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Calcium, physical activity and bone health – building bones for a stronger future

Published online by Cambridge University Press:  01 February 2001

Francesco Branca  and
Silvia Vatueña
Francesco Branca*
Affiliation:
Istituto Nazionale per gli Alimenti e la Nutrizione, Via Adreatina 546, Rome, Italy
Silvia Vatueña
Affiliation:
Istituto Nazionale per gli Alimenti e la Nutrizione, Via Adreatina 546, Rome, Italy
*
*Corresponding author: Email [email protected]
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Abstract

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Adequate provision of nutrients composing the bone matrix and regulating bone metabolism should be provided from birth in order to achieve maximal bone mass, compatible with individual genetic background, and to prevent osteoporosis later in life. Low calcium intake (<250 mg day−1) in children is associated with both a reduced bone mineral content and hyperparathyroidism. Optimal calcium intake is, however, still a matter of controversy. The minimisation of fracture risk would be the ideal functional outcome on which to evaluate lifetime calcium intakes, but proxy indicators, such as bone mass measurements or maximal calcium retention, are used instead. Calcium recommendations in Europe and the United States are based on different concepts as to requirements, leading to somewhat different interpretations of dietary adequacy. Minerals and trace elements other than calcium are involved in skeletal growth, some of them as matrix constituents, such as magnesium and fluoride, others as components of enzymatic systems involved in matrix turnover, such as zinc, copper and manganese. Vitamins also play a role in calcium metabolism (e.g. vitamin D) or as co-factors of key enzymes for skeletal metabolism (e.g. vitamins C and K). Physical activity has different effects on bone depending on its intensity, frequency, duration and the age at which it is started. The anabolic effect on bone is greater in adolescence and as a result of weight-bearing exercise. Adequate intakes of calcium appear necessary for exercise to have its bone stimulating action.

Keywords

Mineral requirementsBone growthOsteoporosisChildrenAdolescents
Type
Research Article
Information
Public Health Nutrition , Volume 4 , Issue 1a , February 2001 , pp. 117 - 123
Copyright
Copyright © CABI Publishing 2001

