROUND Race and sex differences in the effect of diet on bone mineral density ( BMD ) at the hip in the elderly are unknown . OBJECTIVES This study related cross-sectional nutrient and dairy product consumption to hip BMD in white and black men and women aged > 60 y and evaluated the influence of nutrient and dairy product consumption on changes in BMD in a white cohort participating in a calcium , vitamin D , or placebo trial . DESIGN The Health Habits and History Question naire was used in 289 white women and 116 white men who participated in the trial and in 265 black women and 75 black men to predict total hip and femoral neck BMD or  changes in BMD . RESULTS Blacks had higher calcium intakes than did whites ( 700 and 654 mg/d , respectively ; P = 0.0094 ) , and men had higher calcium intakes than did women ( 735 and 655 mg/d , respectively ; P = 0.0007 ) . For men , the correlation between total hip BMD and dairy calcium intake after adjustment for age , race , and weight was 0.23 ( P < 0.005 ) ; this relation was not significant in women ( r = 0.02 , P = 0.12 ) . Similar results were found for femoral neck BMD . In the longitudinal study , calcium supplementation reduced bone loss from the total hip and femoral neck in those who consumed < 1.5 servings of dairy products/d and were < 72 y old . CONCLUSIONS Cross-sectional results indicated that higher dairy product consumption is associated with greater hip BMD in men , but not in women . Calcium supplementation protected both men and women from bone loss in the longitudinal study of whites BACKGROUND Rural Gambian children have poor growth , delayed puberty , a low bone mineral content , and a low calcium intake . OBJECTIVE We investigated the effect of a calcium supplement on bone mineral accretion in rural Gambian children . DESIGN A r and omized , double-blind , placebo-controlled study was conducted in 160 children ( 80 boys , 80 girls ) aged 8.3 - 11.9 y.  Bone mineral content ( BMC ) , bone mineral density ( BMD ) , and BMC adjusted for bone width , body weight , and height ( size-adjusted BMC ) were measured at the midshaft and distal radius . Each child received either 1000 mg Ca/d ( as calcium carbonate ) or a placebo 5 d/wk for 12 mo . Supplementation increased calcium intake from 342 to 1056 mg/d ( 8.6 to 26.4 mmol/d ) . RESULTS Calcium supplementation result ed in a higher BMC , BMD , and size-adjusted BMC ( & xmacr ; difference + /- SE ) : midshaft radius- BMC ( 3.0 + /- 1.4 % ; P = 0.034 ) , BMD ( 4.5 + /- 0.9 % ; P < /= 0.0001 ) , and size-adjusted BMC ( 4.6 + /- 0.9 % ; P < /= 0.0001 ) ; distal radius- BMC ( 8 . 4 + /- 3.2 % ; P = 0.009 ) , BMD ( 7.0 + /- 2.7 % ; P = 0.011 ) , and size-adjusted BMC ( 5.5 + /- 2.7 % ; P = 0.042 ) . Supplementation had no significant effect on height , weight , or bone width at the midshaft radius or distal radius . At the end of the study , the calcium group had a significantly lower mean plasma osteocalcin concentration than the placebo group after adjustment for baseline concentration , sex , and pubertal status ( -21.9 + /- 6.5 % ; P = 0.001 ) . CONCLUSIONS Increased calcium intake result ed in increased bone mineral status , possibly in association with a decreased bone remodeling space . Further studies are needed to determine whether an increased calcium intake has long-term benefits in Gambian children Objective : Many studies have shown that soy isoflavones have an effect in preventing estrogen-related bone loss , but no data reported whether such an effect could be influenced by other important factors affecting bone loss . This study examines whether the associations between isoflavone supplementation and rates of change in bone mineral content ( BMC ) could be modified by years since menopause ( YSM ) , body weight ( BW ) , and dietary calcium intake in postmenopausal Chinese women aged 48 to 62 years . Design : A group of 203 eligible women were r and omly assigned to three treatment groups : placebo ( daily dose of 0 mg isoflavones + 500 mg calcium , n = 67 ) , mid-dose ( 40 mg isoflavones + 500 mg calcium , n = 68 ) ; and high-dose ( 80 mg isoflavones + 500 mg calcium , n = 68 ) . Bone mineral density ( BMD ) and BMC at the whole body , spine , and hip were measured by dual-energy x-ray absorptiometry at baseline and posttreatment after 1 year . YSM , BW , and dietary calcium intake stratified analyses were performed to evaluate whether the associations between isoflavones  supplementation and BMC change rates were varied with these factors . Results : Both univariate and multivariate analyses observed significant favorable effect of isoflavone supplementation on rates of change in BMC at the total hip and trochanter among later postmenopausal women ( > 4 y ) , in women with lower BW ( ≤median , 55.5 kg ) , or among women with lower level of calcium intake ( ≤median , 1095 mg/d ) . Conclusions : The independent effect of soy on the maintenance of hip BMC is more marked in women in later menopause or those with lower BW or calcium intake BACKGROUND Short-term studies established that calcium influences bone accretion during growth . Whether long-term supplementation influences bone accretion in young adults is not known . OBJECTIVE This study evaluated the long-term effects of calcium supplementation on bone accretion among females from childhood to young adulthood . DESIGN A 4-y r and omized clinical trial recruited 354 females in pubertal stage 2 and optionally was extended for an additional 3 y. The mean dietary calcium intake of the participants over 7 y was approximately 830 mg/d ;  calcium-supplemented persons received an additional approximately 670 mg/d . Primary outcome variables were distal and proximal radius bone mineral density ( BMD ) , total-body BMD ( TBBMD ) , and metacarpal cortical indexes . RESULTS Multivariate analyses of the primary outcomes indicated that  calcium-supplementation  effects vary over time . Follow-up univariate analyses indicated that all primary outcomes were significantly larger in the supplemented group than in the placebo group at the year 4 endpoint . However , at the year 7 endpoint , this effect vanished for TBBMD and distal radius BMD . Longitudinal models for TBBMD and proximal radius BMD , according to the time since menarche , showed a highly significant effect of supplementation during the pubertal growth spurt and a diminishing effect thereafter . Post hoc stratifications by compliance-adjusted total calcium intake and by final stature or metacarpal total cross-sectional area showed that calcium effects depend on compliance and body frame . CONCLUSIONS Calcium supplementation significantly influenced bone accretion  in young females during the pubertal growth spurt . By young adulthood , significant effects remained at metacarpals and at the forearm of tall persons , which indicated that the calcium requirement for growth is associated with skeletal size . These results may be important for both primary prevention of osteoporosis and prevention of bone fragility fractures during growth We have previously documented evidence of dietary calcium deficiency in black children living in a rural community in the eastern part of South Africa . The present study determined the bone mass of the distal one-third of the radius in a r and om sample of children living in the same community and compared their bone mass measurements with those of black children living in a similar rural community but without evidence of dietary calcium deficiency . Further , factors ( weight , height , serum corrected total calcium , phosphorus , and alkaline phosphatase [ ALP ] ) that might influence appendicular bone mass were assessed and correlated with the bone mass measurements . A r and om sample of 306 boys and 345 girls between the ages of 1 and 20 years were included in the study .  Hypocalcemia was found in 6.5 % of the boys and 5 % of the girls , while elevated ALP values were recorded in 20 and 26 % of the boys and girls , respectively . After adjusting for differences in age , weight , and height , bone mineral density ( BMD ) and bone mineral apparent density ( BMAD ) were significantly lower and bone width ( BW ) greater in study than control children . In a stepwise regression analysis , weight and /or height accounted for the majority of the observed variance in BMC , BW , and BMD ; however , a significant effect of serum calcium ( positively ) and ALP ( negatively ) on BMC and BMD was also found . In boys , but not girls , serum ALP also had a positive effect on BW.BMAD was negatively correlated to ALP and positively correlated to serum calcium in both boys and girls . Those children with hypocalcemia or elevated ALP levels had significantly lower BMC , BMD , and BMAD and a trend toward greater BW than children with normal biochemistry . The findings suggest that low dietary calcium intake may have a detrimental effect on appendicular bone density in rural black children . Whether or not these effects are disadvantageous in the long-term is not known The effects of a supervised 1-y walking program and increased dietary calcium ( milk supplement , 831 mg/d , vs placebo drink , 41 mg/d ) on bones were examined in 36 postmenopausal women ( 60.2 + /- 6.5 y ) .  Trabecular bone-mineral density ( BMD ) of the lumbar spine ( L1-L3 ) , measured by computed tomography , increased by 0.5 % in exercising women ( n = 18 ) and decreased by 7.0 % in sedentary women ( n = 18 ; P = 0.02 ) . Femoral-neck BMD measured by dual-photon absorptiometry ( DPA ) increased by 2.0 % in women consuming high dietary calcium ( n = 18 ) and decreased by 1.1 % in those on moderate calcium intake ( n = 18 ; P = 0.001 ) . Neither exercise nor  dietary calcium  had an effect on lumbar spine ( L2-L4 ) measured by DPA , distal radius measured by single-photon absorptiometry , or total body calcium measured by in vivo neutron activation . The varying proportions and rates of turnover of trabecular and cortical bone from one site to another suggest that exercise and high dietary calcium may preferentially alter bone density at different skeletal sites Background Limited information is available on ways to influence osteoporosis risk in premenopausal women . This study tested four hypotheses regarding the effects of individualized bone density ( BMD ) feedback and different educational interventions on osteoporosis preventive behavior and BMD in pre-menopausal women , namely : that women are more likely to change calcium intake and physical activity if their BMD is low ; that group education will be more efficacious at changing behavior than an information leaflet ; that BMD feedback and group education have independent effects on behavior and BMD ; and , that women who improve their physical activity or calcium intake will have a change in bone mass over 2 years that is better than those who do not alter their behavior . Methods We performed a 2-year r and