Consumption of Calcium-Fortified Cereal Bars to Improve Dietary Calcium Intake of Healthy Women: Randomized Controlled Feasibility Study

Calcium is an important structural component of the skeletal system. Although an adequate intake of calcium helps to maintain bone health and reduce the risk of osteoporosis, many women do not meet recommended daily intakes of calcium. Previous interventions studies designed to increase dietary intake of women have utilized primarily dairy sources of calcium or supplements. However, lactose intolerance, milk protein allergies, or food preferences may lead many women to exclude important dairy sources of dietary calcium. Therefore, we undertook a 9 week randomized crossover design trial to examine the potential benefit of including a non-dairy source of calcium in the diet of women. Following a 3 week run-in baseline period, 35 healthy women > 18 years were randomized by crossover design into either Group I or Group II. Group I added 2 calcium-fortified cereal bars daily (total of 400 mg calcium/day) (intervention) to their usual diet and Group II continued their usual diet (control). At the end of 3 weeks, diets were switched for another 3 weeks. Intakes of calcium and energy were estimated from 3-day diet and supplemental diaries. Wilcoxon signed-rank tests were used for within group comparisons and Mann Whitney U tests were used for between group comparisons of calcium and energy intake. Dietary calcium was significantly higher during intervention (1071 mg/d) when participants consumed 2 calcium-fortified cereal bars daily than during the baseline (720 mg/d, P <0.0001) or control diets (775 mg/d, P = 0.0001) periods. Furthermore, the addition of 2 calcium-fortified cereal bars daily for the 3 week intervention did not significantly increase total energy intake or result in weight gain. In conclusion, consumption of calcium-fortified cereal bars significantly increased calcium intake of women. Further research examining the potential ability of fortified cereal bars to help maintain and improve bone health of women is warranted.

Trial Registration

ClinicalTrials.gov NCT01508689     

Dietary intake of calcium and postmenopausal bone loss.

The use of calcium supplements to prevent postmenopausal bone loss and hence osteoporosis is widespread, but the evidence for their efficacy, either alone or in combination with other treatments, is contradictory. Skeletal measurements and dietary intake of calcium were determined in 59 healthy postmenopausal women, most of whom were within five years of the menopause. No correlation was found between current intake of calcium and either total calcium in the body or the density of trabecular or cortical bone in the forearm or vertebral trabecular bone. Dietary intake of calcium did not influence the rate of postmenopausal bone loss in the 54 women who completed 12 months of active or placebo treatment. Even when extremes of calcium intake were examined no difference was found in bone measurements between the women with the highest and lowest intakes. The results of this study suggest that the bone density of women in the early menopause is not influenced by current dietary intake of calcium.     

Review: Dairy foods,red meat and processed meat in the diet: implications for health at key life stages

Social and health care provision have led to substantial increases in life expectancy. In the UK this has become higher than 80 years with an even greater proportional increase in those aged 85 years and over. The different life stages give rise to important nutritional challenges and recent reductions in milk consumption have led to sub-optimal intakes of calcium by teenage females in particular when bone growth is at its maximum and of iodine during pregnancy needed to ensure that supply/production of thyroid hormones to the foetus is adequate. Many young and pre-menopausal women have considerably sub-optimal intakes of iron which are likely to be associated with reduced consumption of red meat. A clear concern is the low intakes of calcium especially as a high proportion of the population is of sub-optimal vitamin D status. This may already have had serious consequences in terms of bone development which may not be apparent until later life, particularly in post-menopausal women. This review aims to examine the role of dairy foods and red meat at key life stages in terms of their ability to reduce or increase chronic disease risk. It is clear that milk and dairy foods are key sources of important nutrients such as calcium and iodine and the concentration of some key nutrients, notably iodine can be influenced by the method of primary milk production, in particular, the iodine intake of the dairy cow. Recent meta-analyses show no evidence of increased risk of cardiovascular diseases from high consumption of milk and dairy foods but increasing evidence of a reduction in the risk of type 2 diabetes associated with fermented dairy foods, yoghurt in particular. The recently updated reports from the World Cancer Research Fund International/American Institute for Cancer Research on the associations between dairy foods, red meat and processed meat and various cancers provide further confidence that total dairy products and milk, are associated with a reduced risk of colorectal cancer and high intakes of milk/dairy are not associated with increased risk of breast cancer. Earlier evidence of a significant increase in the risk of colorectal cancer from consumption of red and particularly processed meat has been reinforced by the inclusion of more recent studies. It is essential that nutrition and health-related functionality of foods are included in evaluations of sustainable food production.     

