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Dietary calcium and serum 25-hydroxyvitamin D status in relation to bone mineral density among U.S. adults


Bischoff-Ferrari, H A; Kiel, D P; Dawson-Hughes, B; Orav, J E; Li, R; Spiegelman, D; Dietrich, T; Willett, W C (2009). Dietary calcium and serum 25-hydroxyvitamin D status in relation to bone mineral density among U.S. adults. Journal of Bone and Mineral Research, 24(5):935-942.

Abstract

A higher calcium intake is still the primary recommendation for the prevention of osteoporosis, while vitamin D deficiency is often not addressed. To study the relative importance of dietary calcium intake and serum 25-hydroxyvitamin D (25(OH)D) status in regard to hip bone mineral density (BMD) in 4958 community-dwelling women and 5003 men age 20 years + from the US NHANES III population-based survey. Calcium supplement users and individuals with a prior radius or hip fracture were excluded. We calculated standardized means for BMD by quartiles of gender-specific calcium intake for three 25(OH)D categories (< 50, 50-74, 75+ nmol/l) among men and women separately controlling for other important predictors of BMD . Only for women with 25(OH)D status below 50 nmol/l , a higher calcium intake was significantly associated with higher BMD (p-value for trend: p = 0.005), whereas calcium intake beyond the upper end of the lowest quartile ( > 566 mg/d) was not significantly associated with BMD at 25(OH)D concentrations above 50 nmol/l. Among men, there was no significant association between a higher calcium intake beyond the upper end of the lowest quartile (626 mg/d) and BMD within all 25(OH)D categories. Among both genders, BMD increased stepwise and significantly with higher 25(OH)D concentrations(< 50, 50-74, 75+ nmol/l; p-value for trend: women < 0.0001; men = 0.0001). Among men and women, 25(OH)D status appears to be the dominant predictor of BMD relative to calcium intake. Only women with 25(OH)D concentrations below 50 nmol/l appear to benefit from a higher calcium intake.

A higher calcium intake is still the primary recommendation for the prevention of osteoporosis, while vitamin D deficiency is often not addressed. To study the relative importance of dietary calcium intake and serum 25-hydroxyvitamin D (25(OH)D) status in regard to hip bone mineral density (BMD) in 4958 community-dwelling women and 5003 men age 20 years + from the US NHANES III population-based survey. Calcium supplement users and individuals with a prior radius or hip fracture were excluded. We calculated standardized means for BMD by quartiles of gender-specific calcium intake for three 25(OH)D categories (< 50, 50-74, 75+ nmol/l) among men and women separately controlling for other important predictors of BMD . Only for women with 25(OH)D status below 50 nmol/l , a higher calcium intake was significantly associated with higher BMD (p-value for trend: p = 0.005), whereas calcium intake beyond the upper end of the lowest quartile ( > 566 mg/d) was not significantly associated with BMD at 25(OH)D concentrations above 50 nmol/l. Among men, there was no significant association between a higher calcium intake beyond the upper end of the lowest quartile (626 mg/d) and BMD within all 25(OH)D categories. Among both genders, BMD increased stepwise and significantly with higher 25(OH)D concentrations(< 50, 50-74, 75+ nmol/l; p-value for trend: women < 0.0001; men = 0.0001). Among men and women, 25(OH)D status appears to be the dominant predictor of BMD relative to calcium intake. Only women with 25(OH)D concentrations below 50 nmol/l appear to benefit from a higher calcium intake.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Geriatric Medicine
Dewey Decimal Classification:610 Medicine & health
360 Social problems & social services
300 Social sciences, sociology & anthropology
Language:English
Date:May 2009
Deposited On:27 Feb 2009 07:15
Last Modified:05 Apr 2016 13:07
Publisher:American Society for Bone and Mineral Research
ISSN:0884-0431
Publisher DOI:10.1359/jbmr.081242
PubMed ID:19113911
Permanent URL: http://doi.org/10.5167/uzh-16926

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