omized controlled trial of BMD feedback according to T-score and either an osteoporosis information leaflet or small group education in a population -based r and om sample of 470 healthy women aged 25–44 years ( response rate 64 % ) . Main outcome measures were dietary calcium intake , calcium supplement use , smoking behavior , physical activity , endurance fitness , lower limb strength and BMD . We used paired t-tests , one-way ANOVA and linear regression techniques for data analysis . Results Women who had feedback of low BMD had a greater increase in femoral neck BMD than those with normal BMD ( 1.6 % p.a . vs. 0.7 % p.a . , p = 0.0001 ) , but there was no difference in lumbar spine BMD change between these groups ( 0.1 % p.a . vs. 0.08 % p.a . , p = 0.9 ) . Both educational interventions had similar increases in femoral neck BMD ( Leaflet = + 1.0 % p.a . , Osteoporosis self-management course = + 1.3 % p.a . , p = 0.4 ) . Femoral neck BMD change was only significantly associated with starting calcium supplements ( 1.3 % p.a , 95%CI + 0.49 , + 2.17 ) and persistent self-reported change in physical activity levels ( 0.7 % p.a . , 95%CI + 0.22 , + 1.22 ) . Conclusion Individualized BMD feedback combined with a minimal educational intervention is effective at increasing hip but not spine bone density in premenopausal women . The changes in behavior through which this was mediated are potentially important in the prevention of other diseases , thus measuring BMD at a young age may have substantial public health benefits , particularly if these changes are sustained High calcium intake combined with physical activity during childhood have been shown to improve bone mass accrual and bone mineral density . Our aim was to study the combined effect of calcium and exercise on  bone gain in children . Two milk-powder products containing either 800 mg of calcium phosphate ( calcium ) or not ( placebo ) were r and omly allocated to 113 healthy premenarchal girls on a daily basis for 1 year . The group was composed of 63 exercise ( 7.2 + /- 4 hours of exercise/week ) and 50 sedentary ( 1.2 + /- 0.8 hours of exercise/week ) children . The final experiment had 4 groups : exercise/calcium ( n = 12 ) , exercise/placebo ( n = 42 ) , sedentary/calcium ( n = 10 ) , and sedentary/placebo ( n = 21 ) . Bone mineral density ( BMD ) at 6 skeletal sites and body composition were determined by DXA . Bone age was calculated and the daily spontaneous calcium intake was assessed by a frequency question naire . All the tests were performed at baseline and 1 year by the same observer . BMD gains were significantly greater in the exercise/calcium group than in other groups at the total body ( increase of 6.3 % , p < 0.05 ) , lumbar spine ( 11 % , p < 0.05 ) , femoral neck ( 8.2 % , p < 0.02 ) , and Ward 's triangle ( 9.3 % , p < 0.01 ) . There was no difference between the other groups . These data suggest that calcium supplementation increases the effect of physical exercise on bone mineral acquisition in the period preceding puberty , and that calcium supplementation without physical activity does not improve the BMD acquisition during this period . Physical exercise that stimulates bone accretion needs a high calcium intake to be completely effective BACKGROUND Our r and omized , placebo-controlled supplementation study of 160 rural Gambian children aged 8.3 - 11.9 y showed that an increase in calcium intake of 714 mg/d for 12 mo result ed in a 5 % increase in forearm bone mineral acquisition and a 22 % decrease in plasma osteocalcin concentration , a bone formation marker , but had no effect on height or bone dimensions . OBJECTIVE We investigated whether these results were sustained after supplement withdrawal . DESIGN All participants were followed up 12 ( FU1 ) and 24 ( FU2 ) mo after supplementation ended . Bone mineral content ( BMC ) , bone mineral density ( BMD ) , and BMC adjusted for bone width , body weight , and height ( size-adjusted BMC ) were measured at the midshaft and distal radius . Plasma osteocalcin concentration was measured at FU1 . RESULTS At follow-up , the calcium group had greater bone mineral status than did the placebo group at the midshaft radius ( mean difference + /- SE ) , FU1 : BMC ( 4.7 + /- 1.6 % ; P = 0.004 ) , BMD ( 5.1 + /- 1.1 % ; P < /= 0.0001 ) , size-adjusted BMC ( 5.0 + /- 1.1 % ; P < /= 0.0001 ) ; FU2 : BMC ( 3.8 + /- 1.6 % ; P = 0.02 ) , BMD ( 2.7 + /- 1.3 % ; P = 0.04 ) , size-adjusted BMC ( 2.5 + /- 1.3 % ; P = 0.06 ) . Similar differentials were observed at the distal radius but were not significant . No significant differences in plasma osteocalcin concentrations ( FU1 : -0.5 + /- 6.5 % ; P = 0.9 ) were observed between groups . CONCLUSION Although some of the effects of calcium supplementation were still evident at follow-up , further studies are required to determine whether short-term increases in calcium intake have lasting benefits for Gambian children Background Vitamin D insufficiency in children may have long-term skeletal consequences as vitamin D affects calcium absorption , bone mineralization and bone mass attainment . Methodology /Principal Findings This school-based study investigated vitamin D status and its association with vitamin D intake and bone health in 195 Finnish children and adolescents ( age range 7–19 years ) . Clinical characteristics , physical activity and dietary vitamin D intake were evaluated . Blood and urine sample s were collected for serum 25-hydroxyvitamin D ( 25-OHD ) and other parameters of calcium homeostasis . Bone mineral density ( BMD ) and body composition were measured with dual-energy X-ray absorptiometry ( DXA ) . Altogether 71 % of the subjects were vitamin D insufficient ( 25-OHD < 50 nmol/L ) . The median 25-OHD was 41 nmol/L for girls and 45 nmol/L for boys , and the respective median vitamin D intakes 9.1 µg/day and 10 µg/day . In regression analysis , after adjusting for relevant factors , 25-OHD concentration explained 5.6 % of the variance in lumbar BMD ; 25-OHD and exercise together explained 7.6 % of the variance in total hip BMD and 17 % of the variance in whole body BMD . S-25-OHD was an independent determinant of lumbar spine and whole body BMD and in magnitude surpassed the effects of physical activity . Conclusions / Significance Vitamin D insufficiency was common even when vitamin D intake exceeded the recommended daily intake . Vitamin D status was a key determinant of BMD . The findings suggest urgent need to increase vitamin D intake to optimize bone health in children BACKGROUND Increased vitamin D intake may preserve or increase bone mineral density ( BMD ) in older persons . OBJECTIVE A 2-y double-blind study was undertaken to determine whether weekly administration of 10 000 units of vitamin D(2 ) maintained or increased BMD in younger postmenopausal women more efficiently than did calcium supplements alone . DESIGN One hundred eighty-seven women who were > or= 1 y postmenopausal were r and omly assigned to take either 1000 mg Ca/d after the evening meal or 1000 mg Ca/d plus 10 000 U vitamin D(2)/wk in a double-blind , placebo-controlled format . The BMD of the proximal forearm , lumbar spine , femoral neck , Ward 's triangle , and femoral trochanter was measured at 6-mo intervals by osteodensitometry . RESULTS During the 2-y period , there was no significant difference in the change in BMD at any site between the subjects taking calcium supplements and those taking calcium plus vitamin D(2 ) . Both groups significantly ( P < 0.005 ) gained BMD in Ward 's triangle and the femoral trochanter but significantly ( P < 0.005 ) lost bone in the proximal radius . There was no significant change in the lumbar spine or femoral neck BMD . CONCLUSION In younger postmenopausal women ( age : 56 y ) whose average baseline serum 25-hydroxyvitamin D concentration was well within the normal range , the addition of 10 000 U vitamin D(2)/wk to calcium supplementation at 1000 mg/d did not confer benefits on BMD beyond those achieved with calcium supplementation alone BACKGROUND There is no consistent evidence , to our knowledge , that calcium supplementation affects  bone mineral density ( BMD ) in men , despite male osteoporosis being a common clinical problem . METHODS To determine the effects of calcium supplementation ( 600 mg/d , 1200 mg/d , or placebo ) on BMD in men , we conducted a double-blind , r and omized controlled trial for a 2-year period at an academic clinical research center . A total of 323 healthy men at least 40 years old ( mean age , 57 years ) were recruited by newspaper advertisement . Complete follow-up was achieved in 96 % of subjects . RESULTS The BMD increased at all sites in the group receiving calcium , 1200 mg/d , by 1 % to 1.5 % more than those receiving placebo . The results for the group receiving calcium , 600 mg/d , were not different from the placebo group at any BMD site . There was no interaction between the BMD treatment effect and either age or dietary calcium intake . There were dosage-related , sustained decreases in serum parathyroid hormone ( P < .001 ) , total alkaline phosphatase activity ( P = .01 ) , and procollagen type 1 N-terminal propeptide ( P < .001 ) amounting to 25 % , 8 % , and 20 % , respectively , in the group receiving calcium , 1200 mg/d , at 2 years . Tooth loss , constipation , and cramps were unaffected by calcium supplementation , falls tended to be less frequent in the group receiving calcium , 1200 mg/d , but vascular events tended to be more common in the groups receiving calcium vs the group receiving placebo . CONCLUSION Calcium , 1200 mg/d , has effects on BMD in men comparable with those found in postmenopausal women but a dosage of 600 mg/d is ineffective for treating BMD . TRIAL REGISTRATION actr.org.au Identifier : 012605000274673 BACKGROUND The role of dietary protein in bone metabolism is controversial . OBJECTIVE We investigated the associations of dietary protein intake with baseline bone mineral density ( BMD ) and the rate of bone loss over 3 y in postmenopausal elderly women . DESIGN Women aged 65 - 77 y ( n = 489 ) were enrolled in an osteoporosis intervention trial . We studied the associations of protein intake as a percentage of energy with baseline BMD and the rate of bone loss in 96 women in the placebo group ( n = 96 ) . We also examined the effect of the interaction of dietary  calcium  intake with protein intake on BMD . RESULTS In the cross-sectional study , a higher intake of protein was associated with higher BMD . BMD was significantly higher ( P < 0.05 ) in the spine ( 7 % ) , midradius ( 6 % ) , and total body ( 5 % ) in subjects in the highest quartile of protein intake than in those in the lower 2 quartiles . This positive association was seen in women with calcium intakes > 408 mg/d . There was no significant effect of protein intake on hip BMD . In the longitudinal study of the placebo group , there