Effects of a multicomponent exercise program combined with calcium–vitamin D3-enriched milk on health-related quality of life and depressive symptoms in older men: secondary analysis of a randomized controlled trial



Osteoporosis is associated with both lower health-related quality of life and depression in older people. We examined the independent and combined effects of a multi-component exercise program and calcium–vitamin D3 fortified milk on health-related quality of life (HR-QoL) and depression in older men.


In this 12-month, factorial design randomized controlled trial, 180 healthy community-dwelling men aged 50–79 years with normal to below average bone mineral density were allocated into one of four groups: exercise + fortified milk; exercise; fortified milk; or controls. Exercise consisted of high-intensity resistance training with weight-bearing exercise (3 days per week; 60–75 min per session). Men assigned to fortified milk consumed 400 ml/day of low-fat milk containing 1000 mg/day calcium and 800IU/day vitamin D3. Questionnaires were used to assess HR-QoL (SF-36) and depressive symptoms (Center for Epidemiologic Studies Depression Scale) at baseline, and 6 and 12 months. A linear mixed model analysis was used to test whether there was a synergistic interaction between exercise and calcium–vitamin D3. If no significant interactions were detected, the main effects of exercise and fortified milk were examined.


Mean adherence to the exercise program and fortified milk was 67% (95% CI 61, 73%) and 90% (95% CI 86, 93%), respectively. There were no exercise-by-fortified milk interactions nor main effects of exercise or calcium–vitamin D for any of the HR-QoL measures or depressive symptoms.


In healthy community-dwelling older men, exercise training and/or calcium–vitamin D fortified milk did not improve HR-QoL or depressive symptoms.

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We acknowledge all the participants involved and the staff responsible for conducting the GENTS study. We thank Murray Goulburn, Cooperative Co., Ltd., for providing the calcium–vitamin D3 low-fat ultrahigh temperature fortified milk used in the study and the City of Greater Geelong and Ocean View Health Club for their generous provision of the gymnasium facilities used throughout the study.

Author information




JM and SJT performed the data analysis and wrote the manuscript with RMD. IH performed the data analysis. SJT, CMM and RMD conceived the research question. SK was responsible for the implementation of the entire trial and collection of all data under the guidance of RMD and CAN. RMD with CAN conceived the original GENTS study, received funding to conduct the study and were chief investigators for the overall trial. All authors critically reviewed the manuscript, and read and approved the final version.

Corresponding author

Correspondence to Susan J. Torres.

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Ethical statement

This study was conducted according to the guidelines laid down in the 1964 Declaration of Helsinki and its later amendments. All procedures involving human subjects were reviewed and approved by the Deakin University Human Ethics Committee and Barwon Health Research and Ethics Advisory Committee (no. 03/17). Written informed consent was obtained from all participants.

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The authors declare no conflict of interest.

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Matthews, J., Torres, S.J., Milte, C.M. et al. Effects of a multicomponent exercise program combined with calcium–vitamin D3-enriched milk on health-related quality of life and depressive symptoms in older men: secondary analysis of a randomized controlled trial. Eur J Nutr 59, 1081–1091 (2020). https://doi.org/10.1007/s00394-019-01969-8

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  • Calcium
  • Vitamin D3
  • Progressive resistance training
  • Elderly men
  • Health-related quality of life
  • Depression