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These studies suggest that supplements containing calcium and vitamin D generally improve bone health and bone mineral density, particularly in older adults, postmenopausal women, and individuals with deficiencies, while their effects in healthy children with normal levels are less significant.
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Calcium and vitamin D are critical for maintaining bone health, particularly during periods of high physical stress. A study involving military personnel undergoing basic combat training demonstrated that supplementation with calcium (2000 mg/day) and vitamin D (1000 IU/day) significantly improved bone density and strength. The supplementation maintained parathyroid hormone (PTH) levels and increased the osteoprotegerin:RANKL ratio, which are indicators of bone health.
In older adults, calcium and vitamin D supplementation has been shown to reduce bone loss and the incidence of fractures. A study involving men and women aged 65 and older found that daily supplementation with 500 mg of calcium and 700 IU of vitamin D3 resulted in moderate improvements in bone mineral density (BMD) at the femoral neck, spine, and total body, and reduced the incidence of nonvertebral fractures. Another study confirmed that calcium supplementation (750 mg/day) effectively prevented bone loss and reduced secondary hyperparathyroidism in elderly individuals.
Postmenopausal women are at a higher risk of osteoporosis. A systematic review and meta-analysis revealed that combined calcium and vitamin D supplementation significantly increased BMD at various sites, including the lumbar spine and femoral neck, and reduced the incidence of hip fractures.
The effectiveness of vitamin D supplementation alone in improving bone density in children has shown inconsistent results. A meta-analysis of randomized controlled trials found no significant effects on total body BMC, hip BMD, or forearm BMD, although there was a trend towards a small effect on lumbar spine BMD. These findings suggest that vitamin D supplementation may be more beneficial in children with low baseline vitamin D levels.
Calcium supplementation in children has shown a small but significant effect on increasing BMD, particularly in the upper limbs. However, this increase is unlikely to result in a clinically significant decrease in fracture risk, and the effect does not persist after supplementation ceases. Another study involving prepubertal children found that calcium supplementation increased the rate of BMD increase, which could potentially reduce fracture risk if the gain persists into adulthood.
Emerging evidence suggests a positive link between ascorbic acid (vitamin C) intake and bone health. Studies have shown that higher dietary intake and blood levels of ascorbic acid are associated with higher BMD. Supplementation with ascorbic acid has also been found to increase BMD in postmenopausal women.
A study on older adults with sarcopenia found that a nutritional supplement enriched with vitamin D, calcium, and leucine improved measures of bone health. The supplement increased serum 25-hydroxyvitamin D levels, suppressed PTH, and had small but positive effects on BMD.
Calcium and vitamin D are well-established supplements for maintaining and improving bone health across various age groups and conditions. While vitamin D alone shows mixed results, particularly in children, combined supplementation with calcium and vitamin D is effective in reducing bone loss and fracture risk in older adults and postmenopausal women. Emerging evidence also supports the role of ascorbic acid and leucine-enriched whey protein in promoting bone health. Further research is needed to explore the long-term benefits and optimal dosages of these supplements.
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