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Archives of Osteoporosis

, 14:17 | Cite as

Physical activity modifies the effect of calcium supplements on bone loss in perimenopausal and postmenopausal women: subgroup analysis of a randomized controlled trial

  • Kazutoshi NakamuraEmail author
  • Toshiko Saito
  • Ryosaku Kobayashi
  • Rieko Oshiki
  • Kaori Kitamura
  • Yumi Watanabe
Short Scientific Communication
  • 12 Downloads

Abstract

Summary

We aimed to determine whether the effect of calcium supplements on bone metabolism is modified by physical activity (PA) through a subgroup analysis of an RCT. PA may be a favorable effect modifier of the association between calcium intake and bone loss in perimenopausal and postmenopausal women.

Purpose

Physical exercise can potentially modify bone metabolism. Here we aimed to determine whether the effect of calcium supplements on bone metabolism is modified by physical activity (PA) through a subgroup analysis of a randomized, double-blind, placebo-controlled trial.

Methods

The trial was conducted over the course of 2 years, and participants were 450 healthy women between 50 and 75 years of age who were randomly assigned to three equally-sized (N = 150 each) groups (500 mg calcium, 250 mg calcium, and placebo). Levels of PA at baseline were evaluated by quantifying moderate (4 METs) and vigorous (6 METs) activities based on a 7-day activity recall, and the total MET-hours per week was calculated. Follow-up BMD examinations were conducted 2 years later. Two-year changes in BMD were compared between the intention-to-treat higher PA subgroup (≥ 10 MET-hours/week) and the lower PA subgroup (< 10 MET-hours/week).

Results

Of the 450 participants, 418 underwent follow-up BMD measurements. Regarding the lower PA subgroup, spinal BMD in the 500 mg/day calcium supplement group decreased significantly less (− 0.029 g/cm2, P = 0.042) than in the placebo group (− 0.045 g/cm2), and femoral neck BMD in the 500 mg/day calcium supplement group decreased significantly less (− 0.027 g/cm2, P = 0.049) than in the placebo group (− 0.038 g/cm2). In contrast, changes in neither spinal nor femoral neck BMD significantly differed between the three treatment groups in the higher PA subgroup.

Conclusions

PA is a favorable effect modifier of the association between calcium intake and bone loss in perimenopausal and postmenopausal women with low calcium intake.

Clinical trials registry number

UMIN000001176

Keywords

Bone density Calcium Postmenopause Physical activity Randomized controlled trial 

Notes

Author contribution

Study design: KN. Acquisition of data: KN, RK, RO, and KK. Interpretation of data: KN, TS, KK, and YW. Drafting of the manuscript: KN. Critical revision of the manuscript for important intellectual content: KN, KK, and YW. Statistical analysis: KN.

Funding information

This trial was supported in part by a Grant-in-Aid for Scientific Research (B) No.20390183 from the Japanese Ministry of Education, Culture, Sports, Science and Technology; a Grant-in-Aid for Advanced Research from the Niigata University of Health and Welfare (2008-2010); a grant from the Japan Dairy Association (2009, 2010); and a grant from the Daiwa Securities Health Foundation (2008).

Compliance with ethical standards

Ethical statement

The study was conducted in accordance with the Declaration of Helsinki, written informed consent was obtained from all participants, and the study protocol was approved by the Ethics Committee of Niigata University School of Medicine.

Conflict of interest

None.

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2019

Authors and Affiliations

  • Kazutoshi Nakamura
    • 1
    Email author
  • Toshiko Saito
    • 2
  • Ryosaku Kobayashi
    • 3
  • Rieko Oshiki
    • 4
  • Kaori Kitamura
    • 1
  • Yumi Watanabe
    • 1
  1. 1.Division of Preventive MedicineNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
  2. 2.Department of Health and NutritionNiigata University of Health and WelfareNiigata CityJapan
  3. 3.Department of Physical TherapyNiigata University of Health and WelfareNiigata CityJapan
  4. 4.Department of RehabilitationNiigata University of RehabilitationNiigataJapan

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