Effect Of Calcium Supplementation On Bone Status


642 Institute of
Nutrition EFFECT OF
CALCIUM SUPPLEMENTATION ON BONE STATUS IN HEALTHY THAI
CHILDREN Nutawan Chaolilitkul1, Vongsvat
Kosulwat1, Somsri Charoenkiatkul1, Umaporn
Suthutvoravut2, Nipa Rojroongwasinkul1 and
Pat Mahachoklertwattana2 1Institute
of Nutrition, Mahidol University at Salaya, Nakhon Pathom 73170,
Thailand, 2Department of Paediatrics, Faculty of
Medicine Ramathibodi Hospital, Mahidol University
Key words : calcium supplementation / children / peak
bone mass / bone mineral content / bonemineral density / bone
mineral Apparent density /
dual-energy x-ray absorptiometry
Osteoporosis is characterized by decreased bone mass and
increased susceptibility of fractures.

It is becoming a major
health and socioeconomic problem worldwide. Maximizing peak bone
mass (PBM) is the most effective prophylaxis against osteoporosis.
The previous intervention studies suggested that increasing calcium
intake during childhood and adolescence could enhance bone
acquisition resulting in a greater PBM. The effect of increased
calcium intake through supplementation on bone acquisition in
healthy Thai children and adolescents aged 9-12 years was
evaluated.


One hundred and thirty-three children and adolescents from Samsen
and Phayathai schools underwent a 1 year randomized, double-blind,
controlled trial. Subjects were randomized to receive either 500 mg
calcium as calcium carbonate or a placebo capsule daily by matching
with puberty and sex. Bone measurements by dual-energy x-ray
absorptiometry (DEXA) were determined at the midshaft radius and
lumbar spine, and expressed as bone mineral content (BMC, g), bone
mineral density (BMD, g/cm2), and bone mineral apparent
density (BMAD, g/cm3), at baseline and 12 months.
Baseline dietary calcium intake and physical activity were assessed
by a semi-quantitative food frequency questionnaire (sFFQ), and a
physical activity questionnaire, respectively, and were repeated
every 6 months.

Weight and height also were measured at baseline
and every 6 months. There was no significant difference with
respect to baseline characteristics between the
supplement and placebo group.
During the study, the average daily calcium intake of the
supplement group was 1,069 mg ( 580 mg from
diet and 489 mg from the
supplement), and that of the placebo group was 647 mg. Subjects
given supplements had significantly greater increases of
midshaft radius BMD (9.

5% VS. 7.2%) even after adjustment for
puberty, sex, age, initial dietary calcium intake, time spent
for weight-bearing sport activity, and baseline bone values, as
shown by multiple regression analysis. The benefit of calcium
supplementation on bone acquisition was more evidenced in
early-pubertal males (BMC, BMD and BMAD at lumbar spine) as well
as males who had low habitual dietary calcium intake of less
than 77% of the recommended values (BMC and BMD at midshaft
radius, BMAD at lumbar spine).

Both male and female subjects who
spent more than 7 hrs/wk of weight-bearing sport activities also
had benefit from calcium supplementation on bone acquisition
(BMD at midshaft radius and lumbar spine, BMAD at lumbar spine).

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