Osteoporosis,calcium and physical activity.

Sales of calcium supplements have increased dramatically since 1983, as middle-aged women seek to prevent or treat bone loss due to osteoporosis. However, epidemiologic studies have failed to support the hypothesis that larger amounts of calcium are associated with increased bone density or a decreased incidence of fractures. The authors examine the evidence from controlled trials on the effects of calcium supplementation and physical activity on bone loss and find that weight-bearing activity, if undertaken early in life and on a regular basis, can increase the peak bone mass of early adulthood, delay the onset of bone loss and reduce the rate of loss. All of these factors will delay the onset of fractures. Carefully planned and supervised physical activity programs can also provide a safe, effective therapy for people who have osteoporosis.     

Calcium Supplements: an Additional Source of Lead Contamination

The risk posed by the quantity of heavy metal lead present in Ca supplements is of grave concern. Some lead levels have been measured up to the extent of regulatory limit set by the United States. Calcium supplements inevitably get contaminated with lead as both are naturally occurring elements having the same charge density. Therefore, it is imperative to indicate the level of this toxic metal in these supplements in order to create awareness among consumers. The calcium in the supplements is derived from natural as well as synthetic/refined sources (chelated or non-chelated). In this study, a sophisticated analytical technique, atomic absorption spectrometer (both with FAAS and GFAAS modes of atomization), was used for the purpose of analyzing Pb contents in 27 commonly used Ca supplements manufactured by different national and multinational companies. The daily intake of lead through these supplements was calculated. Only 10% of the calcium supplements analyzed met the criteria of acceptable Pb levels (1.5 μg/daily dose) in supplements/consumer products set by the United States. It was also found that Pb intake was highest in chelated calcium supplements whereas lowest through calcium supplements with vitamin D formulation. The Pb concentration in calcium supplements was significantly increased (p < 0.001) according to their composition. In order to validate our results from the study conducted, IAEA-certified reference material (animal bone, H-5) was analyzed for Pb levels. The limit of detection of the method used was 0.05 μg/g and a 95% lead recovery of IAEA-certified reference material (animal bone, H-5).     

Phytoestrogen consumption and association with breast, prostate and colorectal cancer in EPIC Norfolk

Phytoestrogens are polyphenolic secondary plant metabolites that have structural and functional similarities to 17β-oestradiol and have been associated with a protective effect against hormone-related cancers. Most foods in the UK only contain small amounts of phytoestrogens (median content 21 μg/100 g) and the highest content is found in soya and soya-containing foods. The highest phytoestrogen content in commonly consumed foods is found in breads (average content 450 μg/100 g), the main source of isoflavones in the UK diet. The phytoestrogen consumption in cases and controls was considerably lower than in Asian countries. No significant associations between phytoestrogen intake and breast cancer risk in a nested case-control study in EPIC Norfolk were found. Conversely, colorectal cancer risk was inversely associated with enterolignan intake in women but not in men. Prostate cancer risk was positively associated with enterolignan intake, however this association became non-significant when adjusting for dairy intake, suggesting that enterolignans can act as a surrogate marker for dairy or calcium intake.     

Calcium intake, food sources and seasonal variations in eastern Croatia

The objective of this study was to examine the quantity of calcium intake among adults, the sources of calcium, differences among seasons, as well as the differences between sexes, correlation with body mass index (BMI), and age. The study included 161 healthy volunteers from the eastern part of Croatia. Each subject completed three food frequency questionnaires (FFQ) with 150 items, at an interval of 3-4 months. The mean calcium intake for whole population for all three FFQs was 965 mg/day. At the same time, the quantity of calcium for all subjects was 14.2 mg/kg, women 14.5 mg/kg, and men 13.6 mg/kg, respectively. There was an inverse relation between calcium intake and age for men (r = -0.32 p = 0.028), but not for women. Correlation between calcium intake and BMI was negative, but not significantly. Milk and dairy products were the main source of calcium. Marginally low mean calcium intake goes to show the needful to educate the population.     

