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Duration of exposure to sunlight, the type of clothing and level of calcium intake and BMI were quantified based on a questionnaire.
The importance and optimal level of calcium intake to compensate for skeletal calcium losses 1 and for the prevention of osteoporosis and fractures have been much debated and remain unclear.
In one study, the strength of the negative association between dietary vitamin D and breast density was found related to the level of calcium intake in pre-menopausal, but not in post-menopausal women (Berube et al, 2005).
18 19 This observed low level of calcium intake can be part of the reason for the insignificant relation between physical activities and BMD with the possibility that the beneficial effect of physical activity on bone is manifest only through synergistic interaction with high calcium intake over 1000 mg/day.
Several previous studies have recognized that the association between VDR alleles and bone mineral density may vary depending on the level of calcium intake [ 25, 26, 43- 45], and there is evidence that calcium is able to enhance cartilage repair and stimulate collagen production [ 46].
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Calcium absorption varies depending on previous and current levels of calcium intake and type of diet.
Varying levels of calcium intake [ 59] and reduced absorption in the vitamin D deficient elderly [ 12] makes it hard to generalise this finding to other populations.
Because previous calcium supplement trial participants showed high baseline levels of calcium intake over 750 mg/day [ 6], effects of calcium supplementation on trial group could have been minimized in the RCTs.
The leaflet provides a description of osteoporosis, an overview of the role of lifestyle factors such as diet, exercise and smoking and outlines ideal levels of calcium intake and exercise.
However, calcium intake above the level required by bones is likely to be excreted through the urine [7] and there is even evidence that higher levels of calcium intake (greater than around 1100 mg) may increase the risk of hip fractures [10].
There were small differences in calcium supplement use, comorbidity, educational level, smoking status, and physical activity level between categories of calcium intake.
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