Skip to main content
SpringerLink
Log in

A co-twin study of the effect of calcium supplementation on bone density during adolescence

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

The effect of calcium supplementation on bone mineral density (BMD) was evaluated in female twin pairs aged 10–17 years with a mean age of 14 years. Forty-two twin pairs (22 monozygotic, 20 dizygotic; (including one monozygotic pair from a set of triplets) completed at least 6 months of the intervention: 37 pairs to 12 months and 28 pairs to 18 months. BMD was measured by dual-energy X-ray absorptiometry (DXA). In a double-blind manner, one twin in each pair was randomly assigned to receive daily a 1000 mg effervescent calcium tablet (Sandocal 1000), and the other a placebo tablet similar in taste and appearance to the calcium supplement but containing no calcium. Compliance (at least 80% tablets consumed), as measured by tablet count, was 85% in the placebo group and 83% in the calcium group over the 18 months of the study, on average increasing dietary calcium to over 1600 mg/day. There was no within-pair difference in the change in height or weight. When the effect of calcium supplementation on BMD was compared with placebo at approximately 6, 12 and 18 months, it was found that there was a 0.015±0.007 g/ cm2 greater increase in BMD (1.62±0.84%) at the spine in those on calcium after 18 months. At the end of the first 6 months there was a significant within-pair difference of 1.53±0.56% at the spine and 1.27±0.50% at the hip. However, there were no significant differences in the changes in BMD after the initial effect over the first 6 months. Therefore, we found an increase in BMD at the spine with calcium supplementation in females with a mean age of 14 years. The greatest effect was seen in the first 6 months; thereafter the difference was maintained, but there was no accelerated increase in BMD associated with calcium supplementation. The continuance of the intervention until the attainment of peak bone mass and follow-up after cessation of calcium supplementation will be important in clarifying the optimal timing for increased dietary calcium and the sustained, long-term effects of this intervention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ott SM. Bone density in adolescents. N Engl J 1991;325:1646–47.

    Google Scholar 

  2. Gordon CI, Halton JM, Atkinson SA. The contribution of growth and puberty to peak bone mass. Growth Dev Aging 1991;55:257–62.

    Google Scholar 

  3. Glastre C, Braillon P, David L, Cochat P, Meunier PJ, Delmas PD. Measurement of bone mineral content of the lumbar spine by dual energy X-ray absorptiometry in normal children: correlations with growth parameters. J Clin Endocrinol Metab 1990;705:1330–3.

    Google Scholar 

  4. Recker RR, Davies KM, Hinders SM, Heaney RP, Stegman MR, Kimmel DB. Bone gain in young adult women. JAMA 1992;268:2403–8.

    Google Scholar 

  5. Young D, Hopper JL, Nowson CA, Green RM, Sherwin AJ, Kaymakci B, Smid M, Guest CG, Larkins RG, Wark JD. Determinants of bone mass in 10 to 26 year old females: a twin study. Bone Miner Res 1995;10:558–67.

    Google Scholar 

  6. Bonjour JP, Theintz G, Buchs B, Slosman D, Rizzoli R. Critical years and stages of puberty for spinal and femoral bone mass accumulation during adolescence. J Clin Endocrinol Metab 1991;73:555–63.

    Google Scholar 

  7. Pocock NA, Eisman JA, Hopper JL, Yeats PN, Sambrook PN, Ebert S. Genetic determinants of bone mass in adults: a twin study. J Clin Invest 1987;80:706–10.

    Google Scholar 

  8. Matkovic V, Kostial K, Simonovic I, Buzina R, Brodarec A, Nordin BEC. Bone status and fracture rates in two regions of Yugoslavia. Am J Clin Nutr 1979;32:540–9.

    Google Scholar 

  9. Hopper JL, Seeman E. The bone density of female twins discordant for tobacco use. N Engl J Med 1994;330:387–92.

    Google Scholar 

  10. Sandier RB, Slemenda CW, La Porte RE, Cauley JA, Schramm MM, Barresi L, Rriska AM. Postmenopausal bone density and milk consumption in childhood and adolescence. Am J Clin Nutr 1985;42:270–4.