was no association between protein intake and the rate of bone loss . CONCLUSIONS The highest quartile of protein intake (: 72 g/d ) was associated with higher BMD  in elderly women at baseline only when the calcium intake exceeded 408 mg/d . In the longitudinal study , no association was seen between protein intake and the rate of bone loss , perhaps because the sample size was too small or the follow-up period of 3 y was not long enough to detect changes Much existing data on the effects of calcium or milk products on bone mineral accretion are based on bone mineral content ( BMC ) or areal bone mineral density ( aBMD ) , neither of which accounts for changing bone size during the growing period . The aim of this study was to investigate the effects of 2-year milk supplementation on total body size-corrected BMD in Chinese girls with low habitual dietary calcium intake . Chinese girls aged 10 years were r and omised , according to their school , to receive calcium fortified milk ( Ca milk ) , or calcium and vitamin D fortified milk ( CaD milk ) for two years or act as unsupplemented controls . Dual-energy X-ray absorptiometry  total body bone measures were obtained from 345 girls at baseline and 2 years . Size-corrected total body and regional BMD was calculated as : BMDsc = BMC /BApc , where pc was the regression coefficient of the natural logarithm transformed total body BMC and bone area . After 2 years , both supplemented groups had significantly greater gain in BMDsc of total body ( 3.5 - 5.8 % , p < 0.05 ) and legs ( 3.0 - 5.9 % , p < 0.05 ) than did the control group . Milk supplementation showed positive effects on bone mineral accretion when accounting for the changing skeletal size during growth . The effects were mainly on the lower limbs The aim of the current study was to examine whether calcium supplementation could prevent bone loss in postmenopausal women or more favourable outcomes could be obtained via the consumption of dairy products fortified with calcium and vitamin D3 . For this purpose changes in bone mineral density ( BMD ) at different skeletal sites , assessed by dual-energy X-ray absorptiometry , as well as in quantitative ultrasound ( QUS ) parameters of the calcaneus over 12 months were estimated . A population of 101 postmenopausal women ( 55 - 65 years old ) was r and omized into a dairy group ( DG : n 39 ) , receiving approximately 1200 mg calcium/d and 7.5 microg vitamin D3/d through fortified dairy products ; a calcium-supplemented group ( CaG : n 26 ) provided with a calcium supplement of 600 mg/d ; and a control group ( CG : n 36 ) . Over the intervention period the DG was found to have more favourable changes in pelvis ( P=0.040 ) , total spine ( P<0.001 ) and total body BMD ( P<0.001 ) than the other groups . A significant increase was also observed for DG in lumbar spine BMD ( 2.0 % ; 95 % CI 0.5 , 3.5 ) although it did not differentiate significantly compared to the other groups . No significant differences were observed with respect to the changes in QUS parameters . The current study revealed that recommended intakes of vitamin D3 and calcium via fortified dairy products for 12 months can induce favourable changes in pelvis , total spine and total body BMD in postmenopausal women but not in QUS parameters . No such favourable changes were observed via supplementation of calcium alone OBJECTIVE To study the effect of calcium supplementation with dairy products on the bone and body composition of pubertal girls . DESIGN R and omized control study with 12-month follow-up . SETTING General community . SUBJECTS Forty-eight white girls whose mean age was 11 years and sexual development at Tanner stage 2 . INTERVENTION One group 's diet was supplemented with dairy products to the recommended dietary allowance of 1200 mg calcium daily . The other group ate their usual diet . MAIN OUTCOME MEASURES Bone mineral content and density were measured at the radius , femoral neck , lumbar spine , and total body bone mineral by single-photon and dual-energy x-ray absorptiometry at the start of the study and after 3 , 6 , 9 , and 12 months . Body composition ( lean body mass and body fat ) was measured by dual-energy x-ray absorptiometry at the same intervals . Serum calcium , phosphate , 25-hydroxyvitamin D , 1,25-dihydroxyvitamin D , alkaline phosphatase , magnesium , and albumin concentrations were determined at the start and end of the study . The urinary calcium/creatinine ratio and hydroxyproline concentration were also determined . RESULTS The dairy group had higher intakes of calcium , phosphate , vitamin D , and protein than control subjects . The dairy group had significantly greater increases during the 1-year study in bone mineral density at the lumbar spine bones ( 22.8 % + /- 6.9 % vs 12.9 % + /- 8.3 % ) and in total body bone mineral ( 14.2 % + /- 7.0 % vs 7.6 % + /- 6.0 % ) than control subjects . Dietary calcium , phosphate , vitamin D , and protein intakes were associated with the lumbar bone density and total body bone calcium . There were no differences in serum or urinary biochemical values between the two groups at the start or end of the study . CONCLUSIONS Young girls whose dietary calcium intake was provided primarily by dairy products at or above the recommended dietary allowances had an increased rate of bone mineralization . Increased intake of dairy foods did not increase overall total or saturated fat intake and was not associated with excessive weight gain or increased body fat Elderly women are at increased risk for bone loss and fractures . In previous cross-sectional and longitudinal studies of women residing in northern latitudes , bone loss was most pronounced during winter months and in those consuming less than 1 g calcium per day . In this study we sought to test the hypothesis that calcium supplementation by either calcium carbonate or dietary means would prevent seasonal bone loss and preserve bone mass . Sixty older postmenopausal women without osteoporosis were r and omized to one of three treatment arms : Dietary milk supplementation ( D-4 glasses of milk/day ) , Calcium carbonate ( CaCO3 - 1000 mg/day in two divided doses ) , or placebo ( P ) . After 2 yr , placebo-treated women consumed a mean of 683 mg/day of calcium and lost 3.0 % of their greater trochanteric ( GT ) bone mineral density ( BMD ) ( P < 0.03 vs. baseline ) ; Dietary supplemented women averaged a calcium intake of 1028 mg/day and sustained minimal loss from the GT ( -1.5 % ; P = 0.30 ) , whereas CaCO3-treated women ( total Ca intake , 1633 mg/day ) suffered no bone loss from the GT and showed a significant increase in spinal and femoral neck BMD ( P < 0.05 ) . Femoral bone loss occurred exclusively during the two winters of the study ( i.e. total loss , -3.2 % ; P < 0.02 in placebo-treated women ) with virtually no change in GT BMD during summer . Serum 25-OH vitamin D declined by more than 20 % ( P < 0.001 ) in all groups during the winter months but returned to baseline in summer ; PTH levels rose approximately 20 % ( P < 0.001 ) during winter but did not return to baseline during the summers . Urine N-telopeptide and osteocalcin levels increased significantly but only in the P-treated women and only during winter . Serum insulin growth factor binding protein 4 , an inhibitory insulin growth factor binding protein , rose 15 % ( P < 0.03 ) from summer to winter , but this increase was significant only in those women consuming < 1000 mg/day of calcium . By multivariate analysis , total calcium intake was the strongest predictor of bone loss from the hip . Urinary N-telopeptide also closely correlated with GT BMD but only during winter ( P = 0.003 ) . We conclude that calcium supplementation prevents bone loss  in elderly women by suppressing bone turnover during the winter when serum 25-OH vitamin D declines and serum PTH increases . The precise amount of calcium necessary to preserve BMD in elderly women requires further studies , although in this study , at least 1000 mg/day of supplemental calcium was adequate prophylaxis against femoral bone loss BACKGROUND Increased dietary intake of calcium during childhood , usually as calcium in milk , is associated with increased bone mass in adulthood ; the increase in mass is important in modifying the later risk of fracture . Whether the increase is due to the calcium content of milk , however , is not certain . METHODS We conducted a three-year , double-blind , placebo-controlled trial of the effect of calcium supplementation ( 1000 mg of calcium citrate malate per day ) on bone mineral density in 70 pairs of identical twins ( mean [ + /- SD ] age , 10 + /- 2 years ; range , 6 to 14 ) . In each pair , one twin served as a control for the other ; 45 pairs completed the study .  Bone mineral density was measured by photon absorptiometry at two sites in the radius ( at base line , six months , and one , two , and three years ) and at three sites in the hip and in the spine ( at base line and three years ) . RESULTS The mean daily calcium intake of the twins given placebo was 908 mg , and that of the twins given calcium supplements was 1612 mg ( 894 mg from the diet and 718 mg from the supplement ) . Among the 22 twin pairs who were prepubertal throughout the study , the twins given supplements had significantly greater increases in bone mineral density at both radial sites ( mean difference in the increase in bone mineral density : midshaft radius , 5.1 percent [ 95 percent confidence interval , 1.5 to 8.7 percent ] ; distal radius , 3.8 percent [ 95 percent confidence interval , 1.4 to 6.2 percent ] ) and in the lumbar spine ( increase , 2.8 percent [ 95 percent confidence interval , 1.1 to 4.5 percent ] ) after three years ; the differences in the increases at two of three femoral sites approached significance ( Ward 's triangle in the femoral neck , 2.9 percent ; greater trochanter , 3.5 percent ) . Among the 23 pairs who went through puberty or were postpubertal , the twins given supplements received no benefit . CONCLUSIONS In prepubertal children whose average dietary intake of calcium approximated the recommended dietary allowance , calcium supplementation increased the rate of increase in bone mineral density . If the gain persists , peak bone density should be increased and the risk of fracture reduced A significant relationship between body weight ( BW ) and bone mass ( BM ) has been established previously . A diet-induced weight loss is accompanied by a significant decrease in bone mineral density ( BMD ) and total body bone mineral ( TBBM ) , but the underlying mechanisms are not clarified . Sixty-two obese women were included in the study .  