Calcium and Vitamin-D supplementation on bone structural properties - - PowerPoint PPT Presentation

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calcium and vitamin d supplementation on bone structural
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Calcium and Vitamin-D supplementation on bone structural properties - - PowerPoint PPT Presentation

Feb 19, 2023 192 likes •410 views

Calcium and Vitamin-D supplementation on bone structural properties in young male jockeys: a randomised controlled trial Presented by Leslie Silk ICHSWJ Hong Kong , 24 th - 25 th September 2015 . Dean McWhinney , age 21, falling off Sir Knox

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Dean McWhinney , age 21, falling off Sir Knox in the last race on the Sunshine Coast. Courier Mail; Photo courtesy: Grant Peters, Trackside Photography

Calcium and Vitamin-D supplementation on bone structural properties in young male jockeys: a randomised controlled trial

Presented by Leslie Silk

ICHSWJ Hong Kong , 24th - 25th September 2015.

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Introduction

  • Weight restricted sport

Ø no defined competition season

(Hitchens, et al, 2011)

Ø lowest 5th percentile

(Kuczmarski et al, 2000)

Ø train >24hrs per week

(Greene, et al, 2013)

  • Disordered eating and

dehydration

(Cotugna, et al, 2011; Dolan et al, 2011; Greene, et al, 2013; Leydon & Wall, 2002; Moore et al, 2002)

Bad for growing bones

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Introduction

  • Evidence of poor bone

health

Ø Osteopenia Ø Reduced bone strength in Apprentices Ø Bone turnover markers elevated

Higher fracture risk

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Introduction

  • Low calcium intakes

(Dolan et al, 2011 ; Greene et al, 2013; Leydon & Wall, 2002)

  • vitamin D insufficiency
  • Supplementation?

Ø calcium and vitamin D

(Abrahamsen et al, 2010; Chung et al, 2009; Cranney et al, 2007; Shea et al, 2002; Tang, et al, 2007; Silk et al 2015; Winzenberg et al, 2006)

ØFew male studies ØNo athlete studies

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Study Aim

  • To establish whether calcium

and vitamin D supplementation would improve bone mineral properties of young male jockeys

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Study design

  • 29 Apprentice Jockeys
  • Average age 20
  • 17 completed study
  • Double-blind,

randomised, placebo controlled trial of calcium and vitamin D supplementation

  • Six months duration
  • 800mg Calcium plus

400IU vitamin D

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Test variables

§ Primary outcome measures:

§ Changes to bone § Changes to serum bone markers

§ pQCT used to assess bone health

§ Alterations to cortical bone more responsive than overall bone mineral density IOF recommended bone metabolism markers:

  • procollagen type I N propeptide (s-PINP)
  • serum C-terminal telopeptide of type I

collagen (s-CTX)

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Ø Serum Vitamin D Ø Full Anthropometric profile Ø Hydration status Ø Dietary Questionnaire Ø Lifestyle Questionnaire Ø Energy expenditure estimates

Secondary measures

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Baseline data

Supplement group (n=8) Placebo group (n=9) Mean (SD) Mean (SD) p-value Age (yrs) 22.3 5.0 19.3 1.8 0.152 Height (cm) 165.6 4.4 167.3 4.3 0.517 Weight (kg) 52.7 3.6 52.6 3.3 0.453 Sum of six skinfolds (mm) 34.4 5.9 32.9 5.1 0.588 Hydration levels (Usg) 1.022 0.01 1.020 0.01 0.348 Energy intake (kJ·day-1) 7,723 2,974 8,700 2,454 0.469 Calcium intake (mg·day-1) 669.7 274.3 790.4 423.9 0.503 25OH Vit D (nmol/L) 64.6 19.5 81.2 24.4 0.146

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pQCT bone results

Variable % difference in Supplemented group p- value

Tibia 66% site Cortical content (mg·mm)

6.6 <0.001 Cortical area (mm2) 5.9 <0.001 Cortical density (mg·cm2) 1.3 0.001 Total area (mm2) 4.0 0.003 Radius 4% Trabecular area (mm2) 8.6 0.028 66% Cortical area (mm2) 10.0 0.003

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Blood results

Variable % difference in Supplemented group p-value CTX

  • 24.8

0.011 P1NP 5.0 0.511 25 (OH) Vitamin D 18.1 0.014

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Secondary measure results

  • Anthropometric variables

Ø Sum of six skinfold measures 32.9 to 34.4mm

  • Dietary Habits

Ø Average intake 144-152kj per kg body weight Ø Calcium intake 670-790mg

  • Lifestyle Questionnaire

Ø smoking (33%) and regularly drinking alcohol (72%) Ø 60% reported previous fractures

J Barbour, the jockey who rode Apsley to a Grand National Steeplechase win at Flemington in 1894, weighs in after the race. National Museum of Australia

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Bone geometry

Endocortical radius (mm):

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Bone geometry

Pericortical radius (mm):

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Cortical distribution

Posterior

Supplement group Placebo group

980.57 1181.84 1264.76

Anterior Lateral Medial

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Cortical distribution

980.57 1181.84 1264.76

Supplement group

Mineral mass p=0.07 p=0.08 p=0.03

p=0.02

p=0.09

vBMD

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Conclusions

  • Improvements in both

tibia and radius

  • Viable strategy for

improving bone health

  • Study size small
  • Short duration
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With thanks

  • Australian Jockey Association
  • Racing NSW
  • Racing Victoria
  • USANA Health Sciences Inc