School-based calcium-vitamin D with micronutrient supplementation enhances bone mass in underprivileged Indian premenarchal girls.
Study Goal
The researchers aimed to investigate the effect of 1-year calcium supplementation, with or without multivitamins and zinc, on bone mass accrual in premenarchal girls from low-income groups.
Results Summary
Calcium supplementation (with or without multivitamins and zinc) significantly improved total body bone mineral content (TBBMC) and bone mineral density (TBBMD) compared to the control group, with no significant difference between the two calcium-supplemented groups. The improvement in bone-related Z-scores was notably higher in calcium-supplemented groups.
Population
Premenarchal girls (8-12 years) from low-income groups in Pune, India.
Effective Dosage
500 mg/d calcium (Ca-group), 500 mg/d calcium + multivitamin tablet containing 15 mg/d zinc (Ca+MZ-group).
Duration
1 year
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
1-year supplementation of calcium, multivitamin with zinc along with vitamin-D | neutral | bone mass accrual | school-going premenarchal girls from low income groups in Pune, India | - | effect on bone mass accrual | #1 |
500 mg/d calcium supplementation (Ca-group) | increase | total body bone mineral content (TBBMC) | premenarchal girls (8-12 years) | 22.3% | mean percent increase in TBBMC was significantly higher | #2 |
500 mg/d calcium+multivitamin tablet containing 15 mg/d zinc (Ca+MZ-group) | increase | total body bone mineral content (TBBMC) | premenarchal girls (8-12 years) | 20.8% | mean percent increase in TBBMC was significantly higher | #3 |
multivitamin tablet without any minerals (C-group) | increase | total body bone mineral content (TBBMC) | premenarchal girls (8-12 years) | 17.6% | mean percent increase in TBBMC | #4 |
calcium supplementation with multivitamins and zinc (Ca+MZ-group) | no change | total body bone mineral content (TBBMC) | premenarchal girls (8-12 years) | p>0.1 | no significant differences observed | #5 |
calcium supplementation (Ca-group) | no change | total body bone mineral content (TBBMC) | premenarchal girls (8-12 years) | p>0.1 | no significant differences observed | #6 |
calcium supplementation (two calcium supplemented groups) | increase | TBBMC-for-age Z-scores | premenarchal girls (8-12 years) | 13.6%-22% | Improvement in TBBMC-for-age Z-scores was higher | #7 |
multivitamin tablet without any minerals (C-group) | no change | TBBMC-for-age Z-scores | premenarchal girls (8-12 years) | no improvement | no improvement | #8 |
Calcium supplementation, with or without multivitamins and zinc | increase | bone health | underprivileged premenarchal girls | - | showed a promising improvement in bone health | #9 |
Calcium supplementation, with or without multivitamins and zinc | increase | bone related Z-scores | underprivileged premenarchal girls | - | improvement in bone related Z-scores | #10 |
Low adult bone mass is linked to osteoporosis and fractures and is dependent on the extent of childhood and adolescent bone mineralization. The aim of the study was to investigate the effect of 1-year supplementation of calcium, multivitamin with zinc along with vitamin-D on bone mass accrual of school-going premenarchal girls from low income groups in Pune, India. Double-blind, matched-pair, cluster, randomization study was carried out in 214 premenarchal girls (8-12 years) from 2 schools in Pune, India. The two schools together formed 3 classes with 3 clusters each of age-matched girls of which one cluster was allocated to either one of the intervention groups (Ca-group:500 mg/d calcium, Ca+MZ-group:500 mg/d calcium+multivitamin tablet containing 15 mg/d zinc) or control group (C-group: multivitamin tablet without any minerals); all subjects received vitamin-D supplementation. Anthropometry, biochemical parameters, total body bone mineral content (TBBMC) and bone mineral density (TBBMD) (Dual energy X-ray absorptiometry) were assessed at baseline and endline. Post supplementation, mean percent increase in TBBMC was significantly higher in Ca-group (22.3%) and Ca+MZ-group (20.8%) compared to C-group (17.6%) (p<0.05) with no significant differences observed between Ca+MZ and Ca groups (p>0.1). Improvement in TBBMC-for-age Z-scores was higher in the two calcium supplemented groups (13.6%-22%) compared to the C-group (no improvement). Calcium supplementation, with or without multivitamins and zinc, showed a promising improvement in bone health especially with regards to improvement in bone related Z-scores in our population of underprivileged premenarchal girls.