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ARTICLE

Calcium Supplementation with and without Hormone Replacement Therapy To Prevent Postmenopausal Bone Loss

John F. Aloia; Ashok Vaswani; James K. Yeh; Patrick L. Ross; Edith Flaster; and F. Avraham Dilmanian

15 January 1994 | Volume 120 Issue 2 | Pages 97-103

Objective: To determine whether augmentation of dietary calcium is effective in the prevention of early postmenopausal bone loss.

Design: Three-arm, placebo-controlled, randomized parallel trial. The study duration was 2.9 ±1.1 (SD) years.

Setting: General community.

Participants: 118 healthy, white women 3 to 6 years after spontaneous menopause, recruited by community announcement.

Interventions: Random allocation to daily intake of 1700 mg of calcium (calcium carbonate given in divided doses with meals); placebo; or conjugated equine estrogens (0.625 mg; days 1 to 25), progesterone (10 mg; days 16 to 25), and 1700 mg of elemental calcium daily. Each participant received 400 IU of vitamin D daily.

Main Outcome Measures: Total body calcium measured by delayed neutron activation analysis and whole-body counting; bone mineral density of the spine, femur, and radius measured by photon absorptiometry.

Results: Bone mineral density declined in the placebo group for the lumbar spine ( –2.1%/y;95% CI, –3.3 to –0.9),femoral neck ( –2.0%/y;CI,-2.6 to –1.2),trochanter ( –1.6%/y;CI, –2.4 to –0.8),Ward triangle ( –2.7%/y;CI, –3.7 to –1.7),and total body calcium ( –2.0%/y;CI, –2.2 to –1.8).Rates of change were intermediate for calcium augmentation compared with placebo and estrogen-progesterone-calcium but statistically significant compared with placebo for total body calcium ( –0.5%/y;CI, –0.9 to –0.1;P = 0.006) and the femoral neck ( –0.8%/y;CI, –1.4 to –0.2;P = 0.03).

Conclusions: Although less effective than estrogen-progesterone-calcium, calcium augmentation alone significantly retards bone loss from the femoral neck and improves calcium balance in recently postmenopausal women. Dietary calcium augmentation should be recommended as a strategic option in helping to prevent early postmenopausal bone loss.

Author and Article Information

From Winthrop-University Hospital, Mineola, New York, and Brookhaven National Laboratory, Upton, New York.
Requests for Reprints: John F. Aloia, MD, Department of Medicine, Winthrop-University Hospital, 259 First Street, Mineola, NY 11501.
Acknowledgments: The authors thank Diane McGill, RN, for her role as coordinator and Sharon Sprintz for performance of the densitometry.
Grant Support: By National Institutes of Health RO1-AR37520-05 and DOE DE AC 02 76CN-0016.

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