Prevention of postmenopausal osteoporosis: a comparative study of exercise, calcium supplementation, and hormone-replacement therapy

Article Abstract:

This two-year study was carried out to compare the effects of three treatments for preventing bone loss in postmenopausal women who were already at risk for bone fracture. One hundred twenty women were randomly assigned to one of three study groups: exercise alone (41 women); exercise plus 1 gram of elemental calcium each day (39); or exercise plus replacement estrogen and progesterone (40). Forty-two postmenopausal women who were not at risk for fracture (based on bone density scores) served as control subjects. The exercise consisted of a weekly exercise class and two 30-minute walks per week. Subjects' forearm bone density was measured every three months and the women underwent physical examinations every six months, which included the measurement of substances in blood and urine that reflected calcium metabolism. Results showed that the exercise-only and control groups lost bone density in the distal forearm (just above the wrist) at approximately the same rate, while the exercise-plus-calcium group lost bone density less rapidly. Bone density in the exercise-estrogen group increased at all three forearm sites measured. Side effects, too, differed among the groups: women in the exercise-estrogen group were less likely to experience hot flashes than those in the exercise-calcium or exercise groups during the first three months of treatment. However, these symptoms decreased as the study progressed. Sleeplessness and pain during intercourse improved for the exercise-estrogen group, but did not change for the other two groups. More women in the exercise-estrogen group (52 percent) than the other groups (11 percent in the exercise group, 12.5 percent of the exercise-calcium group) developed vaginal bleeding and breast tenderness during the study. A discussion is presented of the physiology of bone loss after menopause. It may be best for women with intermediate decreases in bone density to follow an exercise-calcium regimen, with exercise plus estrogen, because of the need for medical supervision, reserved for women with low bone density. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Bones, Complications and side effects, Physiological aspects, Hormone therapy, Bone density, Menopause

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Diet and the prevention of osteoporotic fractures

Article Abstract:

There is enough evidence to recommend that all nursing home residents receive calcium and vitamin D supplements. Fractures resulting from osteoporosis affect half of all women and 30% of all men over the age of 50. A 1997 study of elderly people found that supplementation with calcium and vitamin D prevented bone loss and reduced the rate of fractures by half. Calcium loss in the elderly is thought to occur because calcium absorption in the intestines declines with age. Nursing home residents are not exposed to sunlight, which produces vitamin D in the skin. Consequently, they may benefit from calcium and vitamin D supplementation.

Aged, Elderly, Editorial, Food and nutrition, Vitamin D in human nutrition, Nutritional aspects, Vitamin D, Calcium (Nutrient), Fractures (Injuries), Fractures, Nursing home patients, Calcium, Dietary

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Hypovitaminosis D in medical inpatients

Article Abstract:

Many hospital patients may be deficient in vitamin D even though they receive the recommended daily amount through their diet. Analysis of vitamin D levels in 290 hospital patients revealed that 57% were vitamin D-deficient. Twenty-two percent were severely deficient. Almost 40% of those with adequate vitamin D intakes were also deficient. Many hospital patients have conditions that can lead to vitamin D deficiency, including poor diet, lack of sun exposure, chronic diseases and use of certain drugs. Vitamin D deficiency can increase the risk of fractures.

Statistics, Hospital patients, Vitamin D deficiency

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