Effect of Calcium or 25OH Vitamin D3 Dietary Supplementation on Bone Loss at the Hip in Men and Women over the Age of 60*

Abstract

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 randomized, 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.

Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women

“…In comparison with calcium, few clinical trials have focused on vitamin D and postmenopausal osteoporosis. Reductions in bone loss at the spine (23) and femoral neck (24,25) were reported, although benefits from additional vitamin D may be seen only at low calcium intakes (26). For fractures, overall incidence was significantly reduced with an annual injection of vitamin D in one study (27); another found no effect of daily vitamin D supplementation on the risk of hip fractures (28).…”

Milk Supplementation of the Diet of Postmenopausal Chinese Women on a Low Calcium Intake Retards Bone Loss

“…Storm et al (7) showed that calcium supplementation (by either calcium carbonate or dietary means) prevented seasonal bone loss in elderly women living in North America. Moreover, Peacock et al (8) showed that a calcium supplement of 750 mg/day prevented loss of bone mineral density (BMD) as well as reduced femoral medullary expansion, secondary hyperparathyroidism, and high bone turnover.…”

Effects of Cholecalciferol vs Calcifediol on Total and Free 25-Hydroxyvitamin D and Parathyroid Hormone

“…An alternative approach may therefore be required. Presumably owing to its ability to bypass carbon-25 hydroxylation in the liver and its relative affinity for the circulating vitamin D binding protein (DBP), pharmacologic 25-hydroxyvitamin D3 (calcefidiol, 25D3) more rapidly and robustly raises serum 25D levels than parent D3 (12)(13)(14)(15)(16)(17)(18). 25D3 administration also suppresses PTH secretion while D3 does not (18).…”