Los suplementos de calcio y el posible aumento del riesgo cardiovascular

The primary goal of osteoporosis treatment is to prevent the occurrence of fragility fractures, and thereby reduce morbidity and mortality. Among the various approaches to the treatment of this disease include ensuring proper calcium intake and to obtain adequate levels of vitamin D. Virtually all clinical trials with drugs used to treat osteoporosis systematically include calcium and vitamin D supplements. In light of the recent publication of clinical trials and meta-analyses, a possible increase in cardiovascular risk, particularly in the form of a myocrdial infarction, is hypothesised in patients taking calcium supplements. However, data published to date are inconclusive. Until the development of new scientific evidence, it seems reasonable to recommend, whenever practicable and individualized for each patient, increasing calcium intake with food and reserve supplements for patients with very low calcium intake in the diet. It would also be advisable for the administration of total daily dose to be fractionated throughout the day and with meals, and to obtain appropriate levels of vitamin D (25-hydroxycholecalciferol or calcidiol), along with the basic treatment for osteoporosis that is decided to be prescribed to patients.     

Relationship Between Nutritional Habits and Hair Calcium Levels in Young Women

The present study was conducted to investigate whether hair calcium levels are related to nutritional habits, selected status parameters, and life-style factors in young women. Eighty-five healthy female students neither pregnant nor lactating, using no hair dyes or permanents were recruited for the study. Food consumption data, including fortified products and dietary supplements were collected with 4-day records. The calcium levels in hair and serum were analyzed by atomic absorption spectroscopy. Serum osteocalcin and the C-terminal telopeptide of type I collagen were assayed by ELISA. The women were divided into four groups according to their total vitamin D and calcium intakes and hair calcium levels. At adequate calcium intake and comparable serum bone biomarker levels, supplemental vitamin D increased the hair calcium levels. On the other hand, at lower than estimated adequate requirement of vitamin D intake the hair calcium levels were comparable in women with low calcium intakes but consuming high amounts of meat products or those whose diets were rich in dairy products, possibly due to homeostatic mechanisms. Elevated hair calcium was seen in 25% of subjects and could not be related to nutritional or life-style factors. The results show that the hair calcium levels were weakly related to the quality of diet, with some synergistic interactions between nutrients, especially vitamin D and magnesium.     

The effect of calcium supplements on plasma alkaline phosphatase and urinary hydroxyproline in postmenopausal women

Although calcium supplements are widely used in the treatment of osteoporosis, their beneficial effect is not conclusively established. We now report some effects of a calcium supplement (1 g/day) given for 6 to 12 weeks to 15 postmenopausal osteoporotic women. The mean fasting urinary hydroxyproline/creatinine ratio decreased from 0.021 +/- 0.002 to 0.015 +/- 0.001 (P less than 0.0025), indicating a significant reduction in bone resorption. The mean plasma alkaline phosphatase fell from 123 +/- 5 U/l to 104 +/- 3.1 U/l (P less than 0.01), probably representing some secondary reduction in bone formation following the inhibition of bone resorption. These results support the concept that calcium supplementation is useful in the treatment of postmenopausal osteoporosis.     

蚌埠市蚌山区老年人群骨质疏松症流行病学调查及对跌倒风险和认知功能的影响

摘要 目的：对蚌埠市蚌山区老年人群骨质疏松症进行流行病学调查,并探讨骨质疏松症对跌倒风险和认知功能的影响。方法：于2019年11月~2021年4月采用多阶段分层随机抽样的方法,抽取蚌埠市蚌山区的常住居民,调查老年人群骨质疏松症发生率,共发放960份调查问卷,回收941份,回收率为98.02%。根据有无骨质疏松症分为骨质疏松症组和无骨质疏松症组,观察两组跌倒风险和认知功能状况。应用多因素logistic回归分析老年人群发生骨质疏松症的危险因素和保护因素。结果：941例研究对象中,检查出存在骨质疏松症者325人,发病率为34.54%。根据有无骨质疏松症分为骨质疏松症组（n=325）和无骨质疏松症组（n=616）。单因素分析结果显示,老年人群发生骨质疏松症与乳制品和钙片摄入情况、年龄、连续服用类固醇激素超过3个月情况、骨折史、性别、其他慢性病患病情况、体质量指数、婚姻状况、饮茶情况、每天运动情况有关（P<0.05）。多因素logistic回归性分析,结果显示：年龄≥70岁、性别为女性、连续服用类固醇激素超过3个月情况是老年人群发生骨质疏松症的危险因素,而每天运动情况≥30 min、有乳制品和钙片摄入情况、体质量指数≥24 kg/m²是老年人群发生骨质疏松症的保护因素（P<0.05）。骨质疏松症组的跌倒风险评估工具（FROP-Com）评分高于无骨质疏松症组,跌倒效能量表（MFES）评分低于无骨质疏松症组（P<0.05）。骨质疏松症组的简明精神状态检查量表（MMSE）评分低于无骨质疏松症组,画钟试验（CDT）评分高于无骨质疏松症组（P<0.05）。结论：蚌埠市蚌山区老年人群骨质疏松症患病率较高,且受到年龄、性别、连续服用类固醇激素超过3个月情况等因素的影响,而每天运动情况≥30 min、乳制品和钙片摄入情况、体质量指数≥24 kg/m²可减少骨质疏松症患病率,同时存在骨质疏松症的患者其跌倒风险升高,认知功能下降。     