    Google Scholar 

  11. Johnston CC, Miller JZ, Slemenda CW, Reister TK, Hui S, Christian JC, Peacock M. Calcium supplementation and increases in bone mineral density in children. N Engl J Med 1993;327:82–7.

    Google Scholar 

  12. Lloyd T, Andon MB, Rollings NJK, Mattel MS, Landis JR, Demers LM, Eggli DF, Kieselhorst K, Kulin HE. Calcium supplementation and bone mineral density in adolescent girls. JAMA 1993;270:841–4.

    Google Scholar 

  13. Lee WTK, Leung SSF, Wang S, Xu Y, Zeng W, Lau J, Oppenheimer SJ, Cheng. Double-blind, controlled calcium supplementation and bone mineral accretion in children accustomed to a low calcium diet. Am J Clin Nutr 1994;60:744–50.

    Google Scholar 

  14. McCormick DP, Ponder SW, Fawcett HD, Palmer JL. Spinal bone mineral density in 355 normal and obese children and adolescents: evidence for ethnic and sex differences. J Bone Miner Res 1991;6:507–13.

    Google Scholar 

  15. Lloyd T, Rollings N, Chinchilli V, Martel J, Eggli D, Demers LM, Andon MB. The effect of starting calcium supplementation at age 12 or at age 14 on bone aquistion in teenage girls (abstract). J Bone Miner Res 1995;10(Suppl 1)S152–4.

    Google Scholar 

  16. Nowson CA, Sherwin AJ, Green RM, Wark JD. Limitations of dietary calcium assessment in female twins of different ages. In: Burckhardt P, Heaney RP, editors. Nutritional aspects of osteoporosis. Ares-Serono Symposia 1995;7:97–104.

    Google Scholar 

  17. Weaver CM, Martin BR, Peacock M. Calcium metabolism in adolescent girls. In: Burckhardt P, Heaney RP, editors. Nutritional aspects of osteoporosis. Ares-Serono Symposia 1995;7:123–8.

    Google Scholar 

  18. Matkovic V. Calcium metabolism and caclium requirements during skeletal modelling and consolidation of bone mass. Am J ClinNutr 1991;54:S245–60.

    Google Scholar 

  19. Weaver CM, Martin BR, Plawecki KL, Peacock M, Wood OB, Smith DL, Wastney ME. Differences in calcium metabolism between adolescent and adult females. Am J Clin Nutr 1995;61;577–81.

    Google Scholar 

  20. Slemenda CW, Reister TK, Peacock M, Johnston CC. Bone growth in children following the cessation of calcium supplementation (abstract). J Bone Miner Res 1993;8(Suppl 1) S151.

  21. Bonjour JPH, Carrie AL, Ferrai S, Slosman D, Rizzoli R. Calcium-fortified foods increased bone modeling in prepubertal girls in a double-blind, placebo-controlled randomized trial (abstract). Osteoporosis Int 1996;6(Suppl 1):88.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, Victoria, Australia

    C. A. Nowson, R. M. Green, A. J. Sherwin, B. Kaymakci, M. Smid, R. G. Larkins & J. D. Wark

  2. Department of Public Health and Community Medicine, The University of Melbourne, Carlton, Victoria, Australia

    J. L. Hopper & D. Young

  3. Department of Community Medicine, The University of Adelaide, Adelaide, South Australia

    C. S. Guest

Authors
  1. C. A. Nowson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. M. Green
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. L. Hopper
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. J. Sherwin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D. Young
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. B. Kaymakci
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. C. S. Guest
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. M. Smid
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. R. G. Larkins
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. J. D. Wark
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nowson, C.A., Green, R.M., Hopper, J.L. et al. A co-twin study of the effect of calcium supplementation on bone density during adolescence. Osteoporosis Int 7, 219–225 (1997). https://doi.org/10.1007/BF01622292

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01622292

Keywords

Search

Navigation