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

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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

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Funding

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).

Author information

Authors and Affiliations

  1. Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan

    Kazutoshi Nakamura, Kaori Kitamura & Yumi Watanabe

  2. Department of Health and Nutrition, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata City, 951-3198, Japan

    Toshiko Saito

  3. Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata City, 951-3198, Japan

    Ryosaku Kobayashi

  4. Department of Rehabilitation, Niigata University of Rehabilitation, Murakami, Niigata, Japan

    Rieko Oshiki

Authors
  1. Kazutoshi Nakamura
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  2. Toshiko Saito
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  3. Ryosaku Kobayashi
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  4. Rieko Oshiki
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  5. Kaori Kitamura
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  6. Yumi Watanabe
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Contributions

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.

Corresponding author

Correspondence to Kazutoshi Nakamura.

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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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Nakamura, K., Saito, T., Kobayashi, R. et al. Physical activity modifies the effect of calcium supplements on bone loss in perimenopausal and postmenopausal women: subgroup analysis of a randomized controlled trial. Arch Osteoporos 14, 17 (2019). https://doi.org/10.1007/s11657-019-0575-4

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  • DOI: https://doi.org/10.1007/s11657-019-0575-4

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