PAGET'S DISEASE—Changes Occurring Following Treatment with Newer Hormonal Agents

From experience in six cases the anabolic steroid hormones, especially long-acting testosterone and estrogen preparations, are the treatment of choice in Paget''s disease, as in postmenopausal osteoporosis. Details of the management of three patients over a period of four years are presented.Roughly 4 per cent of the population, mostly persons over 40, show some evidence of Paget''s disease. Only a small number of them, however, have severe manifestations requiring treatment, such as pain, howing or fracture of the bones, pressure on nerves or heart failure. In rare cases malignant changes occur in the involved bone.Since the cause of Paget''s disease is not known, treatment in the past has been largely empirical. Reifenstein and Albright had advocated the therapeutic use of calcium, vitamin D and ascorbic acid, and, in postmenopausal women, administration of estrogens; but with fractures or immobilization, intake of calcium-containing foods, such as milk, must be restricted to avoid dangerous piling up of calcium and kidney stones, and fluids must be forced. In recent years anabolic steroid hormones, principally oral androgens and estrogens, have been employed by Gordan and others to promote bone repair, lessen bone pain and decrease urinary excretion of calcium. While these hormones probably do not arrest the disease, they seem to stabilize it and bring relief of symptoms.More recently, Albright and Henneman demonstrated that very large doses of corticotropin (ACTH) or cortisone resulted in immediate cessation of bone pain, decrease in urinary excretion of calcium and histologic evidence of regression of the disease process. The large doses required, however, also produce dangerous side effects, such as psychosis and osteoporosis, indicating that such treatment probably should not be continued over long periods.     

Prevalence of Osteoporosis in Ambulatory Postmenopausal Women from A Semiurban Region in Southern India: Relationship to Calcium Nutrition and Vitamin D Status

ObjectiveTo assess the prevalence of osteoporosis in healthy ambulatory postmenopausal Indian women as measured by dual-energy x-ray absorptiometry and to study the dietary calcium intake and vitamin D status and their influence on bone mineral density (BMD).MethodsWe conducted a community-based crosssectional study in a semiurban region. A randomized cluster sampling technique was used. The study cohort consisted of 150 ambulatory postmenopausal women (≥ 50 years old). Dual-energy x-ray absorptiometry for BMD was performed at the lumbar spine and femoral neck. Dietary calcium intake and biochemical variables were assessed.ResultsThe prevalence of osteoporosis was 48% at the lumbar spine, 16.7% at the femoral neck, and 50% at any site. The mean dietary calcium intake was much lower than the recommended intake for this age-group. There was a significant positive correlation between body mass index and BMD at the lumbar spine and the femoral neck (r = 0.4; P = .0001). BMD at the femoral neck was significantly less (mean, 0.657 versus 0.694 g/cm²) in the vitamin D-insufficient study subjects in comparison with the vitamin D-sufficient women (P = .03).ConclusionThe high prevalence of osteoporosis and vitamin D insufficiency in this semiurban group of postmenopausal women in India is a major health concern. Measures such as adequate calcium intake and vitamin D supplementation in women of this age-group may be beneficial. (Endocr Pract. 2008;14:665-671)     

Age at First Delivery and Osteoporosis Risk in Korean Postmenopausal Women: The 2008–2011 Korea National Health and Nutrition Examination Survey (KNHANES)

