Skip to main content
SpringerLink
Log in

Physical activity and dietary calcium interactions in bone mass in Scottish postmenopausal women

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

Abstract

Summary

In this population-based cohort of 1,254 older Scottish women we found significant interactions between the mechanical component of self-reported habitual physical activity (PA) and dietary calcium (Ca) in BMD, independent of other risk factors. At low and/or medium Ca intakes BMD was higher amongst the most active people.

Introduction

Although there is general agreement that increased activity (PA) and dietary calcium (Ca) consumption may help maintain bone mass in later life and prevent fractures, the amount required remains uncertain.

Methods

In 2001–2003, 1,847 postmenopausal women (mean ± SD age: 69.3 ± 5.5 years) underwent bone mineral density (BMD) measurement and, in 2004, 68.7% (n = 1,254) completed a bone-specific Physical Activity Questionnaire (bsPAQ) and a food frequency questionnaire. The bsPAQ measures the metabolic and mechanical components of PA. Interactions of PA and Ca in BMD were examined using ANCOVA.

Results

Significant interactions were identified in the BMD of the lumbar spine (LS), right hip (RH) and left hip (LH), after adjustment for confounders, between tertiles of PA classified according to the mechanical component and tertiles of energy-adjusted Ca intake (ANCOVA p = 0.006, p = 0.004 and p = 0.013 respectively). For example, at medium Ca intakes LH BMD was higher by 7.8% in the highest tertile of PA compared with the lowest tertile of PA.

Conclusions

These data suggest that health promotion campaigns to increase PA would be most effective in populations with a low/medium calcium intake.

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.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Genant HK, Cooper C, Poor G et al (1999) Interim report and recommendations of the World Health Organization Task-Force for Osteoporosis. Osteoporos Int 10:259–264

    Article  PubMed  CAS  Google Scholar 

  2. World Health Organization (2002) Osteoporosis in the workplace: the social, economic and human costs of osteoporosis on employees, employers and governments. An “Invest in Your Bones” report compiled by the World Health Organisation Collaborating Centre, Liège, Belgium on behalf of the International Osteoporosis Foundation Committee of Scientific Advisors www.iofbonehealth.org

  3. Torgeson DT, Inglesias CP, Reid DM (2001) The economics of fracture prevention. In: Barlow DH, Frances RM, Miles A (eds) The effective management of osteoporosis. Aesculapius Medical Press, London, pp 111–121

    Google Scholar 

  4. Prentice A (2001) The relative contribution of diet and genotype to bone development. Proc Nutr Soc 60:45–52

    Article  PubMed  CAS  Google Scholar 

  5. Seeman E, Hopper JL (1997) Genetic and environmental components of the population variance in bone density. Osteoporos Int 7 [Suppl 3]:S10–S16

    PubMed  Google Scholar 

  6. Heaney RP, Abrams S, Dawson-Hughes B et al (2000) Peak bone mass. Osteoporos Int 11:985–1009

    Article  PubMed  CAS  Google Scholar 

  7. Murphy S, Khaw KT, May H et al (1994) Milk consumption and bone mineral density in middle aged and elderly women. BMJ 308:939–941

    PubMed  CAS  Google Scholar 

  8. Soroko S, Holbrook TL, Edelstein S et al (1994) Lifetime milk consumption and bone mineral density in older women. Am J Public Health 84:1319–1322

    Article  PubMed  CAS  Google Scholar 

  9. Devine A, Dick IM, Heal SJ et al (1997) A 4-year follow-up study of the effects of calcium supplementation on bone density in elderly postmenopausal women. Osteoporos Int 7:23–28

    Article  PubMed  CAS  Google Scholar 

  10. Bassey EJ (2001) Exercise for prevention of osteoporotic fracture. Age Ageing 30 [Suppl 4]:29–31

    PubMed  Google Scholar 

  11. Law MR, Wald NJ, Meade TW (1991) Strategies for prevention of osteoporosis and hip fracture. BMJ 303:453–459

    PubMed  CAS  Google Scholar 

  12. Kemper HC, Bakker I, Twisk JW et al (2002) Validation of a physical activity questionnaire to measure the effect of mechanical strain on bone mass. Bone 30:799–804

