Evidence map›Paper›PMID 42463975›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2026

Dietary and supplemental calcium intake and bone changes during antiresorptive osteoporosis treatment in older women: a longitudinal observational study.

Maria Papageorgiou, Yvan Gugler, Serge Ferrari, René Rizzoli, Philippe Zysset, Emmanuel Biver

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Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Maria PapageorgiouDivision of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Yvan GuglerARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
Serge FerrariDivision of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
René RizzoliDivision of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Philippe ZyssetARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
Emmanuel BiverDivision of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland. Emmanuel.Biver@hug.ch.ORCID http://orcid.org/0000-0001-6174-1951

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Calcium supplements are often prescribed with osteoporosis medications without considering dietary adequacy. In calcium-replete older women, calcium supplements had little effect on the response to antiresorptives, whereas low protein intake blunted their benefits. Calcium supplementation may be unnecessary when intake is adequate, and nutrition should be optimized for osteoporosis treatment. PURPOSE: Osteoporosis medications (OM) are commonly prescribed with calcium supplements (CaS) without considering dietary adequacy. We investigated whether calcium and protein intakes influence the effect of OM on total hip bone mineral density (BMD) and strength in calcium-replete women.

methodsData from 586 women (median age 67 years) from the Geneva Retirees Cohort were analyzed: 101 on menopausal hormone therapy (MHT), 67 on antiresorptives (AR) (bisphosphonates, denosumab or raloxifene), and 418 without OM. Annual changes in total hip BMD, strength, and structure were assessed over a median 3.5 years using 2D/3D-DXA and finite element analysis. Calcium and protein intakes were assessed by food frequency questionnaire; CaS use was recorded at baseline and follow-up.

resultsTotal calcium intake (diet + supplements) was 1503 mg/day; 71% women met recommendations (≥ 1200 mg/day), 51% used CaS, and 70% vitamin D. MHT or AR increased total hip BMD and strength versus no OM. Neither total calcium intake (above or below 1200 mg/day) nor CaS use significantly affected bone outcomes. However, in women with low calcium intake (< 800 mg/day), no difference in changes of BMD or bone strength was observed between women with and without OM in the absence of CaS. In women with protein intake < 0.8 g/kg/day, AR effects were blunted, with reduced improvements in trabecular BMD (P = 0.009) and total hip strength (P = 0.040).

conclusionIn calcium-replete older women, protein intake rather than CaS influences total hip bone changes with OM. These findings question routine CaS in women with adequate calcium intake and emphasize the importance of sufficient protein intake for optimal osteoporosis management. CLINICAL

trial registrationGERICO http://www.isrctn.com/ISRCTN11865958.

Indexed as

Bone mineral densityCalcium intakeCalcium supplementsOsteoporosis medicationsProtein intake

Identifiers

PMID42463975

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.