It has been reported in several studies that there may be a significant correlation between reproductive history and the risk of osteoporosis due to the effect of estrogen. Under this hypothesis, however, it is unclear whether the age at first delivery has any major influences on the risk of osteoporosis. Therefore, this study aimed to investigate the relationship between the age at first delivery and the risk of osteoporosis in Korean menopausal women. This study was performed using data from the 2008–2011 Korea National Health and Nutrition Examination Survey and included 2,530 Korean postmenopausal women. The diagnosis of osteoporosis was made using the World Health Organization T-score criteria (T-score ≤ -2.5, at the femoral neck or lumbar spine). Participants were categorized into 3 groups according to age at first delivery: ≤23, 24–29, and ≥30 years. Older age, lower body mass index, lower calcium intake, later menarche, and earlier menopause increased the risk of osteoporosis, whereas hormone therapy and oral contraceptive use were associated with a decreased risk of osteoporosis. Postmenopausal women whose first delivery occurred at age 24–29 years were shown to have a significantly increased risk of osteoporosis (odds ratio, 2.124; 95% confidence interval, 1.096–4.113; P = 0.026) compared to those who first gave birth after the age of 30 years. These findings suggest that postmenopausal women whose first delivery occurred in their mid to late 20s, a period during which bone mass slowly accumulates to the peak, are at an increased risk of osteoporosis.     

Liver and bone

Osteoporosis is a frequent complication in patients with chronic liver disease, especially in end-stages and in cases with chronic cholestasis, hemochromatosis and alcohol abuse. The problem is more critical in transplant patients when bone loss is accelerated during the period immediately after transplantation, leading to a greater incidence of fractures. Advanced age, low body mass index and severity of the liver disease are the main risk factors for bone disease in patients with cholestasis. Mechanisms underlying osteoporosis in chronic liver disease are complex and poorly understood, but osteoporosis mainly results from low bone formation, related to the effects of retained substances of cholestasis, such as bilirubin and bile acids, or to the effects of alcohol on osteoblastic cells. Increased bone resorption has also been described in cholestatic women with advanced disease. Although there is no specific treatment, bisphosphonates associated with supplements of calcium and vitamin D are effective for increasing bone mass in patients with chronic cholestasis and after liver transplantation. The outcome in reducing the incidence of fractures has not been adequately demonstrated essentially because of the low number of patients included in the therapeutic trials. Randomized studies assessing bisphosphonates in larger series of patients, the development of new drugs for osteoporosis and the improvement in the management of liver transplant recipients may change the future.     

Phenolic phytochemicals and bone

Concerning the prevention of osteoporosis, recognized as a major public health problem, nutrition may appear as an alternative strategy for optimizing health skeleton. The importance of adequate calcium and vitamin D intakes for bone health is now well documented. But, in addition to essential macro- and micronutrients, human diet contains a complex array of non-nutrient natural bioactive molecules, namely the phytochemicals that may act and protect bone. Among phytochemicals, emphasis has been so far placed upon polyphenols. Indeed, subsequent epidemiological studies have suggested associations between long-term consumption of diets rich in polyphenols and protection against chronic diseases. With respect to human health, flavonoids are the most extensively studied polyphenols. These compounds may be partly responsible for some of the positive links found between fruit and vegetables intake and higher bone mineral density in adults and children. However, no long-term intervention studies in humans have investigated the effect of specific phenolic phytochemicals on the prevention of bone loss in postmenopausal women, except for phytoestrogens (soy isoflavones, lignans). Besides, in animal models of postmenopausal osteoporosis, consumption of some dietary flavonoids has been shown to prevent ovariectomy-induced bone loss. Finally, few in vitro experiments with bone cells have reported cellular and molecular mechanisms of phytochemicals involved in bone metabolism. To date, investigations providing some evidence of a positive impact of some phytochemicals on bone metabolism are accumulating but further studies, notably clinical trials, are needed to explore the various bioactivities offered by such compounds. Anyway, it can be postulated that increased consumption of plant-derived foods, especially fruit and vegetables, may be positive in the prevention of osteoporosis.     

