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Randomized Controlled Trial of Calcium Supplementation in Healthy, Nonosteoporotic, Older Men
Ian R. Reid, MD;
Ruth Ames, NZCS;
Barbara Mason, BSc;
Helen E. Reid, BSc;
Catherine J. Bacon, MSc;
Mark J. Bolland, MBChB;
Gregory D. Gamble, MSc;
Andrew Grey, MD;
Anne Horne, MBChB
Arch Intern Med. 2008;168(20):2276-2282.
Background There is no consistent evidence, to our knowledge, that calcium supplementation affects bone mineral density (BMD) in men, despite male osteoporosis being a common clinical problem.
Methods To determine the effects of calcium supplementation (600 mg/d, 1200 mg/d, or placebo) on BMD in men, we conducted a double-blind, randomized controlled trial for a 2-year period at an academic clinical research center. A total of 323 healthy men at least 40 years old (mean age, 57 years) were recruited by newspaper advertisement. Complete follow-up was achieved in 96% of subjects.
Results The BMD increased at all sites in the group receiving calcium, 1200 mg/d, by 1% to 1.5% more than those receiving placebo. The results for the group receiving calcium, 600 mg/d, were not different from the placebo group at any BMD site. There was no interaction between the BMD treatment effect and either age or dietary calcium intake. There were dosage-related, sustained decreases in serum parathyroid hormone (P < .001), total alkaline phosphatase activity (P = .01), and procollagen type 1 N-terminal propeptide (P < .001) amounting to 25%, 8%, and 20%, respectively, in the group receiving calcium, 1200 mg/d, at 2 years. Tooth loss, constipation, and cramps were unaffected by calcium supplementation, falls tended to be less frequent in the group receiving calcium, 1200 mg/d, but vascular events tended to be more common in the groups receiving calcium vs the group receiving placebo.
Conclusion Calcium, 1200 mg/d, has effects on BMD in men comparable with those found in postmenopausal women but a dosage of 600 mg/d is ineffective for treating BMD.
Trial Registration actr.org.au Identifier: 012605000274673
Author Affiliations: Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
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