    Article  PubMed  Google Scholar 

  13. Rubin CT, Lanyon LE (1984) Regulation of bone formation by applied dynamic loads. J Bone Joint Surg Am 66:397–402

    PubMed  CAS  Google Scholar 

  14. Kerr D, Morton A, Dick I et al (1996) Exercise effects on bone mass in postmenopausal women are site-specific and load-dependent. J Bone Miner Res 11:218–225

    PubMed  CAS  Google Scholar 

  15. Qin YX, Rubin CT, McLeod KJ (1998) Nonlinear dependence of loading intensity and cycle number in the maintenance of bone mass and morphology. J Orthop Res 16:482–489

    Article  PubMed  CAS  Google Scholar 

  16. Rowlands AV, Ingledew DK, Powell SM et al (2004) Interactive effects of habitual physical activity and calcium intake on bone density in boys and girls. J Appl Physiol 97:1203–1208

    Article  PubMed  CAS  Google Scholar 

  17. Uusi-Rasi K, Sievanen H, Vuori I et al (1998) Associations of physical activity and calcium intake with bone mass and size in healthy women at different ages. J Bone Miner Res 13:133–142

    Article  PubMed  CAS  Google Scholar 

  18. Devine A, Dhaliwal SS, Dick IM et al (2004) Physical activity and calcium consumption are important determinants of lower limb bone mass in older women. J Bone Miner Res 19:1634–1639

    Article  PubMed  CAS  Google Scholar 

  19. Macdonald HM, New SA, Reid DM (2005) Longitudinal changes in dietary intake in Scottish women around the menopause: changes in dietary pattern result in minor changes in nutrient intake. Public Health Nutr 8:409–416

    Article  PubMed  Google Scholar 

  20. Mavroeidi A, Macdonald HM, Stewart AD et al (2004) Validity and repeatability of the Aberdeen bone specific physical activity questionnaire. Osteoporos Int 15 [Suppl 2]:S30

    Google Scholar 

  21. Ferrari P, Friedenreich C, Matthews CE (2007) The role of measurement error in estimating levels of physical activity. Am J Epidemiol 166:832–840

    Article  PubMed  Google Scholar 

  22. Stewart AL, Mills KM, King AC et al (2001) CHAMPS physical activity questionnaire for older adults: outcomes for interventions. Med Sci Sports Exerc 33:1126–1141

    PubMed  CAS  Google Scholar 

  23. Groothausen J, Siemer H, Kemper HCG et al (1997) Influence of peak strain on lumbar bone mineral density: an analysis of 15-year physical activity in young males and females. Pediatr Exerc Sci 9:159–173

    Google Scholar 

  24. McCance RA, Widdowson E (1993) McCance and Widdowson’s the composition of foods. Royal Society of Chemistry: Ministry of Agriculture, Fisheries and Food, Cambridge

    Google Scholar 

  25. Willett WC, Howe GR, Kushi LH (1997) Adjustment for total energy intake in epidemiologic studies. Am J Clin Nutr 65:1220S–1228S

    PubMed  CAS  Google Scholar 

  26. Kriska AM, Caspersen CJ (1997) Introduction to a collection of physical activity questionnaires. Med Sci Sport Exerc 29 [Suppl]:s5–s9

    Google Scholar 

  27. Delmas PD (2002) Treatment of postmenopausal osteoporosis. Lancet 359:2018–2026

    Article  PubMed  CAS  Google Scholar 

  28. Stear SJ, Prentice A, Jones SC et al (2003) Effect of a calcium and exercise intervention on the bone mineral status of 16–18-y-old adolescent girls. Am J Clin Nutr 77:985–992

    PubMed  CAS  Google Scholar 

  29. Gillespie LD, Gillespie WJ, Robertson MC et al (2003) Interventions for preventing falls in elderly people. Cochrane Database Syst Rev CD000340

  30. Kemmler W, Engelke K, Weineck J et al (2003) The Erlangen Fitness Osteoporosis Prevention Study: a controlled exercise trial in early postmenopausal women with low bone density—first-year results. Arch Phys Med Rehabil 84:673–682