Dual-energy X-ray absorptiometry ( DXA ) and measurements of a series of calcium-regulating hormones and biochemical markers of bone turnover were performed at baseline and after 1 month and 3 months on a low calorie diet . Thirty of the women were r and omized to a daily supplement of 1 g of calcium . After an additional 3 months without dietary prescriptions or calcium supplements , a subgroup of 48 subjects ( 24 from each group ) were scanned again using DXA . There was a significant decrease in TBBM after 1 month and 3 months . A similar pattern was observed in the bone mineral content ( BMC ) of the lumbar spine in the patients who did not receive a calcium supplement , whereas no changes occurred in the supplemented group . The initial calcium supplementation seemed to protect against bone loss in the lumbar spine but not in the TBBM . In the nonsupplemented group , a statistically significant inverse correlation was found between the calcium/creatinine ratio in the morning urine and the changes in BMC of the lumbar spine . Such a relationship was not seen in the calcium-supplemented group . In the nonsupplemented group , no significant biochemical changes were observed , whereas a significant decrease in serum parathyroid hormone ( PTH ) was seen in the calcium-supplemented group . This might explain some of the protective effects of calcium supplementation on trabecular bone mass . We conclude that a diet-induced weight loss is accompanied by a generalized bone loss , which probably is explained mainly by a reduced mechanical strain on the skeleton . This loss can be partly inhibited by a high calcium intake . Therefore , a calcium supplementation should be recommended during weight loss , even if the diet contains the officially recommended amounts of calcium BACKGROUND The use of calcium supplements slows bone loss in the forearm and has a beneficial effect on the axial bone density of women in late menopause whose calcium intake is less than 400 mg per day . However , the effect of a calcium supplement of 1000 mg per day on the axial bone density of postmenopausal women with higher calcium intakes is not known . METHODS We studied 122 normal women at least three years after they had reached menopause who had a mean dietary calcium intake of 750 mg per day . The women were r and omly assigned to treatment with either calcium ( 1000 mg per day ) or placebo for two years . The bone mineral density of the total body , lumbar spine , and proximal femur was measured every six months by dual-energy x-ray absorptiometry .  Serum and urine indexes of calcium metabolism were measured at base line and after 3 , 12 , and 24 months . RESULTS The mean ( + /- SE ) rate of loss of total-body bone mineral density was reduced by 43 percent in the calcium group ( -0.0055 + /- 0.0010 g per square centimeter per year ) as compared with the placebo group ( -0.0097 + /- 0.0010 g per square centimeter per year , P = 0.005 ) . The rate of loss of bone mineral density was reduced by 35 percent in the legs ( P = 0.02 ) , and loss was eliminated in the trunk ( P = 0.04 ) . Calcium use was of significant benefit in the lumbar spine ( P = 0.04 ) , and in Ward 's triangle the rate of loss was reduced by 67 percent ( P = 0.04 ) . Calcium supplementation had a similar effect whether dietary calcium intake was above or below the mean value for the group . Serum parathyroid hormone concentrations tended to be lower in the calcium group , as were urinary hydroxyproline excretion and serum alkaline phosphatase concentrations . CONCLUSIONS Calcium supplementation significantly slowed axial and appendicular bone loss in normal post-menopausal women Childhood and adolescence is the period of most rapid skeletal growth in an individual 's lifetime . A greater peak bone mass achieved in the first 2 - 3 decades of life , may protect against the risk of osteoporotic fracture in later life . The aim of this r and omized , controlled study was to assess in pre-pubertal boys and girls ( aged 8 - 10 years ) the effect of 18 months of a calcium enriched , cocoa flavoured product on bone density , bone growth and bone size in New Zeal and children . One hundred and fifty four pre-pubertal boys and girls ( aged 8 - 10 years ) were r and omized to receive a high calcium dairy drink or a control drink reconstituted with water for 18 months . They were assessed at baseline and then every 6 months for the first 18 months , while they were having the supplement ; they were then followed up 12 months after supplementation had finished . Bone mineral density and bone mineral content were assessed at the total body , hip and spine . Indicators of bone size ( vertebral width and height ) were also measured at the spine . Anthropometric data was collected , medical history question naires were administered ( including the Tanner or pubertal stage question naire ) , dietary calcium intake was assessed with a calcium food frequency question naire and calcium supplement compliance was determined . There was no significant difference between the 2 groups for bone mineral density or bone mineral content at any time point . There was no difference in vertebral height or width at any stage of the study , indicating no additional influence on bone size at the lumbar vertebrae . There were no significant differences between height , weight , lean mass or fat mass at any time point . Both groups had higher habitual calcium intakes than recommended for this age group going into the study and throughout the study . In this 2(1/2 ) year study ( 18 months supplementation , 1 year follow-up ) we did not observe a difference in bone mineral density in pre-pubertal children . This was probably due to their high habitual dietary calcium intake whereby minimal addition of calcium to the diet reached the threshold level where no further benefit was seen . There were no significant differences between the two groups in body composition . Growth and the mean height and weight remained between the 50th and 75th percentile for their age . We have shown calcium supplementation in children with high habitual dietary calcium intake appears not to have additional effects on bone mass . Calcium supplementation needs to be targeted in those children with low habitual dietary calcium intake The effect of calcium supplementation on bone mineral density ( BMD ) was evaluated in female twin pairs aged 10–17 years with a mean age of 14 years . Forty-two twin pairs ( 22 monozygotic , 20 dizygotic ; ( including one monozygotic pair from a set of triplets ) completed at least 6 months of the intervention : 37 pairs to 12 months and 28 pairs to 18 months . BMD was measured by dual-energy X-ray absorptiometry ( DXA ) . In a double-blind manner , one twin in each pair was r and omly assigned to receive daily a 1000 mg effervescent calcium tablet ( S and ocal 1000 ) , and the other a placebo tablet similar in taste and appearance to the calcium supplement but containing no calcium .  Compliance ( at least 80 % tablets consumed ) , as measured by tablet count , was 85 % in the placebo group and 83 % in the calcium group over the 18 months of the study , on average increasing dietary calcium to over 1600 mg/day . There was no within-pair difference in the change in height or weight . When the effect of calcium supplementation  on BMD was compared with placebo at approximately 6 , 12 and 18 months , it was found that there was a 0.015±0.007 g/ cm2 greater increase in BMD ( 1.62±0.84 % ) at the spine in those on calcium after 18 months . At the end of the first 6 months there was a significant within-pair difference of 1.53±0.56 % at the spine and 1.27±0.50 % at the hip . However , there were no significant differences in the changes in BMD after the initial effect over the first 6 months . Therefore , we found an increase in BMD at the spine  with calcium supplementation in females with a mean age of 14 years . The greatest effect was seen in the first 6 months ; thereafter the difference was maintained , but there was no accelerated increase in BMD  associated with calcium supplementation . The continuance of the intervention until the attainment of peak bone mass and follow-up after cessation of calcium supplementation will be important in clarifying the optimal timing for increased dietary calcium and the sustained , long-term effects of this intervention CONTEXT It is estimated that 80 % of all women have used oral contraceptives ( OCP ) , but OCP use may prevent attainment of maximal peak bone mass in young women and thus increase the risk of osteoporosis later in life . OBJECTIVE This study examined whether increased calcium intake could reduce the detrimental effects of OCP use on bone mass in young women . DESIGN The study design was a 1-yr intervention . SETTING The study was performed in a general community setting . SUBJECTS One hundred fifty-four young ( 18 - 30 yr old ) healthy women with a dietary calcium intake of less than 800 mg/d began the study , and 135 completed the trial . INTERVENTION Subjects were r and omly assigned to one of three diet intervention groups : 1 ) control , continuous established ( < 800 mg/d ) dietary calcium intake ; 2 ) medium dairy , increase calcium intake to approximately 1000 - 1100 mg/d ; and 3 ) high dairy , increase calcium intake to approximately 1200 - 1300 mg/d . R and omization was stratified by OCP use . MAIN OUTCOME MEASURES The main outcome measures were total body bone mineral density ( BMD ) and content ( BMC ) ; total hip BMD , BMC , and bone area ; and spine BMD , BMC , and bone area . RESULTS Dairy product intervention positively impacted the percentage change in total hip BMD and BMC . In addition , dairy product intake prevented a negative percentage change in total hip and spine BMD in OCP users . CONCLUSION Dairy product intake , at levels necessary to achieve the recommended intakes of calcium , protected the total hip BMD and spine BMD from loss observed in young healthy women with low calcium intakes who were using OCP Background : Mobilization of maternal bone mineral partly supplies calcium for fetal and neonatal bone growth and development . Objective : We investigated whether pregnant women with low calcium intakes may have a more extensive skeletal response postpartum that may compromise their short- or long-term bone health . Design : In a subset of participants ( n = 125 ) in a double-blind , r and omized , placebo-controlled trial ( International Trial Registry : IS RCT N96502494 ) in pregnant women in The Gambia , West Africa , with low calcium intakes ( ≈350 mg Ca/d ) , we measured bone mineral status of the whole body , lumbar spine , and hip by using dual-energy X-ray absorptiometry and measured bone mineral status of the forearm by using single-photon absorptiometry at 2 , 13 , and 52 wk lactation . We collected blood and urine from the subjects at 20 wk gestation and at 13 wk postpartum . Participants received calcium carbonate ( 1500 mg Ca/d ) or a matching placebo from 20 wk gestation to parturition ; participants did not consume supplements during lactation . Results : Women who received the calcium supplement in pregnancy had significantly lower bone mineral content ( BMC ) , bone area ( BA ) , and bone mineral density ( BMD ) at the hip throughout 12 mo lactation ( mean ± SE difference : BMC = −10.7 ± 3.7 % , P = 0.005 ; BA = −3.8 ± 1.9 % , P = 0.05 ; BMD = −6.9 ± 2.6 % , P = 0.01 ) . The women also experienced greater decreases in bone mineral during lactation at the lumbar spine and distal radius and had biochemical changes consistent with greater bone mineral mobilization . Conclusions : Calcium supplementation  in pregnant women with low calcium intakes may disrupt metabolic adaptation and may not benefit maternal bone health . Further study is required to determine if such effects persist long term or elicit compensatory changes in bone structure The focus of this prospect i ve , observational study was to determine the effect of sport-specific training and calcium intake on bone mineral density ( BMD ) in female master cyclists , runners and non-athletes . Thirty women ( 12 cyclists , 9 runners , 9 controls ) , mean age of 49.6 + /- 7.9 years , were assessed at baseline and 18 months for calcium intake ( 4-day records ) , current exercise activity ( recall question naire ) , and BMD of the lumbar spine and hip ( DXA ) . A three ( cyclists , runners , controls ) by two ( 0 and 18 months ) repeated measures ANOVA demonstrated a significant interaction effect of sport and time at the femoral neck ( p < .04 ) . Tukey post hoc analysis indicated that the BMD of the femur was maintained in cyclists and runners but declined in controls ( p < .05 ) . A significant time effect was noted in BMD at the lumbar spine ( p < . 