Taking calcium supplements before age 35 may prevent osteoporosis later in life

WENZHOU, China — Planning ahead can pay serious dividends in many areas of life. Now, new research out of China suggests a little bit of forward thinking when it comes to bone health can help stave off osteoporosis years down the line. Researchers report taking calcium supplements between ages 20 and 35 can help improve bone mass at peak bone mass age.

Study authors believe this work points to a new, easy way adults can proactively protect their bones from a young age, setting the stage for more robust bone health during old age. On an even more general level, researchers add young adults should pay more attention to their bone health.

Osteoporosis and fractures are important global public health problems, particularly in elderly women,” explains lead study author Yupeng Liu, a researcher at Wenzhou Medical University’s School of Public Health and Management, in a media release. “However, although calcium supplementation has been widely used in older age to increase bone mass, a number of studies suggest that it is unlikely to translate into clinically meaningful reductions in fractures.”

“On the other hand, intervention before young adults reach peak bone density might have a greater impact on bone health and prevent osteoporosis later. There has been considerable debate about whether calcium supplementation has effects on bone health among young people, so we conducted a comprehensive review of the evidence for calcium supplement effectiveness in people under the age of 35.”

Are supplements better than the real thing?

The research team made use of previously conducted randomized controlled trials — seen as the gold standard for clinical research — to compile these findings. More specifically, they searched for trials comparing calcium or calcium plus vitamin D with a placebo or no treatment in participants under the age of 35. They also focused on results reported for bone mineral density (BMD) or bone mineral content (BMC).

In total, this project ended up encompassing 43 prior studies involving over 7,300 people. Among those 43 studies, 20 looked at dietary calcium while the other 23 focused on calcium supplementation. The team then combined all of the data to search for changes in BMD and BMC in the lumbar spine, femoral neck, total hip, and total body.

That investigation led to the conclusion that calcium supplements taken by people under 35 have significant potential to improve the BMD levels of both the total body and femoral neck. They also appear to slightly increase the BMC of the femoral neck, total body, and lumbar spine. In comparison to individuals younger than 20 (the pre–peak bone mass age), these benefits were more prominent among participants between 20 and 35 years-old (the peri–peak bone mass age when bone mass plateaus).

Importantly, both dietary sources of calcium and calcium supplements had a positive effect on femoral neck and total body BMD. However, BMC measurements of the femoral neck and lumbar spine only improved following calcium supplementation.

Vitamin D, meanwhile, was a bit of a mixed bag. A combination of calcium and vitamin D did prove more beneficial for the femoral neck bone mineral density and content, but researchers did not see the same robust benefits for BMCs of lumbar spine and total body, or total body BMD.

Moving up the ‘intervention window’

In summation, study authors believe calcium supplements have serious potential to improve both bone mineral density and content, especially in the neck, in a major way. Taking calcium supplements during peri–peak bone mass age (ages 20-35) appears to foster the strongest benefits in comparison to earlier or later in life.

“Although further trials will be needed to verify these findings, our review provides a new train of thought regarding calcium supplementation and the optimal timing of its effects,” concludes senior study author Shuran Wang, a professor at Wenzhou Medical University. “In terms of bone health and an individual’s full life cycle, the intervention window of calcium supplementation should be advanced to the age around the plateau of peak bone mass – namely at 20–35 years of age.”

The study appears in the journal eLife.

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