School-based calcium-vitamin D with micronutrient supplementation enhances bone mass in underprivileged Indian premenarchal girls.

Bone. 2012 Apr 4.
Khadilkar A anuradhavkhadilkar at gmail.com , Kadam N, Chiplonkar S, Fischer PR, Khadilkar V.
Hirabai Cowasji Jehangir Medical Research Institute, Pune, India.

Low adult bone mass is linked to osteoporosis and fractures and is dependent on the extent of childhood and adolescent bone mineralization. The aim of the study was to investigate the effect of 1-year supplementation of calcium, multivitamin with zinc along with vitamin-D on bone mass accrual of school-going premenarchal girls from low income groups in Pune, India. Double-blind, matched-pair, cluster, randomization study was carried out in 214 premenarchal girls (8-12years) from 2 schools in Pune, India. The two schools together formed 3 classes with 3 clusters each of age-matched girls of which one cluster was allocated to either one of the intervention groups

• Ca-group:500mg/d calcium,
• Ca+MZ-group:500mg/d calcium+multivitamin tablet containing 15mg/d zinc or
• Control group (C-group: multivitamin tablet without any minerals);

all subjects received vitamin-D supplementation. Anthropometry, biochemical parameters, total body bone mineral content (TBBMC) and bone mineral density (TBBMD) (Dual energy X-ray absorptiometry) were assessed at baseline and endline.

Post supplementation, mean percent increase in TBBMC was significantly higher in

• Ca-group (22.3%) and
• Ca+MZ-group (20.8%) compared to
• C-group (17.6%) (p<0.05) with

no significant differences observed between Ca+MZ and Ca groups (p>0.1).
Improvement in TBBMC-for-age Z-scores was higher in the two calcium supplemented groups (13.6%-22%) compared to the C-group (no improvement). Calcium supplementation, with or without multivitamins and zinc, showed a promising improvement in bone health especially with regards to improvement in bone related Z-scores in our population of underprivileged premenarchal girls.

Copyright © 2012. Published by Elsevier Inc.

PMID: 22503722
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Summary: Increased Bone mineral density after one year

17% multivitamin including vitamin D (Control)
22% Calcium + multivitamin including vitamin D

Wonder how much vitamin D was given

Wonder how much improvement there would have been if Vitamin K2 and Magnesium, vital for bones, were also given

2007 paper by the lead author

Low calcium intake and hypovitaminosis D in adolescent girls. attached at bottom of this page

See also VitaminDWiki

• All items in category Bone Health and vitamin D 106 items as of April 2012
• 6500 IU vitamin D not improve bone density without co-factors – Jan 2012
• Vitamin D, K2, Magnesium, etc increase bone density when taking together– Jan 2012
• Bone Health and vitamin D book - 2011
• Vitamin D is the first of three ways to make unbreakable bones – Oct 2011
• Calcium (alone) does not reduce risk of bone fracture
• Vitamin D is the best of three ways to make unbreakable bones – Oct 2011
• Bone Health and vitamin D book - 2011
• Vitamin K and Vitamin D
  Includes problems with excess Calcium at end of page
• Must balance co-factors when increasing vitamin D has the following graph