    PubMed  Google Scholar 

  31. Epstein S (2007) Is cortical bone hip? What determines cortical bone properties? Bone 41:S3–S8

    Article  PubMed  Google Scholar 

  32. Prince R, Devine A, Dick I et al (1995) The effects of calcium supplementation (milk powder or tablets) and exercise on bone density in postmenopausal women. J Bone Miner Res 10:1068–1075

    PubMed  CAS  Google Scholar 

  33. Specker BL (1996) Evidence for an interaction between calcium intake and physical activity on changes in bone mineral density. J Bone Miner Res 11:1539–1544

    Article  PubMed  CAS  Google Scholar 

  34. Department of Health (1998) Nutrition and bone health: with particular references to calcium and vitamin D. Report on health and social subjects. H.M. Stationery Office, London

    Google Scholar 

  35. Murphy NM, Carroll P (2003) The effect of physical activity and its interaction with nutrition on bone health. Proc Nutr Soc 62:829–838

    Article  PubMed  CAS  Google Scholar 

  36. Anderson JJ (1999) Plant-based diets and bone health: nutritional implications. Am J Clin Nutr 70:539S–542S

    PubMed  CAS  Google Scholar 

  37. Specker B, Binkley T (2003) Randomized trial of physical activity and calcium supplementation on bone mineral content in 3- to 5-year-old children. J Bone Miner Res 18:885–892

    Article  PubMed  CAS  Google Scholar 

  38. Iuliano-Burns S, Saxon L, Naughton G et al (2003) Regional specificity of exercise and calcium during skeletal growth in girls: a randomized controlled trial. J Bone Miner Res 18:156–162

    Article  PubMed  Google Scholar 

  39. Kerr D, Ackland T, Maslen B et al (2001) Resistance training over 2 years increases bone mass in calcium-replete postmenopausal women. J Bone Miner Res 16:175–181

    Article  PubMed  CAS  Google Scholar 

  40. Engelke K, Kemmler W, Lauber D et al (2006) Exercise maintains bone density at spine and hip EFOPS: a 3-year longitudinal study in early postmenopausal women. Osteoporos Int 17:133–142

    Article  PubMed  CAS  Google Scholar 

  41. Mazzeo RS, Tanaka H (2001) Exercise prescription for the elderly: current recommendations. Sports Med 31:809–818

    Article  PubMed  CAS  Google Scholar 

  42. American College of Sports Medicine (1998) Position stand on exercise and physical activity for older adults. Med Sci Sports Exerc 30:992–1008

    Article  Google Scholar 

  43. Ainsworth BE (2000) Issues in the assessment of physical activity in women. Res Q Exerc Sport 71:S37–S42

    PubMed  CAS  Google Scholar 

Download references

Acknowledgements

We are grateful to everyone that helped with the NOSOS study (radiographers, research nurses, administration staff, clinicians) at both the Aberdeen and Dingwall centres, as well as Dr Malcolm Steven, who assisted with original participant access at the Dingwall centre. We would like to express our thanks to Anta Hardcastle and Lara Dawson for their help in inputting the dietary data. We also thank David and Mike Grubb for providing us with the dietary analysis programme and Mr Allan Walker for his help with extracting the BMD database. Finally, we are extremely grateful to the 1,254 women who responded positively to our invitation to take part in this study. This work was partially funded by the Development Fund, University of Aberdeen, Aberdeen UK and the Grampian University Hospital NHS Trust (GUHT) Endowment Research Grant.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. School of Medical Sciences, University of Aberdeen, Aberdeen, UK

    A. Mavroeidi

  2. School of Health Sciences, The Robert Gordon University, Aberdeen, UK

    A. D. Stewart

  3. School of Medicine, University of Aberdeen, Aberdeen, UK

    D. M. Reid & H. M. Macdonald

  4. Health Sciences Building (room 101), University of Aberdeen Foresterhill, Aberdeen, AB25 2ZD, UK

    A. Mavroeidi

Authors
  1. A. Mavroeidi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. D. Stewart
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. M. Reid
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H. M. Macdonald
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Mavroeidi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mavroeidi, A., Stewart, A.D., Reid, D.M. et al. Physical activity and dietary calcium interactions in bone mass in Scottish postmenopausal women. Osteoporos Int 20, 409–416 (2009). https://doi.org/10.1007/s00198-008-0681-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-008-0681-4

Keywords

Search

Navigation