001 ) and the trochanter ( p < .003 ) . BMD of the lumbar spine was maintained in runners but declined in cyclists ( p < .007 ) and in controls ( p < .03 ) , while trochanteric BMD declined in all groups ( p < .01 ) . No significant interaction effect of sport and dietary calcium intake was noted for BMD at any site A r and omized controlled trial was carried out to determine whether calcium supplementation and load-bearing exercise can increase or maintain bone mass in the elderly . Fifty Chinese women , aged 62–92 years , living in a hostel for the elderly in Hong Kong were r and omized to enter one of four treatment groups : ( I ) calcium supplementation of 800 mg ( as calcium lactate gluconate ) daily ; ( II ) load-bearing exercise four times a week plus a daily placebo tablet ; ( III ) calcium supplementation daily and load-bearing exercise four times a week ; ( IV ) a placebo tablet daily . The interventions went on for 10 months . The bone mineral density ( BMD ) was measured at three sites in the hip ( femoral neck , Ward 's triangle and intertrochanteric area ) and the L2–4 level of the spine . The percentage change in BMD in 10 months was used as the main outcome measurement . The parathyroid hormone level and indices of bone metabolism were also measured before and after 10 months of intervention . The BMD at Ward 's triangle and the intertrochanteric area increased significantly in subjects on calcium supplement ( p<0.05 ) , but there was no significant change at the spine and femoral neck . Exercise had no effect on bone loss at any site . However , the results of two-way analysis of variance showed a significant joint effect of calcium supplements and exercise  at the femoral neck ( p<0.05 ) , but not at the other sites . The parathyroid hormone levels fell significantly in subjects on calcium supplements (p<0.01).Calcium supplement in the form of calcium lactate gluconate was adequately absorbed in elderly Chinese women with a calcium intake of less than 300 mg per day . It was effective in reducing bone loss at the hip , and there may be interaction effects with exercise in maintaining bone density INTRODUCTION A high peak bone mass may be essential for reducing the risk of osteoporosis later in life and a sufficient vitamin D level during puberty may be necessary for optimal bone accretion and obtaining a high peak bone mass . Dietary intake and synthesis during winter of vitamin D might be limited but the effect of vitamin D supplementation in adolescence on bone mass is not well established . OBJECTIVE To investigate the effect of supplementation with 5 and 10 microg/day vitamin D(3 ) for 12 months in 11- to 12-year-old girls on  bone mass and bone turnover as well as the possible influence of VDR and ER genotype on the effect of the supplementation . METHODS The girls ( n=221 ) were r and omized to receive either 5 microg or 10 microg vitamin D(3 ) supplementation per day or placebo for 12 months . Whole body and lumbar spine bone mass measured by DXA and pubertal status were determined at baseline and after 12 months whereas physical activity and dietary intake of calcium and vitamin D were assessed at baseline . Serum ( S ) 25-hydroxyvitamin D ( 25OHD ) , S-osteocalcin , S-parathyroid hormone , S-calcium , S-inorganic phosphate , urinary ( U ) pyridinoline ( Pyr ) and deoxpyridinoline ( Dpyr ) were measured at baseline and after 6 and 12 months . RESULTS The S-25OHD concentration increased ( p<0.001 ) relative to the baseline values in the groups receiving either 5 microg/day ( mean+/-SD ; 11.0+/-10.3 nmol/l , baseline 41.9+/-17.6 nmol/l ) or 10 microg/day ( 13.3+/-11.8 nmol/l , baseline 44.4+/-16.6 nmol/l ) vitamin D(3 ) for 12 months compared to placebo ( -3.1+/-9.8 nmol/l , baseline 43.4+/-17.1 nmol/l ) . There was no effect of vitamin D-supplementation on biomarkers for bone turnover or on whole body or spine bone mineral augmentation . However , vitamin D supplementation increased whole body bone mineral density ( BMD ) ( p=0.007 ) and bone mineral content ( BMC ) ( p=0.048 ) in the FF VDR genotype but not in the Ff or ff VDR genotypes . CONCLUSION Supplementation with vitamin D ( 5 or 10 microg/day ) over 12 months increased the S-25OHD concentration but there was no effect on indices of bone health in the entire group of girls . However , there was an effect on BMD for a subgroup with the FF VDR genotype indicating an influence of genotype Summary This cross-sectional study showed that , although vegans had lower dietary calcium and protein intakes than omnivores , veganism did not have adverse effect on bone mineral density and did not alter body composition . Introduction Whether a lifelong vegetarian diet has any negative effect on bone health is a contentious issue . We undertook this study to examine the association between lifelong vegetarian diet and bone mineral density and body composition in a group of postmenopausal women . Methods One hundred and five Mahayana Buddhist nuns and 105 omnivorous women ( average age = 62 , range = 50–85 ) were r and omly sample d from monasteries in Ho Chi Minh City and invited to participate in the study . By religious rule , the nuns do not eat meat or seafood ( i.e. , vegans ) . Bone mineral density ( BMD ) at the lumbar spine ( LS ) , femoral neck ( FN ) , and whole body ( WB ) was measured by DXA ( Hologic QDR 4500 ) . Lean mass , fat mass , and percent fat mass were also obtained from the DXA whole body scan . Dietary calcium and protein intakes were estimated from a vali date d food frequency question naire . Results There was no significant difference between vegans and omnivores in LSBMD ( 0.74 ± 0.14 vs. 0.77 ± 0.14 g/cm2 ; mean ± SD ; P = 0.18 ) , FNBMD ( 0.62 ± 0.11 vs. 0.63 ± 0.11 g/cm2 ; P = 0.35 ) , WBBMD ( 0.88 ± 0.11 vs. 0.90 ± 0.12 g/cm2 ; P = 0.31 ) , lean mass ( 32 ± 5 vs. 33 ± 4 kg ; P = 0.47 ) , and fat mass ( 19 ± 5 vs. 19 ± 5 kg ; P = 0.77 ) either before or after adjusting for age . The prevalence of osteoporosis ( T scores ≤ −2.5 ) at the femoral neck in vegans and omnivores was 17.1 % and 14.3 % ( P = 0.57 ) , respectively . The median intake of dietary calcium was lower in vegans compared to omnivores ( 330 ± 205 vs. 682 ± 417 mg/day , P < 0.001 ) ; however , there was no significant correlation between dietary calcium and BMD . Further analysis suggested that whole body BMD , but not lumbar spine or femoral neck BMD , was positively correlated with the ratio of animal protein to vegetable protein . Conclusion These results suggest that , although vegans have much lower intakes of dietary calcium and protein than omnivores , veganism does not have adverse effect on bone mineral density and does not alter body composition Abstract : We undertook a double-masked , r and omized , placebo-controlled trial to evaluate the effect of a calcium and vitamin D supplement and a calcium supplement plus multivitamins on bone loss at the hip , spine and forearm . The study was performed in 240 healthy women , 58–67 years of age . Duration of treatment was 2 years . Bone mineral density ( BMD ) was measured at the lumbar spine , hip and forearm . A dietary question naire was administered twice during the study and revealed a fairly good calcium and vitamin D intake ( 919 mg calcium/day ; 3.8 mg vitamin D/day ) . An increase in lumbar spine BMD of 1.6 % was observed in the treatment group after 2 years ( p50.002 ) . In the placebo group no significant changes were observed during the 2 years . Lumbar spine BMD was significantly higher in the treatment group at both 1 ( p50.01 ) and 2 years ( p50.05 ) compared with the placebo group . Though not significant , the same trend was seen at the hip . No significant changes from baseline values were observed at the distal forearm in either the treatment or the placebo group . In conclusion , we found a significant increase in urinary calcium excretion in the treatment group compared with the placebo group . Together with significant changes in serum calcium and serum parathyroid hormone , this indicates that a long-term calcium and vitamin supplement of 1 g elementary calcium ( calcium carbonate ) and 14 mg vitamin D3 increases intestinal calcium absorption . A positive effect on BMD was demonstrated , even in a group of early postmenopausal age , with a fairly good initial calcium and vitamin D status Osteoporosis is a significant health problem and contributor to disability and premature mortality among older men . Incidence rates for hip fracture have stabilized in women , but continue to increase in men . A major risk factor for hip fracture is bone mineral density level . The determinants of bone mineral density ( BMD ) are well defined in women , but not in men . The primary goal of the current research was to increase our underst and ing of the determinants of BMD of the proximal femur in a large community-based sample of older male volunteers . Eligibility requirements included age of 50 years or older , ambulatory , and not having undergone a bilateral hip replacement . Five hundred twenty-three men , mean mean age 66.6 years , met all eligibility requirements and participated in the Study of Osteoporotic Risk in Men or STORM . Information on demographics , medical history , anthropometry , leisure-time and occupational physical activity , muscular strength , cigarette smoking , alcohol consumption , dietary calcium intake , and medication use ( thiazide diuretics and glucocorticoids ) were obtained by question naire , interview , and examination , BMD of the proximal femur ( femoral neck , greater trochanter , and Ward 's triangle ) was measured by dual-energy X-ray absorptiometry using the Hologic QDR-1000 and QDR-2000 . The cross-sectional determinants of BMD included age , blond hair color , current body weight , thiazide diuretic use , historical physical activity , and quadriceps strength . Several variables commonly thought to be determinants of BMD were not related to BMD in this population of older men , including current cigarette smoking , alcohol consumption , current leisure-time physical activity , dietary calcium intake , vitamin D use , and caffeine intake . However , failure to find associations among BMD and some of the potential determinants may be due to lack of statistical power . Identification of the determinants of BMD could lead to the development of interventions aim ed at maximizing BMD in men and could potentially decrease the risk of hip fractures BACKGROUND Pregnancy and lactation in adolescents with habitually low calcium intake may adversely affect maternal bone mass . OBJECTIVE We investigated the effect of calcium plus vitamin D supplementation during pregnancy on bone mass during lactation in Brazilian adolescent mothers with low-calcium diets ( ∼600 mg/d ) . DESIGN Pregnant adolescents ( 14 - 19 y ) r and omly received daily calcium ( 600 mg ) plus vitamin D3 ( 200 IU ) ( n = 30 ) or a placebo ( n = 26 ) from 26 wk of pregnancy ( baseline ) until parturition . The bone mineral content ( BMC ) , bone area ( BA ) , and bone mineral density ( BMD ) at the total body , lumbar spine , and hip ( total and femoral neck ) were evaluated by using dual-energy X-ray absorptiometry at 5 and 20 wk postpartum . Serum hormones and 25-hydroxyvitamin D [ 25(OH)D ] were measured . Group comparisons were adjusted for significant covariates . RESULTS The mean serum 25(OH)D concentration was 59 nmol/L at baseline . In comparison with the placebo , 25(OH)D tended to be 14 - 15 nmol/L higher postpartum in the supplemented group ( P = 0.08 ) . Total body and hip BMC and BMD decreased over time ( P ≤ 0.005 ) in both groups with a group × time interaction at the femoral neck ( P < 0.04 ) . Supplemented mothers had higher lumbar spine BA ( 6.7 % ; P = 0.002 ) and lumbar spine BMC ( 7.9 % , P = 0.08 ) than did mothers who consumed the placebo at 5 wk postpartum . At 20 wk postpartum , differences between groups were more evident , with higher lumbar spine BMC ( 13.9 % ) , lumbar spine BA ( 6.2 % ) , and lumbar spine BMD ( 10.6 % ) in the supplemented group ( P ≤ 0.008 ) . CONCLUSIONS Calcium plus vitamin D supplementation during pregnancy of adolescents with low calcium intake  results in higher lumbar spine bone mass and a reduced rate of femoral neck bone loss during lactation . Additional studies are required to determine whether bone effects are temporary or long-lasting . This trial was registered at clinical trials.gov as NCT01732328 OBJECTIVE To assess the prevalence of osteoporosis in healthy ambulatory postmenopausal Indian women as measured by dual-energy x-ray absorptiometry and to study the dietary calcium intake and vitamin D status and their influence on bone mineral density ( BMD ) . METHODS We conducted a community-based cross-sectional study in a semiurban region . A r and omized cluster sampling technique was used . The study cohort consisted of 150 ambulatory postmenopausal women ( > or = 50 years old ) .  Dual-energy x-ray absorptiometry for BMD was performed at the lumbar spine and femoral neck . Dietary calcium intake and biochemical variables were assessed . RESULTS The prevalence of osteoporosis was 48 % at the lumbar spine , 16.7 % at the femoral neck , and 50 % at any site . The mean dietary calcium intake was much lower than the recommended intake for this age-group . There was a significant positive correlation between body mass index and BMD at the lumbar spine and the femoral neck ( r = 0.4 ; P = .0001 ) . BMD at the femoral neck was significantly less ( mean , 0.657 versus 0.694 g/cm(2 ) ) in the vitamin D-insufficient study subjects in comparison with the vitamin D-sufficient women ( P = .03 ) . CONCLUSION The high prevalence of osteoporosis and vitamin D insufficiency in this semiurban group of postmenopausal women in India is a major health concern . Measures such as adequate calcium intake and vitamin D supplementation in women of this age-group may be beneficial BACKGROUND The achievement of a peak bone mass is an important factor in the prevention of osteoporotic fractures . In normal children , the amount of calcium intake could affect bone mineral increment . AIM To assess the effect of a daily 500 mg calcium supplement on bone mineral density , in a group of healthy Chilean girls . PATIENTS AND METHODS Fifty healthy girls were studied and 25 were r and omly assigned to receive a 500 mg calcium supplement during 10 months . Bone mineral density of the distal and ultradistal region of the forearm was measured in all girls by single X ray absorptiometry ( Osteometer DTX-100 ) at the beginning and end of the study . Bone mineral density was expressed as Z values . RESULTS Significant increments in bone mineral density at the distal radioulnar region were obtained in the supplemented girls . No significant changes in bone density were observed in control girls . CONCLUSIONS A daily 500 mg calcium supplement for 10 months increased bone mineral density in healthy girls BACKGROUND In a previous 2-y r and omized controlled trial , we showed that calcium- and vitamin D3-fortified milk stopped or slowed bone loss at several clinical ly relevant skeletal sites in older men . OBJECTIVE The present study aim ed to determine whether the skeletal benefits of the fortified milk were sustained after withdrawal of the supplementation . DESIGN One hundred nine men > 50 y old who had completed a 2-y fortified milk trial were followed for an additional 18 mo , during which no fortified milk was provided . Bone mineral density ( BMD ) of the total hip , femoral neck , lumbar spine , and forearm was measured by using dual-energy X-ray absorptiometry . RESULTS Comparison of the mean changes from baseline between the groups ( adjusted for baseline age , BMD , total calcium intake , and change in weight ) showed that the net beneficial effects of fortified milk on femoral neck and ultradistal radius BMD at the end of the intervention ( 1.8 % and 1.5 % , respectively ; P < 0.01 for both ) were sustained at 18-mo follow-up ( P < 0.05 for both ) . The nonsignificant between-group differences at the total hip ( 0.8 % ; P = 0.17 ) also persisted at follow-up ( 0.7 % ; P = 0.10 ) , but there were no lasting benefits at the lumbar spine . The average total dietary calcium intake in the milk supplementation group at follow-up approximated recommended amounts for Australian men > 50 y old ( 1000 mg/d ) but did not differ significantly from that in the control subjects ( 1021 versus 890 mg/d ) . CONCLUSION Supplementation with calcium- and vitamin D3-fortified milk for 2 y may provide some sustained benefits for BMD  in older men after withdrawal of supplementation BACKGROUND Relatively little is known about the relations between dietary patterns and bone health in adolescence , which is a period of substantial bone mass accrual . OBJECTIVES We derived dietary patterns that were hypothesized to be related to bone health on the basis of their protein , calcium , and potassium contents and investigated their prospect i ve associations with bone mineral density ( BMD ) , bone area , and bone mineral content ( BMC ) in a cohort of young adults . DESIGN The study included 1024 young adults born to mothers who were participating in the Western Australian Pregnancy Cohort ( Raine ) Study .  Dietary information was obtained from food-frequency question naires at 14 and 17 y of age . Dietary patterns were characterized according to protein , calcium , and potassium intakes with the use of reduced-rank regression . BMD , bone area , and BMC were estimated with the use of a total body dual-energy X-ray absorptiometry scan at 20 y of age . RESULTS We identified 2 major dietary patterns . The first pattern was positively correlated with intakes of protein , calcium , and potassium and had high factor loadings for low-fat dairy products , whole grains , and vegetables . The second pattern was positively correlated with protein intake but negatively correlated with intakes of calcium and potassium and had high factor loadings for meat , poultry , fish , and eggs . After adjustment for anthropometric , sociodemographic , and lifestyle factors , a higher z score for the first pattern at 14 y of age was positively associated with BMD and BMC at 20 y of age [ differences : 8.6 mg/cm(2 ) ( 95 % CI : 3.0 , 14.1 mg/cm(2 ) ) and 21.9 g ( 95 % CI : 6.5 , 37.3 g ) , respectively , per SD increase in z score ] . The z score for this same pattern at 17 y of age was not associated with bone outcomes at 20 y of age . The second pattern at 14 or 17 y of age was not associated with BMD , BMC , or bone area . CONCLUSIONS A dietary pattern characterized by high intakes of protein , calcium , and potassium in midadolescence was associated with higher BMD and BMC at 20 y of age . Our results indicate that high consumption of low-fat dairy products , whole grains , and vegetables in adolescence are associated with beneficial effects on bone development BACKGROUND Maximal bone acquisition in adolescent girls through dietary and lifestyle practice s is advocated to prevent or minimize the development of osteoporosis and its associated complications in later life . Longitudinal investigations of bone acquisition in children and adolescents have utilized areal bone mineral density ( BMD , mg/cm(2 ) ) as a measure of bone mass and strength . Peripheral quantitative computed tomography ( pQCT ) , which provides a three-dimensional display of data , separate analyses of bone compartments , and bone mass in terms of volumetric BMD ( vBMD , mg/cm(3 ) ) , has recently been introduced for clinical use . OBJECTIVE To assess the impact of a 12-month daily calcium supplement on total and trabecular bone acquisition as measured by pQCT in preadolescent girls . DESIGN Early adolescent Caucasian girls ( aged 12 years , Tanner Stage 2 ) were enrolled in a r and omized trial of daily calcium supplement ( TX , 800 mg calcium carbonate and 400 IU vitamin D ) or placebo ( C ) . Body weight , height , and distal tibia measurements by pQCT were obtained at enrollment , 6 and 12 months . Pubertal status and physical activity records were assessed at baseline and 12 months . Three-day food intake records were completed every three months . RESULTS