Possible site-specific effect of an intervention combining nutrition and lifestyle counselling with consumption of fortified dairy products on bone mass: the Postmenopausal Health Study II

Abstract

The aim of the present study was to examine whether a holistic approach combining nutrition and lifestyle counselling with the consumption of milk and yoghurt enriched with calcium, vitamin D(3) and phylloquinone (vitamin K(1)) or menaquinone (vitamin K(2)) would have any additional benefit on bone mineral density (BMD) indices measured at various skeletal sites using two different techniques, dual energy X-ray absorptiometry and quantitative ultrasonography (QUS). A sample of 115 postmenopausal women were randomized to three intervention groups, receiving daily via fortified milk and yoghurt and for 12 months, 800 mg calcium and 10 μg vitamin D(3) (CaD group, n = 26); 800 mg calcium, 10 μg vitamin D(3) and 100 μg vitamin K(1) (CaDK1 group, n = 26); 800 mg calcium, 10 μg vitamin D(3) and 100 μg vitamin K(2) (CaDK2 group, n = 24); and a control group (CO group, n = 39) following their usual diet. All three intervention groups attended biweekly nutrition and lifestyle counselling sessions. Total BMD significantly increased in all three intervention groups and these changes were significantly higher compared to the CO (P < 0.001). Furthermore, the significant increases observed for L2-L4 BMD in the CaDK1 and CaDK2 groups were found to be significantly higher compared to the decrease observed in the CO (P = 0.001). No significant differences were observed for QUS parameters. The combined approach used in the current study led to favourable changes for all three intervention groups in total body BMD, while an additional benefit was observed for L2-L4 BMD in CaDK1 and CaDK2 groups. No significant differences were observed among groups in any of the QUS parameters.

Changes in Parameters of Bone Metabolism in Postmenopausal Women Following a 12-Month Intervention Period Using Dairy Products Enriched with Calcium, Vitamin D, and Phylloquinone (Vitamin K1) or Menaquinone-7 (Vitamin K2): The Postmenopausal Health Study II

“…According to the results derived from DXA measurements, the findings of the present study revealed more favorable changes over the intervention period in totalbody BMD in the three intervention groups compared to the CG (Table 3), with the absolute BMD values at baseline and follow-up examinations presented analytically elsewhere [23]. Similar to the findings from the present study, other intervention studies showed that total dietary calcium intake of 1,200 mg/day or higher was adequate to prevent bone loss from the total body, lumbar spine, femoral neck, and greater trochanter in susceptible populations, such as postmenopausal women [17,42].…”

“…1 was repeated controlling for serum 25(OH)D levels and dietary calcium intake, the significant differences observed for total-body BMD among the three intervention groups and the CG were lost (P = 0.073), while the differences observed for L2-L4 BMD among CADK1, CADK2, and CG remained significant (P = 0.002). No other significant differences among groups were observed regarding changes in pelvis, leg, arm, and hip BMD as described analytically elsewhere [23].…”

Longitudinal Adaptations of Bone Mass, Geometry, and Metabolism in Adolescent Male Athletes: The PRO-BONE Study

“…(7) The childhood and adolescent years are critical for bone acquisition with up to 43% of peak bone mass (PBM) acquired during the 5-year period surrounding the peak height velocity. (8,9) The factors affecting PBM during growth include non-modifiable factors, such as genetics, (10) and modifiable factors, such as nutrition (eg, calcium and vitamin D) (11,12) and physical activity. (13)(14)(15) Exercise and sports participation can enhance bone mineral content (BMC) and bone mineral density (BMD) during youth, (16,17) and the benefits can be maintained into adulthood.…”

Vitamin K and musculoskeletal health in postmenopausal women

“…Despite differences mentioned above, there is no evidence in humans that vitamin K2 is more effective on improving BMD or lowering risk of fractures compared to vitamin K1 . To our knowledge only three human studies have compared the effects of vitamin K1 and K2 on bone health with inconclusive results . In a 1‐year clinical trial, Binkley et al.…”

“…In another 1‐year clinical trial, Moschonis et al. found no significant differences between the effects of phylloquinone supplementation (0.1 mg/day) and MK‐7 supplementation (0.1 mg/day) on BMD of the lumbar spine, hip, or total body among postmenopausal Greek women receiving calcium and vitamin D supplementation via fortified milk and yoghurt . Comparing the properties of vitamin K1 and K2 in clinical trials may be fruitless, as among healthy adults vitamin K1 is converted to vitamin K2 endogenously.…”