References

1Wang, YL, Wu, H, Yi, BL, LeBlanc, J. Newborn bone mineral density and health care during pregnancy. J. Bone Miner. Metab. 1998; 16(3): 190–2.Google Scholar
2Hui, SL, Slemenda, CW, Johnston, CC. Baseline measurement of bone mass predicts fracture in white women. Ann. Intern. Med. 1989; 111: 355–61.Google Scholar
3Mazzuoli, G, Acca, M, Pisani, D. et al. Annual skeletal balance and metabolic bone marker change in healthy early postmenopausal women: results of a prospective study. Bone 2000; 26: 381–6.Google Scholar
4Riggs, B, Melton, L. New Eng. J. Med. 1992; 327: 620.Google Scholar
5Kelly, PJ, Eisman, JA, Sambrook, PN. Interaction of genetic and environmental influences on peak bone density. Osteoporosis Int. 1990; 1: 56–60.CrossRefGoogle ScholarPubMed
6Lee, WTK, Leung, SSF, Ng, MY. et al. Bone mineral content of two populations of Chinese children with different calcium intake. Bone and Mineral 1993; 23: 195–206.CrossRefGoogle Scholar
7Pettifor, JM, Ross, P, Moodley, G, Shuenyane, E. Calcium deficiency in rural black children in South Africa – a comparison between rural and urban communities. Am. J. Clin. Nutr. 1979; 34: 2187–91.Google Scholar
8Luyken, R, Luyken-Koning, FWM. Studies on physiology of nutrition in Surinam. XII. Nutrition and development of muscular, skeletal and adipose tissues in Surinam children. Am. J. Clin. Nutr. 1969; 22: 519–26.Google Scholar
9Prentice, A, Laskey, MA, Shaw, J, Cole, TJFraser, DR. Bone mineral content of Gambian and British children aged 0–36 months. Bone and Mineral 1990; 10: 211–4.CrossRefGoogle ScholarPubMed
10Institute of Medicine. Dietary reference intakes for Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride. Standing Committee on the scientific evaluation of dietary reference intakes. Washington DC: National Academy Press, 1997.Google Scholar
11Hegsted, D. Calcium and osteoporosis. J. Nutr. 1986; 116: 2316.Google Scholar
12Cummings, S, Black, D, Nevitt, M. et al. Bone density at various sites for prediction of hip fractures. Lancet 1993; 341: 72–5.Google Scholar
13Cummings, S, Nevitt, M, Browner, W. et al. Risk factors for hip fracture in white women. N. Engl. J. Med. 1995; 332: 767–73.CrossRefGoogle ScholarPubMed
14World Health Organisation. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Geneva: WHO, 1994.Google Scholar
15Matkovic, V. Calcium metabolism and calcium requirements during skeletal modelling and consolidation. Am. J. Clin. Nutr. 1991; 54: 245S–60S.Google Scholar
16Boot, A, de Ridder, M, Pols, H, Krenning, E, de Muinck KeizerSchrama, S. Bone mineral density in children and adolescents: relation to puberty, calcium intake, and physical activity. J. Clin. Endocrinol. Metab. 1997; 82: 57–62.Google Scholar
17Ilich, JM, Hangartner, T, Baoshe, A, Matkovic, V. Relation of nutrition, body composition and physical activity to skeletal development: a cross-sectional study in preadolescent females. J. Am. Coll. Nutr. 1998; 17: 136–47.CrossRefGoogle ScholarPubMed
18Teegarden, D, Lyle, R, Proulx, W, Johnston, C, Weaver, C. Previous milk consumption is associated with greater bone density in young women. Am. J. Clin. Nutr. 1999; 69: 1014–7.Google Scholar
19Specker, B, Beck, A, Kalkwarf, H, Ho, M. Randomized trial of varying mineral intake on total body bone mineral accretion during the first year of life. Pediatrics 1997.Google Scholar
20Ilich, J, Badenhop, N, Jelic, T, Clairmont, A, Nagode, L, Matkovic, V. Calcitriol and bone mass accumulation in females during puberty. Calcif. Tissue Int. 1997; 61: 104–9.Google Scholar
21Magarey, A, Boulton, T, BE, C, Schultz, C, Nordin, B. Familial and environmental influences on bone growth from 11–17 years. Acta Paediatr. 1999; 88: 1204–10.Google Scholar
22Specker, BL. Evidence for an interaction between calcium intake and physical activity on changes in bone mineral density. J. Bone Min. Res. 1996; 11: 1539–44.Google Scholar
23Kardinaal, A, Ando, S, Charles, P. et al. Dietary calcium and bone density in adolescent girls and young women in Europe. J. Bone Miner. Res. 1999; 14: 583–92.Google Scholar
