Impact Evaluation of Calcium and Vitamin D Supplementation and Physical Activity on Bone Health Status of Elderly Population of Urban Vadodara


 Elderly, BMD, Calcium, Vitamin D, Physical Activity.

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Annapurna Maity, Komal Chauhan, Nishita Panwar, & Pooja Mistry. (2015). Impact Evaluation of Calcium and Vitamin D Supplementation and Physical Activity on Bone Health Status of Elderly Population of Urban Vadodara. Journal of Pharmacy and Nutrition Sciences, 5(1), 50–56.


Background: Osteoporosis is a global public health problem affecting the ageing population and influenced by poor nutrition, lack of physical activities, and absence of supplementation on time.
Objectives: To study the impact of Calcium and vitamin D supplementation along with weight bearing exercises on bone health status of elderly.
Methods:30 elderly males and 20 elderly females having poor BMD and poor serum vitamin D were supplemented with 1000 mg calcium and 500 IU vitamin D/ day along with weight bearing exercises for a period of 3 months, along with that 60000 IU vitamin D3/week for 2 months were given to 30 males only. Serum calcium, Vitamin D, BMD, dietary calcium intake, frequency of vitamin D rich food intake, anthropometry etc. were measured at the baseline as well as after the intervention.
Results: Mean BMD T-scores (-1.1 to -2.5: osteopenia; >-2.5: osteoporosis) of the elderly males and females were significantly (p?0.001) decreased after the intervention depicting improvement (baseline:-2.34±0.50, final:-1.86±0.61). 26.7% reduction in osteoporotic cases among males and 50 % among women was achieved. Mean serum calcium (baseline: 9.38±0.63, final: 9.46±0.61) and vitamin D level (baseline: 23.76±13.17, final: 35.48±14.84) was increased significantly (p?0.05). 60% males and 70% females achieved vitamin D sufficiency level after the intervention. Mean physical endurance (Grip strength, standing balance, walking speed and rise from chair) scores were significantly increased in both males and females. Locomotor problems were reduced among 6.7% males and 40% females after regular weight bearing exercise and supplementation.
Conclusion:Calcium and vitamin D supplementation with daily weight bearing exercise has a preventive and curative effect on BMD and it maintains the serum calcium and vitamin D levels. Long term and high dose supplementation needs further investigation.


Cummings S, Melton L. Epidemeology and outcomes of osteoporotic fracture. Lancet 2002; 359: 1761-1767.

Szulc P, Munoz F, Duboeuf F, et al. Bone mineral density predicts osteoporotic fractures in elderly men: the MINOS study. Osteoporosis International 2005; 16: 1184.

Samar DM, Kribakaran V, Savita R, Anburajan M. Screening Rural and Urban Indian Population for osteoporosis using heel ultrasound Beone Denditometer. International Conference on Communication Systems and Network Technologies 2011; 629-633.

Osteoporosis Society of India. Consensus statement of an expert group. New Delhi 2003.

Rizvi H, Vaishnava S. Frequency of osteomalacia and osteoporosis in fractures of proximal femur 1974; 1: 676-7.

Cashman K, Flynn A. Trace elements and bone metabolism. Bibliotheca Nutrition Et Dieta 1998; 54: 150-164.

Land Coup C, Wood D, Cooper C. Physical inactivity is an independent risk factor for hip fracture in the elderly. Journal of Epidemiology and Community Health 1993; 47(6): 441-443.

Gupta A. Osteoporosis in India the nutritional hypothesis. National Medcal Journal of India 1996; 9: 268-74.

Murray CJL, Lopez AD. The global burden of diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge: Harvard University Press 1996.

Dawson HB, Harris SS, Karl EA, Dallal GE. Effect of calcium and vitamin D supplimentation on bone density in men and women 65 yeras of age or older. The New England Journal of Medicine 1997; 337(10): 670-676.

