Calcium and Vitamin D Supplementation for Osteopenia.

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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 functions.

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

¹ Tenta 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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Source: European Journal of Nutrition 2/18/2011

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