Protective role of n-3 lipids and soy protein in osteoporosis

It is well established that bone loss due to estrogen deficiency after menopause is greater in women consuming higher quantities of animal protein than in women consuming vegetable protein, particularly soy protein. Besides the dietary protein source altering bone loss, it has also been postulated recently that the source of a higher n-6/n-3 ratio in dietary oils is implicated in causing osteoporosis. Both animal and human studies have indicated that an increased intake of n-6 fatty acids from vegetable oils elevates prostaglandin E(2) levels as well as pro-inflammatory cytokines such as IL-1, IL-6 and TNF-alpha. Interestingly, it has been found that lack of estrogen also increases the production of these cytokines by immune cells and thereby activates osteoclasts during the peri-menopausal period. We speculated that the use of n-3 fatty acids and soy protein, which are known to act as anti-inflammatory and down regulate pro-inflammatory cytokines, may also protect against bone loss by decreasing osteoclast activation and bone resorption. Similar to the results of others, our ongoing studies indeed show that the bone loss in ovariectomized mice is significantly attenuated by feeding diets enriched with either fish oil or soy protein when compared to corn oil and casein-fed mice. One of the mechanisms appears to be decreasing the activation of receptor activator of NF-kappaB ligand (RANKL) on T cells, which has been found to increase osteoclast activation along with increasing pro-inflammatory cytokines in OVX mice. Since hormone replacement therapy has been found to cause adverse effects, further both animal and human studies are required with moderate soy protein and fish oil supplements in understanding the mechanisms involved in altering immune function and bone loss during menopause in women and aging in men.     

Effect of 1-year dairy product intervention on fat mass in young women: 6-month follow-up

Objective: Previous results from this laboratory suggest that a 1‐year dairy intake intervention in young women does not alter fat mass. The objective of this study was to determine the impact of the 1‐year dairy intervention 6 months after completion of the intervention. Research Methods and Procedures: Previously, normal‐weight young women (n = 154) were randomized to one of three calcium intake groups: control (<800 mg/d), medium dairy (1000 to 1100 mg/d), or high dairy (1300 to 1400 mg/d) for a 1‐year trial (n = 135 completed). In the current study, 51 women were assessed 6 months after completion of the intervention trial. Body compositions (body fat, lean mass) were measured using DXA. Self‐report questionnaires were utilized to measure activity and dietary intake (kilocalories, calcium). Results: The high‐dairy group (n = 19) maintained an elevated calcium intake (1027 ± 380 mg/d) at 18 months compared with the control group (n = 18, 818 ± 292; p = 0.02). Mean calcium intake over the 18 months predicted a negative change in fat mass (p = 0.04) when baseline BMI was controlled in regression analysis (model R² = 0.11). 25‐Hydroxyvitamin D levels were correlated with fat mass at each time‐point (baseline, r = ?0.41, p = 0.003; 12 months, r = ?0.42, p = 0.002; 18 months, r = ?0.32, p = 0.02) but did not predict changes in fat mass. Discussion: Dietary calcium intake over 18 months predicted a negative change in body fat mass. Thus, increased dietary calcium intakes through dairy products may prevent fat mass accumulation in young, healthy, normal‐weight women.     

Inhibition of osteoporosis due to restricted food intake by the fish oils DHA and EPA and perilla oil in the rat

Seven-week old female rats fed restricted foods including the fish oils Docosahesaenoic Acid (DHA) and Eicosapentaenoic Acid (EPA) and perilla oil with food intake decreased by 50%, had increases of fracture force and bone mineral density (BMD) and decreases in levels of Deoxypiridinoline (Dpd) and Calcium (Ca) in the urine, compared with those of rats with osteoporosis due to restricted soy bean oil food intake. Therefore, the fish oils DHA and EPA and perilla oil depressed excretion of urinary Ca and inhibited osteoporosis due to restricted food intake.     

The effect of calcium and vitamin D supplementation on osteoporotic rabbit bones studied by vibrational spectroscopy

Fourier transform infrared spectroscopy is utilized to examine the effects of increased calcium, vitamin D, and combined calcium-vitamin D supplementation on osteoporotic rabbit bones with induced inflammation. The study includes different bone sites (femur, tibia, humerus, vertebral rib) in an effort to explore possible differences among the sites. We evaluate the following parameters: mineral-to-matrix ratio, carbonate content, and non-apatitic species (labile acid phosphate and labile carbonate) contribution to bone mineral. Results show that a relatively high dose of calcium or calcium with vitamin D supplementation increases the bone mineralization index significantly. On the other hand, vitamin D alone is not as effective in promoting mineralization even with high intake. Mature B-type apatite was detected for the group with calcium supplementation similar to that of aged bone. High vitamin D intake led to increased labile species concentration revealing bone formation. This is directly associated with the suppression of pro-inflammatory cytokines linked to induced inflammation. The latter is known to adversely alter bone metabolism, contributing to the aetiopathogenesis of osteoporosis. Thus, a high intake of vitamin D under inflammation-induced osteoporosis does not promote mineralization but suppresses bone resorption and restores metabolic balance.