Effects of a multi-component exercise program and calcium-vitamin-D₃-fortified milk on bone mineral density in older men: a randomised controlled trial

• Published in: Osteoporosis international Vol. 20; no. 7; pp. 1241 - 1251
• Main Authors: Kukuljan, S, Nowson, C. A, Bass, S. L, Sanders, K, Nicholson, G. C, Seibel, M. J, Salmon, J, Daly, R. M
• Format: Journal Article
• Language: English
• Published: London London : Springer-Verlag 01-07-2009; Springer-Verlag; Springer; Springer Nature B.V
• Subjects: Absorptiometry, Photon; Aged; Animals; Biological and medical sciences; BMD; Bone density; Bone Density - drug effects; Bone Density - physiology; calcium; Calcium, Dietary - administration & dosage; Cholecalciferol - administration & dosage; Clinical trials; Diseases of the osteoarticular system; Endocrinology; Exercise; Exercise Therapy; Femur - diagnostic imaging; Femur Neck - diagnostic imaging; Food, Fortified; Fortified milk; Hip Joint - diagnostic imaging; Humans; Investigative techniques, diagnostic techniques (general aspects); Lumbar Vertebrae - diagnostic imaging; Male; Medical sciences; Medicine; Medicine & Public Health; Men; Middle Aged; Milk; Muscle Strength - physiology; Muscle, Skeletal - drug effects; Muscle, Skeletal - physiology; Nutrition; Older people; Original Article; Orthopedics; Osteoarticular system. Muscles; Osteoporosis. Osteomalacia. Paget disease; Parathyroid Hormone - blood; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Rheumatology; Treatment Outcome; Victoria; vitamin D; Vitamin D - analogs & derivatives; Vitamin D - blood; BMD; Exercise; Fortified milk; Calcium; Vitamin D; Men; Physical exercise; Human; Osteoporosis; Diseases of the osteoarticular system; Bone mineral density; Colecalciferol
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-008-0776-y

Summary We examined the independent and combined effects of a multi-component exercise program and calcium-vitamin-D₃-fortified milk on bone mineral density (BMD) in older men. Exercise resulted in a 1.8% net gain in femoral neck BMD, but additional calcium-vitamin D₃ did not enhance the response in this group of older well-nourished men. Introduction This 12-month randomised controlled trial assessed whether calcium-vitamin-D₃-fortified milk could enhance the effects of a multi-component exercise program on BMD in older men. Methods Men (n = 180) aged 50-79 years were randomised into: (1) exercise + fortified milk; (2) exercise; (3) fortified milk; or (4) controls. Exercise consisted of high intensity progressive resistance training with weight-bearing impact exercise. Men assigned to fortified milk consumed 400 mL/day of low fat milk providing an additional 1,000 mg/day calcium and 800 IU/day vitamin D₃. Femoral neck (FN), total hip, lumbar spine and trochanter BMD and body composition (DXA), muscle strength 25-hydroxyvitamin D and parathyroid hormone (PTH) were assessed. Results There were no exercise-by-fortified milk interactions at any skeletal site. Exercise resulted in a 1.8% net gain in FN BMD relative to no-exercise (p < 0.001); lean mass (0.6 kg, p < 0.05) and muscle strength (20-52%, p < 0.001) also increased in response to exercise. For lumbar spine BMD, there was a net 1.4-1.5% increase in all treatment groups relative to controls (all p < 0.01). There were no main effects of fortified milk at any skeletal site. Conclusion A multi-component community-based exercise program was effective for increasing FN BMD in older men, but additional calcium-vitamin D₃ did not enhance the osteogenic response.