24Maggiolini, M, Bonofiglio, D, Giorno, A. et al. The effect of dietary calcium intake on bone mineral density in healthy adolescent girls and young women in southern Italy. Int. J. Epidemiol. 1999; 28: 479–84.CrossRefGoogle Scholar
25Sentipal, J, Wardlaw, G, Mahan, J, Matkovic, V. Influence of calcium intake and growth indexes on vertebral bone mineral density in young females. Am. J. Clin. Nutr. 1991; 54: 425–8.Google Scholar
26Johnston, CC, Miller, JZ, Slemenda, CW. et al. Calcium supplementation and increases in bone mineral density in children. N. Engl. J. Med. 1992; 327: 82–7.CrossRefGoogle ScholarPubMed
27Lloyd, T, Andon, MB, Rollings, N. et al. Calcium supplementation and bone mineral density in adolescent girls. JAMA 1993; 270: 841–4.Google Scholar
28Nowson, C, Green, R, Hopper, J. et al. A co-twin study of the effect of calcium supplementation on bone density during adolescence. Osteoporos. Int. 1997; 7: 219–25.CrossRefGoogle Scholar
29Stallings, V. Calcium and bone health in children: a review. Am. J. Ther. 1997; 4: 259–73.Google Scholar
30Agnusdei, D, Civitelli, R, Camporeale, A. et al. Age-related decline of bone mass and intestinal calcium absorption in normal males. Calcif. Tissue Int. 1998; 63: 197–201.CrossRefGoogle ScholarPubMed
31Ireland, P, Fordtran, JS. Effect of dietary calcium and age on jekjunal calcium absorption in humans studies by intestinal perfusion. J. Clin. Invest. 1973; 52: 2672–81.Google Scholar
32Younoszai, MK, Ghishan, FK. In vivo intestinal calcium absorption in infant rats: normal and growth retarded. J. Nutr. 1979; 109: 573–9.Google Scholar
33de Portela, ML, Zeni, S, Piazza, N, Rio, ME. Calcium balance in infants recovering from undernutrition. Nutr. Rep. Int. 1982; 26: 1045–51.Google Scholar
34Weaver, C, Proulx, W, Heaney, R. Choices for achieving adequate dietary calcium with a vegetarian diet. Am. J Clin. Nutr. 1999; 70: 543S–8S.CrossRefGoogle ScholarPubMed
35Heaney, R, Weaver, C. Effect of psyllium on absorption of coingested calcium. J. Am. Geriatr. Soc. 1995; 43: 1–3.Google Scholar
36Reid, D, New, S. Nutritional influences on bone mass. Proc. Nutr. Soc. 1997; 56: 977–87.Google Scholar
37Nordin, BEC, Need, AG. The effect of sodium on calcium requirement. In: Draper, HH, ed. Nutrition and osteoporosis. New York: Plenum Press, 1994: 209–30.CrossRefGoogle Scholar
38Devine, A, Criddle, R, Dick, I, Kerr, DPrince, R. A longitudinal study of the effect of sodium and calcium intakes on regional bone density in postmenopausal women. Am. J. Clin. Nutr. 1995; 62: 740–5.CrossRefGoogle ScholarPubMed
39NIH. Consensus Development Conference Statement. Osteoporosis Prevention, Diagnosis, and Therapy. March 27–29, 2000.Google Scholar
40Infante, D, Tormo, R. Risk of inadequate bone mineralization in diseases involving long-term suppression of dairy products. J. Pediatr. Gastroenterol. Nutr. 2000; 30: 310–3.Google Scholar
41Yano, K, Heilbrun, LK, Wasnich, RD, Hankin, JH, Vogel, JM. The relationship between diet and bone mineral content of multiple skeletal sites in elderly Japanese men and women living in Hawaii. Am. J. Clin. Nutr. 1985; 42: 877–88.CrossRefGoogle ScholarPubMed
42Freudenheim, JL, Johnson, NE, Smith, EL. Relationships between usual nutrient intake and bone mineral content of women 35–65 years of age: longitudinal and cross-sectional analysis. Am. J. Clin. Nutr. 1986; 44: 863–76.Google Scholar
43Stendig-Lindberg, G, Tepper, R, Leichter, I. Trabecular bone density in a two year controlled trial of peroral magnesium in osteoporosis. Magnes. Res. 1993; 6: 155–63.Google Scholar
44Abraham, GE, Grewal, H. A total dietary program emphasizing magnesium instead of calcium: effect of the mineral density of calcaneous bone in postmenopausal women on hormonal therapy. J. Reprod. Med. 1990; 35: 503–7.Google Scholar
45Kröger, H, Alhava, E, Honkanen, R, Tuppurainen, M, Saarikoski, S. The effect of fluoridated drinking water on axial bone mineral density: a population-based study. Bone Miner. 2: 33–41.Google Scholar
46Sowers, M, Clark, MK, Jannausch, ML, Wallace, RB. A prospective study of bone mineral content and fracture in communities with differentila fluoride exposure. Am. J. Epidemiol. 1991; 133: 649–60.Google Scholar
