Hostname: page-component-669899f699-g7b4s Total loading time: 0 Render date: 2025-05-04T12:07:34.189Z Has data issue: false hasContentIssue false
  • English
  • Français

Calcium plus vitamin D supplementation during pregnancy has no impact on postpartum transient longitudinal changes in hip geometry in adolescent mothers: a secondary analysis of a randomised controlled trial

Published online by Cambridge University Press:  07 November 2024

Verônica Rached Open the ORCID record for Verônica Rached [Opens in a new window] ,
Maria Eduarda L. Diogenes ,
Marise Crivelli ,
Carmen M. Donangelo  and
Flávia F. Bezerra
Verônica Rached
Affiliation:
Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil
Maria Eduarda L. Diogenes
Affiliation:
Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil Brazilian National Cancer Institute, Rio de Janeiro, Brazil
Marise Crivelli
Affiliation:
Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil Hospital Naval Marcílio Dias, Rio de Janeiro, Brazil
Carmen M. Donangelo
Affiliation:
School of Nutrition, University of the Republic, Montevideo, Uruguay
Flávia F. Bezerra*
Affiliation:
Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil
*
*Corresponding author: Flávia F. Bezerra, email [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

We have previously demonstrated that calcium plus vitamin D supplementation during adolescent pregnancy reduces the magnitude of transient postpartum bone mass loss. In the present post hoc analysis, we further investigated the effect of calcium plus vitamin D supplementation during pregnancy in hip geometry throughout one year postpartum in Brazilian adolescents with low daily calcium intake (∼600 mg/d). Pregnant adolescents (14–19 years) were randomly assigned to receive calcium (600 mg/d) plus vitamin D3 (200 μg/d) or a placebo from 26 weeks of gestation until parturition. Dual-energy X-ray absorptiometry images were obtained at 5 (n 30 and 26 for calcium plus vitamin D and placebo, respectively), 20 (n 26 and 21) and 56 (n 18 and 12) weeks postpartum, and hip geometry parameters were analysed by Advanced Hip Assessment software. The effects of the intervention, time point and their interaction were assessed using repeated-measures mixed-effects models. No significant intervention effects or intervention × time interactions were observed on hip geometry parameters (P > 0·05). Time effects were observed in cross-sectional area, cross-sectional moment of inertia and section modulus parameters with decreases from the 5th to the 20th week postpartum followed by recovery from the 20th to the 56th week (P < 0·05). Our findings indicate that the postpartum period is associated with transient changes in the hip geometry of lactating adolescent mothers, regardless of the low calcium intake and the supplementation offered during pregnancy, suggesting that a physiological adaptation of these adolescents to low calcium intake is at play.

