Calcium supplements  increased BMD by 0.7 - 1.8 % at all five skeletal sites at one , two , and over two and a half years , but the size of the increase in BMD at later time points was similar to the increase at one year .
Increasing calcium intake from dietary sources or by taking calcium supplements produces small non-progressive increases in BMD , which are unlikely to lead to a clinical ly significant reduction in risk of fracture
OBJECTIVE To determine whether increasing calcium intake from dietary sources affects  bone mineral density ( BMD ) and , if so , whether the effects are similar to those of calcium supplements .
Treatment with alendronate plus calcium, alendronate alone, or calcium alone for postmenopausal low bone mineral density
ABSTRACT Objective : Bisphosphonates such as alendronate are widely used for postmenopausal osteoporosis . Supplemental calcium is also generally recommended . This trial directly compares alendronate to supplemental calcium and examines the effect of calcium supplementation on alendronate treatment . Methods : This 2-year , r and omized , double-blind , multicenter trial enrolled healthy , postmenopausal women with low bone mineral density ( BMD ) . Patients with a dietary calcium intake ≥ 800 mg/day received daily vitamin D 400 IU and alendronate 10 mg/calcium-placebo , alendronate 10 mg/elemental calcium 1000 mg , or alendronate-placebo/calcium 1000 mg ( 2:2:1 ) . Endpoints included BMD , bone turnover markers ( BTMs ) , and adverse events . Results : R and omized patients ( N = 701 ) were an average of 20.4 years postmenopausal . After 24 months , increases in lumbar spine BMD differed significantly between patients receiving calcium alone ( 0.8 % ) and either alendronate alone ( 5.6 % ) or alendronate + calcium ( 6.0 % ) ( p < 0.001 ) . Significant differences were also seen at the trochanter and femoral neck ( p < 0.001 ) . BTMs were significantly lower with alendronate-containing treatments than calcium alone ( p < 0.001 ) . Addition of calcium supplementation to alendronate did not significantly increase BMD  compared to alendronate alone ( p = 0.29 to 0.97 ) , but did result in a statistically significant , though small , additional reduction in urinary NTx . Adverse events were similar among treatment groups . Limitations include no assessment of vitamin D levels and a discontinuation rate of approximately 30 % , although discontinuation rates were similar among treatment groups . Conclusions : In postmenopausal women with a daily intake of ≥ 800 mg calcium and 400 IU vitamin D , 24-month treatment with alendronate 10 mg daily with or without calcium 1000 mg result ed in significantly greater increases in BMD and reduction of bone turnover than supplemental calcium alone . Addition of supplemental calcium to alendronate treatment had no effect on BMD and result ed in a small , though statistically significant , additional reduction in NTx
Calcium supplements  increased BMD by 0.7 - 1.8 % at all five skeletal sites at one , two , and over two and a half years , but the size of the increase in BMD at later time points was similar to the increase at one year .
Increasing calcium intake from dietary sources or by taking calcium supplements produces small non-progressive increases in BMD , which are unlikely to lead to a clinical ly significant reduction in risk of fracture
OBJECTIVE To determine whether increasing calcium intake from dietary sources affects  bone mineral density ( BMD ) and , if so , whether the effects are similar to those of calcium supplements .