Marwaha RK, Tandon N, Garg MK, Kanwar R, Narang A, Sastry A, Saberwal A, Bandra K. Vitamin D status in healthy Indians aged 50 years and above. Journal of Association Physician, India 2011; 56: 706-9.

Berger C, Greene-Finestone LS, Langsetmo L, Kreiger N, Joseph L, Kovacs CS, Richards JB, Hidiroglou N, Sarafin K, Davison KS, Adachi JD, Brown J, Hanley DA, Prior JC, Goltzman D, the CaMos Research Group, Temporal Trends and Determinants of Longitudinal Change in 25 Hydroxyvitamin D and Parathyroid Hormone Levels. JBMR 2012; 27(6): 1381-1389.

WHO, Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Technical report series 843, Geneva 1994.

Hollick MF. Vitamin D Deficiency. N Engl J Med 2007; 357: 266-81.

Satyanarayana U, Chakrapani U. Biochemistry, Books and Allied (P) Ltd. 2010; pp. 406-407

Seshadiri S. A data base in IDA in India, prevalence, etiology, Consequences and strategies for control, prepared for Ministry of Human Resource Development, New Delhi, 1999.

Bass S. Exercise before puberty may confer residualbenefits in Bone density in adulthood: studies in active prepubertal and retired female gymnasts. Journal of Bone Mineral Research 1998; 13: 500-507.

Moayyeri A. The Association Between Physical Activity and Osteoporotic Fractures: A Review of the Evidence and Implications for Future Research. Annals of Epidemiology 2008; 18(11): 827-835.

Hughes-Dawson B, Harris SS, Karl EA, Dallal GE. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age and older. England Journal of Medicine 1997; 337: 670-676.

Mackerras D, lumley T. First and second year effects in traisl of calcium supplementation on the loss of bone density in post menopausal women. Bone Mineral Journal 1997; 527-33.

Cashman KD. Calcium intake, calcium bioavailibity and bone health. Edited by The Author 2002. British Journal of Nutrition 2002; 82(Suppl. 2).

Chaupuy MD, Arlot ME, Delmas PD, Meuneir PJ. Effect of Calcium and cholecalciferol treatment for three years on hip fractures in elderly women. British Medical Journal 1994; 1081-82.

Shea B, Wells G, Cranney A, et al. Meta-analyses of therapies for postmenopausal osteoporosis. VII. Meta-analysis of calcium supplementation for the prevention of postmenopausal osteoporosis. Endocrinology Review 2002; 23: 552.

Malhotra N, Mithal A, Gupta S, Shukla M, Godbole M. Effect of vitamin D supplementation on bone health parameters of healthy young Indian women. Archives of Osteoporosis 2009; 4: 47-53.

Goswami R, Gupta N, Ray D, Singh N, Tomar N. Pattern of 25-hydroxy vitamin D response at short (2 months) and long (1 year) interval after 8 weeks of oral supplementation with cholecalciferol in Asian Indians with chronic hypovitaminosis D. British Journal of Nutrition 2008; 100: 526-9.

Kuttikat A, Grant R, Chakravarty K, Management of Osteoporosis. Journal of Indian Rheumatology Association 2004; 12.

Nguyen TV, Eisman JA. Risk factors for low bone mass in elderly men. In: ES Orwoll (ed) Osteoporosis in Men. Academic Press, San Diego, 1999; p. 335.

Iqbal SP, Dodani S, Qureshi R. Risk factors and behaviours for coronary artery disease (CAD) among ambulatory Pakistanis. Journal of Pakistan Medical Association 2004; 54: 261-6.

Fatima M, Nawaz H, Kassi M, Rehman R, Kasi PM, Kassi M, Afghan AK, Baloch SN. Determining the risk factors and prevalence of osteoporosis using quantitative ultrasonography in Pakistani adult women. Singapore Medical Journal 2009; 50(1): 20.

Nutrient requirements and recommended dietary allowances for Indians, ICMR task force report, NIN 2009.

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