47Holloway, WR, Collier, FM, Herbst, RE, Hodge, JM, Nicholson, GC. Osteoblast-mediated effects of zinc on isolated rat osteoclasts: inhibition of bone resorption and enhancement of osteoclast number. Bone 1996; 19: 137–42.Google Scholar
48Strause, L, Saltman, P, Smith, KT, Bracker, M, Andon, MB. Spinal bone loss in postmenopausal women supplemented with calcium and trace minerals. J. Nutr. 1994; 124: 1060–4.Google Scholar
49Jonas, J, Burns, J, Abel, EW, Cresswell, MJ, Strain, JJ, Paterson, CR. Imparied mechanical strength of bone in experimental copper deficiency. Ann. Nutr. Metab. 1993; 37: 245–52.Google Scholar
50Fincham, JE, van Rensburg, SJ, Maras, WFO. Mseleni joint disease – a manganese deficiency? S. Afr. Med. Journ. 1981; 60: 445–7.Google Scholar
51Nielsen, FH, Hunt, CD, Mullen, LM, Hunt, JR. Effect of dietary boron on mineral, estrogen and testosterone metabolism in postmenopausal women. FASEB J 1987; 1: 394–7.CrossRefGoogle ScholarPubMed
52Ladizesky, M, Lu, Z, Oliveri, B, San Roman, N, Diaz, S, Holick, MF, Mautalen, C. Solar ultraviolet B radiation and photo-production of vitamin D3 in central and southern areas of Argentina. J. Bone Miner. Res. 1995; 10: 545–9.CrossRefGoogle Scholar
53Leveille, SG, LaCroix, AZ, Koepsell, TD, Beresford, S, Van Belle, G, Buchner, DM. Do dietary antioxidants prevent postmenopausal bone loss? Nutr. Res. 1997; 17(8): 1261–9.CrossRefGoogle Scholar
54Hodges, SJ, Akesson, K, Verganud, P. et al. Circulating levels of vitamins K1 and K2 decreased in elderly women with hip fracture. J. Bone Miner. Res. 1993; 8: 1241–5.CrossRefGoogle ScholarPubMed
55Melhus, H, Michaelson, K, Kindmark, A. et al. Excessive dietary intake of vitamin A is associated with reduced bone mineral density and increased risk for hip fracture. Ann. Int. Med. 1998; 129: 770–8.Google Scholar
56Cruz, J, Moreiras-Varela, O, van Staveren, W, Trichopoulu, A, Roszkowski, W. Intake of vitamins and minerals. Euronut SENECA investigators. Eur. J. Clin. Nutr. 1991; 45(suppl 3): 121–38.Google Scholar
57Lanyon, L. Control of bone architecture by functional load bearing. J. Bone Miner. Res. 1992; 7(Suppl 2): S369–75.Google Scholar
58Holbrook, T, Barret-Connor, E. The association of lifetime weight and weight control patterns with bone mineral density in an adult community. Bone Miner. 1993; 20: 141–9.Google Scholar
59Langlois, J, Harris, T, Looker, A, Madans, J. Weight change between age 50 years and old age is associated with risk of hip fracture in white women aged 67 years and older. Arch. Intern. Med. 1996; 156: 989–94.Google Scholar
60Judex, S, Gross, T, Zernicke, R. Strain gradients correlate with sites of exercise-induced bone-forming surfaces in the adult skeleton. J. Bone Miner. Res. 1997; 12(10): 1737–45.Google Scholar
61Bailey, D, McKay, H, Milwald, R, Crocker, P, Faulkner, R. A six-year longitudinal study of the relationship of physical activity to bone mineral accrual in growing children: the university of Saskatchewan bone mineral accrual study. J. Bone Miner. Res. 1999; 14: 1672–9.Google Scholar
62Nickols-Richardson, S, Modlesky, C, O'Connor, P, Lewis, R. Premenarcheal gymnasts possess higher bone mineral density than controls. Med. Sci. Exerc. 2000; 32: 63–9.Google Scholar
63Slemenda, CW, Miller, JZ, Hui, SL, Reister, TK, Johnston, CC. Role of physical activity in the development of skeletal mass in children. J. Bone Min. Res. 1991; 6(1): 1227–33.Google Scholar
64Rodriguez, JI, Garcia-Alix, A, Palacios, J, Paniagua, R. Changes in long bones due to fetal immobility caused by neuromuscular disease. J. Bone Joint Surg. 1988; 70A: 1052–60.Google Scholar
65Welten, DC, Kemper, HGC, Post, GB. et al. Weight-bearing activity during youth is a more important factor for peak bone mass than calcium intake. J. Bone Min. Res. 1994; 9: 1089–95.Google Scholar
66Voss, L, Fadale, P, Hulstyn, M. Exercise-induced loss of bone density in athletes. J. Am. Acad. Orthop. Surg. 1998; 6: 349–57Google Scholar
67Specker, B, Mulligan, L, Ho, M. Longitudinal study on calcium intake, physical activity, and bone mineral content in infants 6–18 months of age. J. Bone Miner. Res. 1999; 14: 569–76.CrossRefGoogle ScholarPubMed