Seventy-one girls completed the 12-month trial ( TX=35 , C=36 ) . No differences were found for age , weight , height , body mass index , pubertal maturation , or reported physical activity at enrollment or during the study . Average intakes during the study were 1524 mg calcium and 496 IU vitamin D ( TX ) versus 865 mg calcium and 160 IU vitamin D ( C ) per day . Baseline total bone values were similar , however , trabecular values were greater in TX girls despite r and omization . Percent changes were calculated to adjust for baseline differences . Because of the small cortical thickness at the 10 % site ( mean values < 1.6 mm ) , cortical mass and density were not analyzed . The percent changes for trabecular bone mineral content ( BMC , mg ) and vBMD were significantly greater in TX girls ( + 4.1 % BMC and + 1.0 % vBMD TX versus -1.6 % BMC and -2.0 % vBMD C , p<0.006 ; ANCOVA ) after 12 months of supplement . Trabecular bone area ( BA , cm(2 ) ) and total bone change , however , did not differ between groups . CONCLUSIONS Daily calcium and vitamin D supplementation promotes greater trabecular BMC and vBMD acquisition in preadolescent girls . The single site selected for pQCT evaluation in this study did not allow evaluation of the cortical bone compartment . Future studies that utilize the pQCT technique need to incorporate multiple measurement sites to better assess total , cortical , and trabecular bone Summary Supplementation with elemental calcium 500 mg/day alone for 2 years is able to decrease bone turnover and is effective in retarding bone loss at lumbar spine and slowing bone loss at femoral neck in elderly Thai women who had low dietary calcium intake . Introduction Most elderly Thais have a total dietary calcium intake of less than the recommended amount . The aim of the study was to investigate the effect of calcium supplementation on bone mineral density and biochemical indices of bone remodeling in Thai postmenopausal women . Methods Four hundred and four healthy postmenopausal women 60 years old or older without osteoporosis were recruited and conducted in a r and omized , double-blinded , placebo-controlled trial . They were r and omly given elementary calcium 500 mg/day or placebo for 2 years . Dietary calcium intake was calculated from the nutrient compositional analysis of the 3-day food records . Serum 25 hydroxyvitamin D was measured by radioimmunoassay and bone turnover markers were determined by electrochemiluminescence immunoassay . Results The age of the subjects was 65.8 ± 4.4 years . All baseline characteristics of the subjects in the calcium-supplemented group and the placebo group were not statistically different . At the end of the study , significant decreases in serum C-terminal telopeptide of type I collagen and serum total procollagen type I amino terminal propeptide in the calcium-supplemented group were observed , while there was no change in the placebo group . In addition , plasma parathyroid hormone decreased , although not significantly , only in the calcium-supplemented group . Percent changes from baseline of lumbar spine ( L2–L4 ) bone mineral density increased 2.76 % in the calcium-supplemented group and 0.87 % in the placebo group , whereas the percent changes from baseline of femoral neck decreased 0.21 % in the calcium-supplemented group and 0.90 % in the placebo group . Conclusions Calcium supplementation is necessary for the decrease of bone turnover and prevention of bone loss in Thai elderly women OBJECTIVE To determine the effect of maternal calcium supplementation during pregnancy on fetal bone mineralization . METHODS Healthy mothers with early ultrasound confirmation of date s and singleton pregnancies were enrolled in a double-masked study and r and omized before 22 weeks ' gestation to 2 g/day of elemental calcium or placebo until delivery . Maternal dietary intake at r and omization and at 32 - 33 weeks ' gestation was recorded with 24-hour dietary recalls . Dual-energy x-ray absorptiometry measurements of the whole body and lumbar spine of the neonates were performed before hospital discharge . RESULTS The infants of 256 women ( 128 per group ) had dual-energy x-ray absorptiometry measurements during the first week of life . There were no significant differences between treatment groups in gestational age , birth weight , or length of the infants , or in the total-body or lumbar spine bone mineral content . However , when bone mineral content was analyzed by treatment group within quintiles of maternal dietary calcium intake , total body bone mineral content ( mean + /- st and ard error of the mean ) was significantly greater in infants born to calcium-supplemented mothers ( 64.1+/-3.2 versus 55.7+/-2.7 g in the placebo group ) in the lowest quintile of dietary calcium intake ( less than 600 mg/day ) . The effect of calcium supplementation remained significant after adjustment for maternal age and maternal body mass index and after normalization for skeletal area and body length of the infant . CONCLUSION Maternal calcium supplementation of up to 2 g/day during the second and third trimesters can increase fetal bone mineralization in women with low dietary calcium intake . However , calcium supplementation in pregnant women with adequate dietary calcium intake is unlikely to result in major improvement in fetal bone mineralization Previous research suggests that physical activity may have a beneficial effect on  bone mineral density ( BMD ) in women . This relationship was explored in a 2-year , r and omized , intervention trial investigating the efficacy of exercise and calcium supplementation on increasing peak bone mass in young women . One hundred and twenty-seven subjects ( ages of 20 - 35 years ) were r and omly assigned either to an exercise program that contained both aerobics and weight training components or to a stretching program . Calcium supplementation ( up to 1500 mg/day including dietary intake ) or placebo was given in a double-blinded design to all subjects . Spinal trabecular BMD was determined using quantitative computed tomography ( QCT ) . Spinal integral , femoral neck , and trochanteric BMD were measured by dual X-ray absorptiometry ( DXA ) and calcaneal BMD by single photon absorptiometry ( SPA ) . Fitness variables included maximal aerobic capacity ( VO2max ) , and isokinetic muscle performance of the trunk and thigh . Measurements were made at baseline , 1 year , and 2 years . Sixty-three subjects ( 32 exercise , 31 stretching ) completed the study , and all the measured bone parameters indicated a positive influence of the exercise intervention . There were significant positive differences in BMD between the exercise and stretching groups for spinal trabecular ( 2.5 % ) , femoral neck ( 2.4 % ) , femoral trochanteric ( 2.3 % ) , and calcaneal ( 6.4 % ) measurements . The exercise group demonstrated a significant gain in BMD for spinal integral ( 1.3 + /- 2.8 % , p < 0.02 ) , femoral trochanteric ( 2.6 + /- 6.1 % , p < 0.05 ) , and calcaneal ( 5.6 + /- 5.1 , p < 0.01 ) measurements . In contrast to exercise , the calcium intervention had no positive effect on any of the bone parameters . In regard to fitness parameters , the exercise group completed the study with significant gains in VO2max and isokinetic ( peak torque ) values for the knee flexion and extension and trunk extension . This study indicates that over a 2-year period , a combined regimen of aerobics and weight training has beneficial effects on BMD and fitness parameters in young women . However , the addition of daily calcium supplementation does not add significant benefit to the intervention Bone turnover is increased during weight loss in postmenopausal women and can be suppressed with calcium supplementation . In this study , we assessed the influence of energy restriction with and without calcium supplementation ( 1 g/day ) in premenopausal women . Thirty-eight obese premenopausal women ( body mass index [ BMI ] of 35.0 + /- 3.9 kg/m2 ) completed a 6-month study of either moderate weight loss or weight maintenance . During weight loss , women were r and omly assigned to either a calcium supplementation ( n = 14 ) or placebo group ( n = 14 ) and lost 7.5 + /- 2.5 % of their body weight . The control group of women ( n = 10 ) maintained their body weight . Total body and lumbar bone mineral density ( LBMD ) and content were measured by dual-energy X-ray absorptiometry ( DXA ) at baseline and after weight loss . Throughout the study , blood and urine sample s were collected to measure bone turnover markers and hormones . During moderate energy restriction , dietary calcium intake decreased ( p < 0.05 ) and the bone resorption marker deoxypyridinoline ( DPD ) increased slightly ( p < or = 0.05 ) without evidence of bone loss .  Calcium supplementation during weight loss tended to increase lumbar BMD by 1.7 % ( p = 0.05 ) compared with the placebo or weight maintenance groups . In contrast to our previous findings in postmenopausal women , premenopausal obese women who consume a low calcium diet do not lose bone over a 6-month period , whether their weight is stable or decreasing moderately Adequate nutrition is needed for the accrual of bone mass during the pre- and postpubertal growth periods . This study aim ed to examine the associations between dietary calcium , vitamin D ( calciferol ) , and milk intakes and 25-hydroxyvitamin D [ 25(OH)D ] status and bone mineral content ( BMC ) and bone mineral density ( BMD ) in Spanish adolescents , aged 12.5 - 17.5 years , participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study ( HELENA-CSS ) .  Bone mass was measured with dual-energy X-ray absorptiometry and diet via 2 nonconsecutive 24-h dietary recalls ( n=227 ; 48 % males ) . A r and om sub sample of 101 adolescents ( 46 % males ) had available measures of 25(OH)D. Multiple linear regression was applied . Significant adjusted associations were observed in males , among milk intakes and BMC and BMD . Also in males , whole-body , head , and right arm BMD were positively related to calcium intakes . In females , 25(OH)D was positively related among others to whole-body , subtotal , and left and right arm BMC and BMD . It could be speculated that diet is not a limiting factor of bone mass development in this group of healthy adolescents , and further research on the effect of other factors in addition to diet in a larger sample should be undertaken PURPOSE To determine the long-term effects of calcium supplements or placebo on bone density in healthy women at least 3 years postmenopause . PATIENTS AND METHODS Eighty-six women from our previously reported 2-year study agreed to continue on their double-blind treatment allocation ( 1 g elemental calcium or placebo ) for a further 2 years , with 78 women ( 40 on placebo ) reaching the 4-year end point .  