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. 2016 May 9:5:117-23.
doi: 10.1016/j.bonr.2016.05.001. eCollection 2016 Dec.

Is bone equally responsive to calcium and vitamin D intake from food vs. supplements? Use of (41)calcium tracer kinetic model

Tara S Rogers  1 , Marjorie G Garrod  2 , Janet M Peerson  1 , Darren J Hillegonds  3 , Bruce A Buchholz  3 , Elieke Demmer  1 , Christine Richardson  1 , Erik R Gertz  2 , Marta D Van Loan  4
Affiliations

Is bone equally responsive to calcium and vitamin D intake from food vs. supplements? Use of (41)calcium tracer kinetic model

Tara S Rogers et al. Bone Rep. .

Abstract

Background: Few interventions directly compare equivalent calcium and vitamin D from dairy vs. supplements on the same bone outcomes. The radioisotope calcium-41 ((41)Ca) holds promise as a tracer method to directly measure changes in bone resorption with differing dietary interventions.

Objective: Using (41)Ca tracer methodology, determine if 4 servings/day of dairy foods results in greater (41)Ca retention than an equivalent amount of calcium and vitamin D from supplements. Secondary objective was to evaluate the time course for the change in (41)Ca retention.

Methods: In this crossover trial, postmenopausal women (n = 12) were dosed orally with 100 nCi of (41)Ca and after a 180 day equilibration period received dairy (4 servings/day of milk or yogurt; ~ 1300 mg calcium, 400 IU cholecalciferol (vitamin D3/day)) or supplement treatments (1200 mg calcium carbonate/day and 400 IU vitamin D3/day) in random order. Treatments lasted 6 weeks separated by a 6 week washout (WO). Calcium was extracted from weekly 24 h urine collections; accelerator mass spectrometry (AMS) was used to determine the (41/40)Ca ratio. Primary outcome was change in (41/40)Ca excretion. Secondary outcome was the time course for change in (41)Ca excretion during intervention and WO periods.

Results: The (41/40)Ca ratio decreased significantly over time during both treatments; there was no difference between treatments. Both treatments demonstrated a significant retention of (41)Ca within 1-2 weeks (p = 0.0007 and p < 0.001 for dairy and supplements, respectively). WO demonstrated a significant decrease (p = 0.0024) in (41)Ca retention within 1-2 weeks, back to pre-intervention levels.

Conclusion: These data demonstrate that urinary (41)Ca retention is increased with an increase in calcium and vitamin D intake regardless of the source of calcium, and the increased retention occurs within 1-2 weeks.

Keywords: 41Ca; 41Ca, calcium-41; AI, adequate intake; AMS, accelerator mass spectrometry; ANOVA, analysis of variance; BAP, bone specific alkaline phosphatase; BMC, bone mineral content; BMD, bone mineral density; BMI, body mass index; CTx, serum C terminal telopeptide of type 1 collagen; CV, coefficient of variation; Calcium supplement; DXA, dual energy X-ray absorptiometry; Dairy; ELISA, enzyme linked immune-sorbent assay; HCl, hydrochloric acid; Kinetic model; NDSR, Nutrition Data System for Research; NH4OH, ammonium hydroxide; PTH, parathyroid hormone; Postmenopausal; RCT, randomized controlled trial; RDA, recommended dietary allowances; WHNRC, Western Human Nutrition Research Center; nCi, nanocurrie; qCT, quantitative computed tomography.

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Figures

Fig. 1
Fig. 1
Enrollment and follow up of participants in the randomized crossover trial.
Fig. 2
Fig. 2
Study design. After enrollment, women received a minute labeling dose of 41calcium, which was incorporated into the skeleton over a period of 180 days. Women were then randomly assigned to either the dairy or supplement interventions for 42 days. After a 42 day WO period, subjects completed the second intervention for 42 days.
Fig. 3
Fig. 3
41/40Ca excretion ratio over time (n = 12) for each intervention period and WO. Significant differences were observed by week 1 of each intervention periods I, II and wash out (0.0007, 0.0056, < 0.0001, respectively).
Fig. 4
Fig. 4
Weekly least-square means for urinary 40Ca, 41Ca and the 41/40Ca ratio during interventions.
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