Calcium and Vitamin D Supplementation for Osteopenia.
Journal of Nutrition 2/18/2011
Osteopenia is a condition
where bone mineral density (BMD) is lower than normal. It is considered by many
doctors to be a precursor to osteoporosis. However, not every person diagnosed
with osteopenia will develop osteoporosis. Like osteoporosis, osteopenia occurs
more frequently in post-menopausal women as a result of the loss of estrogen.
It can also be exacerbated by lifestyle factors such as lack of exercise,
excess consumption of alcohol, smoking or prolonged use of glucocorticoid
medications such as those prescribed for asthma.
Calcium is the most abundant
mineral in the human body. Average healthy males have about two and a half to
three pounds of calcium while females have about two pounds. Approximately 99
percent of calcium is present in the bones and teeth, which leaves only about
one percent in cells and body fluids. While the most important function of
calcium involves the maintenance of skeletal health, the small percentage of
calcium outside the bones is used to maintain a variety of vital body
Vitamin D is known as the
"sunshine" vitamin because it is formed in the body by the action of
the sun's ultraviolet rays on the skin. The fat-soluble vitamin is converted in
the kidneys to the hormone calcitrol, which is actually the most active form of
vitamin D. The effects of this hormone are targeted at the intestines and
bones. Decreased vitamin D intake along with not enough sunlight exposure can
cause a vitamin D deficiency. Other causes could be inadequate absorption and
impaired conversion of vitamin D into its active form. When vitamin D
deficiency occurs, bone mineralization is impaired which leads to bone loss.
Rickets, osteomalacia, osteoporosis, crohn's disease and cancer are associated
with vitamin D deficiency.
The purpose of a study
published in the European Journal of Nutrition was to assess the effectiveness
of calcium and vitamin D supplementation combined with fortified dairy products
on bone metabolism in postmenopausal women. Researchers recruited forty
osteopenic postmenopausal women between the ages of 55-65 years old who were
randomly assigned to a control group or a dietary group (DG) receiving 1,200 mg
of calcium and 7.5 micrograms of vitamin D3 daily for the first 12 months and
then increased vitamin D3 to 22.5 micrograms for the remaining 18 months.
Results were after 30 months of intervention, serum vitamin D levels were
significantly lower in the control group while the DG remained at the same high
levels as in the summer period. Results also showed that serum RANKL levels
(receptor activator linked to bone weakening) were significantly reduced in the
DG compared to the control group. The authors concluded "Increasing
dietary intake of calcium and vitamin D in osteopenic postmenopausal women
appears to be effective in producing favorable changes in several bone
metabolism and bone mass indices and in counterbalancing seasonal variations in
hormonal and biochemical molecules."1
R, Moschonis G, Koutsilieris M, et al. Calcium and vitamin D supplementation
through fortified dairy products counterbalances seasonal variations of bone
metabolism indices: the Postmenopausal Health Study. Eur J Nutr. Dec2010.
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