Median ( interquartile range ) dietary calcium intakes for the whole group were 700 mg ( range 540 to 910 ) per day at baseline , 670 mg ( range 480 to 890 ) per day at 2 years , and 640 mg ( range 460 to 880 ) per day at 4 years . The bone mineral density ( BMD ) of the total body , lumbar spine , and proximal femur was measured every 6 months by dual-energy , x-ray absorptiometry . RESULTS There was a sustained reduction in the rate of loss of total body BMD in the calcium group throughout the 4-year study period ( P = 0.002 ) , and bone loss was significantly less in the calcium-treated subjects in years 2 through 4 also ( difference between groups 0.25 % + /- 0.11 % per year , P = 0.02 ) . In the lumbar spine , bone loss was reduced in the calcium group in year 1 ( P = 0.004 ) , but not subsequently . There was , however , a significant treatment effect at this site over the whole 4-year period ( P = 0.03 ) . In the proximal femur , the benefit from calcium treatment also tended to be greater in the first year and was significant over the 4-year study period in the femoral neck ( P = 0.03 ) and the trochanter ( P = 0.01 ) . Nine symptomatic fractures occurred in 7 subjects in the placebo group and 2 fractures in 2 subjects receiving calcium ( P = 0.037 ) . CONCLUSIONS Calcium supplementation produces a sustained reduction in the rate of loss of total body BMD in healthy postmenopausal women The trial is conducted to evaluate the effects of calcium on bone mineral accretion in adolescents . 161 healthy adolescents aged of 9 to 20 year-old are recruited and are r and omly divided into experimental groups in which 300 mg Ca is supplemented per day for each participant and control group . The  dietary calcium , physical activity , SMR , distal one-third radial bone mineral content ( BMC ) , bone width ( BW ) , height , weight and serum total ALP are measured at both the beginning and the end of the trial . It is found that the average calcium intake from dietary sources is 500 mg/d in both groups . Increasing daily calcium intake via calcium supplementation in adolescents results in a moderate increases of BMC , and there is a significant increase of BMC in the females during the late adolescence . No significant differences in anthropometry are observed between the two groups at the end of the study while the increase of serum ALP level in the females in experiment group is significantly lower than that in the control group during the late adolescence . It is concluded that during the pubertal years when the BMC accretion is evident , there are no significant differences in bone mass accrual between the two groups . While in the females , calcium supplementation may help enhance the bone mineral accrual during late adolescence when the BMC accretion is remarkably reduced BACKGROUND Supplementation with calcium and vitamin D reduces bone loss and prevents fractures in elderly people , but it is not known whether any lasting benefit remains if the supplements are discontinued . OBJECTIVE The objective was to determine whether gains in bone mineral density ( BMD ) induced by calcium and vitamin D supplementation persist after supplement withdrawal . DESIGN Two-hundred ninety-five healthy , elderly men and women ( aged > /=68 y ) who had completed a 3-y r and omized , placebo-controlled trial of calcium and vitamin D supplementation were followed for an additional 2 y during which no study supplements were given .  BMD was measured by dual-energy X-ray absorptiometry , and biochemical variables related to calcium metabolism and bone turnover were measured . RESULTS In the 128 men , supplement-induced increases in spinal and femoral neck BMD were lost within 2 y of supplement discontinuation , but small benefits in total-body BMD remained . In the 167 women , there were no lasting benefits in total-body BMD or at any bone site . Consistent with the observations on BMD , the bone turnover rates in both men and women ( as measured by serum osteocalcin concentrations ) returned to their original higher concentrations within the same 2-y period . CONCLUSION Discontinued calcium and vitamin D supplementation has limited cumulative effect on bone mass in men and women aged > /=68 Low dietary calcium intake has been demonstrated to be a risk factor for hip and vertebral fractures in studies conducted among Hong Kong Chinese . Few studies have demonstrated the effect of milk supplementation in bone accretion in Chinese children . The aim was to examine the effects of milk powder supplementation in enhancing bone accretion in Chinese children . Three hundred and forty-four children , aged 9–10 years old , were r and omized to receive milk powder equivalent to 1300 mg and 650 mg calcium , and to a control group , respectively . Bone mineral density ( BMD ) at the proximal femur , lumbar spine and total body were measured at 6 months , 12 months and 18 months . The treatment effects were modeled using linear mixed effect models and compared using linear contrast F-tests , by intention-to-treat . Subjects r and omized to milk powder equivalent to 1300 mg calcium had significantly higher increase in BMD at both the total hip ( 7.4±0.4 % in treatment group versus 6.3±0.4 % in the control ) and the spine ( 8.4±0.5 % in the treatment group versus 7.0±0.5 % in the control group ) . Subjects r and omized to milk powder equivalent to 650 mg calcium had smaller increases in BMD at the total hip and spine , although the increase in BMD at the total body was significantly higher ( 3.1±0.3 % in treatment group versus 2.4±0.2 % in controls ) . It is concluded that supplementing the diet of Chinese children with milk powder was effective in enhancing bone accretion Bone mobilization , lowering of bone mineral density ( BMD ) , and osteoporotic fractures are recognized in postmenopausal women with weight loss . Because a high-calcium intake suppresses bone loss in peri- and postmenopausal women , the present r and omized , double-blind , placebo-controlled study was design ed to test the hypothesis that calcium supplementation prevents net bone mobilization and consequent bone mineral loss during voluntary weight reduction in obese postmenopausal women . Subjects were placed on a moderate energy-restricted diet and either calcium supplementation ( 1 g/day ) or placebo for 6 months . Body weight , bone turnover markers ( pyridinium cross-links ) , osteocalcin , and parathyroid hormone ( PTH ) were measured at treatment weeks 1 - 5 , 7 , 10 , 13 , 16 , 20 , and 25 . Total body BMD , insulin-like growth factor , 25-hydroxyvitamin D , and sex hormone binding globulin ( SHBG ) were measured at baseline and week 25 . The calcium supplemented ( n = 15 ; age 60.9 + /- 9.4 years , body mass index [ BMI ] 33.2 + /- 4.6 kg/m2 ) and placebo ( n = 16 ; age 55.8 + /- 8.3 years , BMI 32.9 + /- 4.5 kg/m2 ) groups lost similar amounts of weight over the study interval ( 10.2 + /- 5.3 % vs. 10.0 + /- 5.2 % ) and both groups increased SHBG ( p < 0.001 ) . There was a statistical effect of calcium supplementation during weight loss to suppress pyridinium cross-links , osteocalcin , and PTH ( p < 0.05 , < 0.01 , and < 0.05 , respectively ) . Loss of BMD tended to be greater in the placebo group by 1.4 % ( p < 0.08 ) after weight loss . One gram per day calcium supplementation normalizes the increased calcium-PTH axis activity and the elevated bone turnover rate observed during moderate voluntary energy restriction in postmenopausal women CONTEXT It has been assumed that the increase in urine calcium ( Ca ) that accompanies an increase in dietary protein was due to increased bone resorption . However , studies using stable Ca isotopes have found that dietary protein increases Ca absorption without increasing bone resorption . OBJECTIVE The objective of the study was to investigate the impact of a moderately high protein diet on bone mineral density ( BMD ) . DESIGN This was a r and omized , double-blind , placebo-controlled trial of protein supplementation daily for 18 months . SETTING The study was conducted at two institutional research centers . PARTICIPANTS Two hundred eight older women and men with a body mass index between 19 and 32 kg/m(2 ) and a self-reported protein intake between 0.6 and 1.0 g/kg participated in the study . INTERVENTION Subjects were asked to incorporate either a 45-g whey protein or isocaloric maltodextrin supplement into their usual diet for 18 months . MAIN OUTCOME MEASURE BMD by dual-energy x-ray absorptiometry , body composition , and markers of skeletal and mineral metabolism were measured at baseline and at 9 and 18 months . RESULTS There were no significant differences between groups for changes in L-spine BMD ( primary outcome ) or the other skeletal sites of interest . Truncal lean mass was significantly higher in the protein group at 18 months ( P = .048 ) . C-terminal telopeptide ( P = .0414 ) , IGF-1 ( P = .0054 ) , and urinary urea ( P < .001 ) were also higher in the protein group at the end of the study period . There was no difference in estimated glomerular filtration rate at 18 months . CONCLUSION Our data suggest that protein supplementation above the recommended dietary allowance ( 0.8 g/kg ) may preserve fat-free mass without adversely affecting skeletal health or renal function in healthy older adults We have prospect ively studied forearm trabecular and cortical bone mineral density gain ( ΔBMD ) in relation to nutrient intake , weight‐bearing physical activity ( WPA ) and daylight exposure ( DE ) in 470 healthy boys and girls aged 8.2‐16.5 years at the baseline . BMD was assessed using single photon absorptiometry ( SPA ) . Cortical ΔBMD peaked at the age of 14.0 ± 0.3 and 16.0 ± 0.3 ( SD ) years in girls and boys , respectively . Girls had achieved adult premenopausal values of trabecular BMD by the age of 15 years and cortical BMD values by the age of 16.5 years . WPA , BMD , body height , height gain , weight , weight gain , dietary polyunsaturated fat and sodium were correlated with ΔBMD . WPA , predicting cortical as well as trabecular ΔBMD , had the greatest effect on trabecular ΔBMD in the presence of a high calcium intake in children below 11 years of age . In conclusion , our results indicate that physical activity and calcium intake should be encouraged at a prepubertal age in order to increase bone density
Calcium supplements  increased BMD by 0.7 - 1.8 % at all five skeletal sites at one , two , and over two and a half years , but the size of the increase in BMD at later time points was similar to the increase at one year .
Increasing calcium intake from dietary sources or by taking calcium supplements produces small non-progressive increases in BMD , which are unlikely to lead to a clinical ly significant reduction in risk of fracture
OBJECTIVE To determine whether increasing calcium intake from dietary sources affects  bone mineral density ( BMD ) and , if so , whether the effects are similar to those of calcium supplements .