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Dietary Calcium and Serum 25-Hydroxyvitamin D Status in Relation to BMD Among U.S. Adults†

  1. Heike A Bischoff-Ferrari1,2,3,*,
  2. Douglas P Kiel4,
  3. Bess Dawson-Hughes5,
  4. John E Orav6,
  5. Ruifeng Li6,7,
  6. Donna Spiegelman5,6,
  7. Thomas Dietrich8,
  8. Walter C Willett2

Article first published online: 29 DEC 2008

DOI: 10.1359/jbmr.081242

Issue

Journal of Bone and Mineral Research

Journal of Bone and Mineral Research

Volume 24, Issue 5, pages 935–942, May 2009

Additional Information

How to Cite

Bischoff-Ferrari, H. A., Kiel, D. P., Dawson-Hughes, B., Orav, J. E., Li, R., Spiegelman, D., Dietrich, T. and Willett, W. C. (2009), Dietary Calcium and Serum 25-Hydroxyvitamin D Status in Relation to BMD Among U.S. Adults. J Bone Miner Res, 24: 935–942. doi: 10.1359/jbmr.081242

Author Information

  1. 1

    Centre on Aging and Mobility, University of Zurich, Zurich, Switzerland

  2. 2

    Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA

  3. 3

    Department of Rheumatology and Institute for Physical Medicine and Rehabilitation, University Hospital Zurich, Zurich, Switzerland

  4. 4

    Institute for Aging Research, Hebrew Senior Life, Harvard Medical School, Boston, Massachusetts, USA

  5. 5

    Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA

  6. 6

    Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA

  7. 7

    Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA

  8. 8

    Department of Oral Surgery, The School of Dentistry, University of Birmingham, Birmingham, United Kingdom

*Address correspondence to: Heike A. Bischoff-Ferrari, MD, DrPA, Centre on Aging and Mobility, Department of Rheumatology and Institute of Physical Medicine, University Hospital Zurich, Gloriatrasse 25, 8091 Zurich, Switzerland

  1. †

    The authors state that they have no conflicts of interest.

Publication History

  1. Issue published online: 4 DEC 2009
  2. Article first published online: 29 DEC 2008
  3. Manuscript Accepted: 22 DEC 2008
  4. Manuscript Revised: 27 AUG 2008
  5. Manuscript Received: 15 JUN 2008

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Keywords:

  • 25-hydroxyvitamin D;
  • dietary calcium intake;
  • BMD;
  • adults;
  • men and women

Abstract

A higher calcium intake is still the primary recommendation for the prevention of osteoporosis, whereas vitamin D deficiency is often not addressed. To study the relative importance of dietary calcium intake and serum 25-hydroxyvitamin D [25(OH)D] status in regard to hip BMD, 4958 community-dwelling women and 5003 men ≥20 yr of age from the U.S. NHANES III population-based survey were studied. Calcium supplement users and individuals with a prior radius or hip fracture were excluded. We calculated standardized means for BMD by quartiles of sex-specific calcium intake for three 25(OH)D categories (<50, 50–74, and 75+ nM) among men and women, separately controlling for other important predictors of BMD. A higher calcium intake was significantly associated with higher BMD (p value for trend: p = 0.005) only for women with 25(OH)D status <50 nM, whereas calcium intake beyond the upper end of the lowest quartile (>566 mg/d) was not significantly associated with BMD at 25(OH)D concentrations >50 nM. Among men, there was no significant association between a higher calcium intake beyond the upper end of the lowest quartile (626 mg/d) and BMD within all 25(OH)D categories. Among both sexes, BMD increased stepwise and significantly with higher 25(OH)D concentrations (<50, 50–74, 75+ nM; p value for trend: women < 0.0001; men = 0.0001). Among men and women, 25(OH)D status seems to be the dominant predictor of BMD relative to calcium intake. Only women with 25(OH)D concentrations <50 nM seem to benefit from a higher calcium intake.

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