Keywords

AdolescenceInterventionAdvanced hip assessmentBone strengthLactation
Type
Research Article
Information
British Journal of Nutrition , Volume 132 , Issue 10 , 28 November 2024 , pp. 1325 - 1333
Check for updates
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of The Nutrition Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Kovacs, CS (2016) Maternal mineral and bone metabolism during pregnancy, lactation, and post-weaning recovery. Physiol Rev 96, 449–547.CrossRefGoogle ScholarPubMed
Olausson, H, Goldberg, GR, Ann Laskey, M, et al. (2012) Calcium economy in human pregnancy and lactation. Nutr Res Rev 25, 40–67.CrossRefGoogle Scholar
Jarjou, LM, Laskey, MA, Sawo, Y, et al. (2010) Effect of calcium supplementation in pregnancy on maternal bone outcomes in women with a low calcium intake. Am J Clin Nutr 92, 450–457.CrossRefGoogle ScholarPubMed
Sawo, Y, Jarjou, LMA, Goldberg, GR, et al. (2013) Bone mineral changes after lactation in Gambian women accustomed to a low calcium intake. Eur J Clin Nutr 67, 1142–1146.CrossRefGoogle ScholarPubMed
Grizzo, FMF, Alarcão, ACJ, Dell’ Agnolo, CM, et al. (2020) How does women’s bone health recover after lactation? A systematic review and meta-analysis. Osteoporos Int 31, 413–427.CrossRefGoogle ScholarPubMed
Diogenes, MEL, Bezerra, FF & Donangelo, CM (2021) Reduction in bone loss from 5 to 20 weeks postpartum in adolescents supplemented with calcium plus vitamin D during pregnancy is not sustained at 1 year postpartum: follow-up study of a randomized controlled trial. J Nutr 151, 548–555.CrossRefGoogle Scholar
Shuhart, C, Cheung, A, Gill, R, et al. (2024) Executive summary of the 2023 adult position development conference of the international society for clinical densitometry: DXA reporting, follow-up BMD testing and trabecular bone score application and reporting. J Clin Densitom 27, 101435.CrossRefGoogle ScholarPubMed
Nagaraj, N, Boudreau, RM, Danielson, ME, et al. (2019) Longitudinal changes in hip geometry in relation to the final menstrual period: study of Women’s Health Across the Nation (SWAN). Bone 122, 237–245.CrossRefGoogle Scholar
Kim, BM, Kim, SE, Lee, D-Y, et al. (2021) Effect of tissue–selective estrogen complex on hip structural geometry in postmenopausal women: a 12-month study. Front Endocrinol 12, 649952.CrossRefGoogle ScholarPubMed
Mazza, E, Ferro, Y, Pujia, R, et al. (2022) Bending resistance at hip and fractures risk in postmenopausal women independent of bone mineral density. J Clin Densitom 25, 198–207.CrossRefGoogle ScholarPubMed
Kistler-Fischbacher, M, Yong, JS, Weeks, BK, et al. (2022) High-intensity exercise and geometric indices of hip bone strength in postmenopausal women on or off bone medication: the medex-op randomised controlled trial. Calcif Tissue Int 111, 256–266.CrossRefGoogle ScholarPubMed
Wang, Q, Chen, D, Cheng, SM, et al. (2015) Growth and aging of proximal femoral bone: a study with women spanning three generations. J Bone Miner Res 30, 528–534.CrossRefGoogle Scholar
Al-Shaar, L, Nabulsi, M, Maalouf, J, et al. (2013) Effect of vitamin D replacement on hip structural geometry in adolescents: a randomized controlled trial. Bone 56, 296–303.CrossRefGoogle ScholarPubMed
Ward, KA, Adams, JE, Roberts, SA, et al. (2009) Postpartum bone status in teenage mothers assessed using peripheral quantitative computed tomography. J Clin Densitom 12, 219–223.CrossRefGoogle ScholarPubMed
Laskey, MA, Price, RI, Khoo, BCC, et al. (2011) Proximal femur structural geometry changes during and following lactation. Bone 48, 755–759.CrossRefGoogle ScholarPubMed
Diogenes, MEL, Bezerra, FF, Rezende, EP, et al. (2013) Effect of calcium plus vitamin D supplementation during pregnancy in Brazilian adolescent mothers: a randomized, placebo-controlled trial. Am J Clin Nutr 98, 82–91.CrossRefGoogle ScholarPubMed
Institute of Medicine (2011) Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academies Press.Google Scholar
Institute of Medicine (1997) Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: National Academies Press.Google Scholar
NEPA-UNICAMP (2011) Tabela brasileira de composição de alimentos (TACO) [Brazilian Food Composition Table - TACO], 4 ed. Campinas: NEPA-UNICAMP.Google Scholar
Universidade de São Paulo (USP) & Food Research Center (FoRC) (2023) Tabela Brasileira de Composição de Alimentos (TBCA) [Brazilian Food Composition Table - TBCA], Version 7.2. São Paulo: Universidade de São Paulo (USP) & Food Research Center (FoRC).Google Scholar
World Health Organization (2008) Indicators for Assessing Infant and Young Child Feeding Practices: Part 1: Definitions: Conclusions of a Consensus Meeting held 6–8 November 2007 in Washington D.C., USA. Geneva: WHO Press. pp. 3–4.Google Scholar
Osborne, DL, Weaver, CM, McCabe, LD, et al. (2012) Body size and pubertal development explain ethnic differences in structural geometry at the femur in Asian, Hispanic, and white early adolescent girls living in the U.S. Bone 51, 888–895.CrossRefGoogle ScholarPubMed
Al Rassy, N, Matta, J, Frenn, F, et al. (2017) Bone geometric properties of the femoral neck in underweight eumenorrheic women. J Clin Densitom 22, 272–278.CrossRefGoogle ScholarPubMed
Nurzenski, MK, Briffa, NK, Price, RI, et al. (2007) Geometric indices of bone strength are associated with physical activity and dietary calcium intake in healthy older women. J Bone Miner Res 22, 416–424.CrossRefGoogle ScholarPubMed
Jackowski, SA, Kontulainen, SA, Cooper, DM, et al. (2011) The timing of BMD and geometric adaptation at the proximal femur from childhood to early adulthood in males and females: a longitudinal study. J Bone Miner Res 26, 2753–2761.CrossRefGoogle ScholarPubMed
Kim, KM, Choi, SH, Lim, S, et al. (2014) Interactions between dietary calcium intake and bone mineral density or bone geometry in a low calcium intake population (KNHANES IV 2008–2010). J Clin Endocrinol Metab 99, 2409–2417.CrossRefGoogle ScholarPubMed
Bislev, LS, Langagergaard Rødbro, L, Rolighed, L, et al. (2018) Bone microstructure in response to vitamin d3 supplementation: a randomized placebo-controlled trial. Calcif Tissue Int 104, 160–170.CrossRefGoogle ScholarPubMed
Dhaliwal, R, Islam, S, Mikhail, M, et al. (2020) Effect of vitamin D on bone strength in older African Americans: a randomized controlled trial. Osteoporos Int 31, 1105–1114.CrossRefGoogle Scholar
Diogenes, ME, Bezerra, FF, Rezende, EP, et al. (2015) Calcium plus vitamin D supplementation during the third trimester of pregnancy in adolescents accustomed to low calcium diets does not affect infant bone mass at early lactation in a randomized controlled trial. J Nutr 145, 1515–1523.CrossRefGoogle Scholar
Chan, GM, McMurry, M, Westover, K, et al. (1987) Effects of increased dietary calcium intake upon the calcium and bone mineral status of lactating adolescent and adult women. Am J Clin Nutr 46, 319–323.CrossRefGoogle ScholarPubMed
Malpeli, A, Mansur, JL, Santiago, SD, et al. (2010) Changes in bone mineral density of adolescent mothers during 12-month postpartum period. Public Health Nutr 13, 1522–1527.CrossRefGoogle ScholarPubMed
Beck, TJ (2007) Extending DXA beyond bone mineral density: understanding hip structure analysis. Curr Osteoporos Rep 5, 49–55.CrossRefGoogle ScholarPubMed
Supplementary material: File

Rached et al. supplementary material

Rached et al. supplementary material
Download Rached et al. supplementary material(File)
File 23.4 KB