Independent and Combined Effects of Calcium-Vitamin D3 and Exercise on Bone Structure and Strength in Older Men: An 18-Month Factorial Design Randomized Controlled Trial
The Journal of Clinical Endocrinology & Metabolism , doi:10.1210/jc.2010-2284
Submitted on September 28, 2010; Accepted on December 15, 2010
Sonja Kukuljan, Caryl A. Nowson, Kerrie M. Sanders, Geoff C. Nicholson, Markus J. Seibel, Jo Salmon, and Robin M. Daly rdaly@unimelb.edu.au.
School of Exercise and Nutrition Sciences (S.K., C.A.N., J.S., R.M.D.), Deakin University, Victoria 3125, Australia; Department of Clinical and Biomedical Sciences: Barwon Health (K.M.S., G.C.N.), University of Melbourne, Geelong Victoria 3220, Australia; Bone Research Program (M.J.S.), ANZAC Research Institute, University of Sydney, New South Wales 2006, Australia; and Department of Medicine (R.M.D.), University of Melbourne, Western Hospital, Melbourne 3011, Australia
Context: Exercise and calcium-vitamin D are independently recognized as important strategies to prevent osteoporosis, but their combined effects on bone strength and its determinants remain uncertain.
Objective: To assess whether calcium-vitamin D3 fortified milk could enhance the effects of exercise on bone strength, structure, and mineral density in middle-aged and older men.
Design, Setting, Participants: An 18-month factorial design randomized controlled trial in which 180 men aged 50–79 years were randomized to the following: exercise + fortified milk; exercise; fortified milk; or controls. Exercise consisted of progressive resistance training with weight-bearing impact activities performed 3 d/week. Men assigned to fortified milk consumed 400 ml/d of 1% fat milk containing 1000 mg/d calcium and 800 IU/d vitamin D3.
Main Outcome Measures: Changes in bone mineral density (BMD), bone structure, and strength at the lumbar spine (LS), proximal femur, mid-femur, and mid-tibia measured by dual energy x-ray absorptiometry and/or quantitative computed tomography.
Results: There were no exercise-by-fortified milk interactions at any skeletal site. Main effect analysis showed that exercise led to a 2.1% (95% confidence interval, 0.5–3.6) net gain in femoral neck section modulus, which was associated with an approximately 1.9% gain in areal BMD and cross-sectional area. Exercise also improved LS trabecular BMD net gain 2.2% (95% confidence interval, 0.2–4.1), but had no effect on mid-femur or mid-tibia BMD, structure, or strength. There were no main effects of the fortified milk at any skeletal site.
Conclusion: A community-based multi-component exercise program successfully improved LS and femoral neck BMD and strength in healthy older men, but providing additional calcium-vitamin D3 to these replete men did not enhance the osteogenic response.
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It is doubtful that 800 IU of vitamin D even increased their vitamin D blood levels.
See also at VitaminDWiki
- Calcium and just 800 IU gave positive effect on skeleton
- Review of vitamin D and bone health studies – with tables Nov 2010 800 IU not enough
- Average of less than 2000 IU of vitamin D2 did not help bone health – July 2010
- Effectiveness and Safety of Vitamin D in Relation to Bone Health - 2007
- Bone Health and Vit D: Evidence Based Review 2007