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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
Kukuljan, Sonja Nowson, Caryl Sanders, Kerrie Nicholson, Geoffrey Seibel, Markus Salmon, Jo Daly, Robin
Kukuljan, Sonja
Nowson, Caryl
Sanders, Kerrie
Nicholson, Geoffrey
Seibel, Markus
Salmon, Jo
Daly, Robin
Abstract
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. - See more at: http://press.endocrine.org/doi/10.1210/jc.2010-2284#sthash.ASAaO9rQ.dpuf
Keywords
Date
2011
Type
Journal article
Journal
The Journal of Clinical Endocrinology and Metabolism
Book
Volume
96
Issue
4
Page Range
955-963
Article Number
ACU Department
Collections
Relation URI
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Event URL
Open Access Status
License
File Access
Controlled