J Sokoll

Lori

and

ABSTRACT stores living.

healthy,

premenopausal

the study. containing

two

daily

meals

P

(r

0.2

=

0.04), hemoglobin

1.

with

women.

for

12 wk.

P

were 0.04).

=

transferrin concentration

correlated

total

TIBC,

tions,

groups.

as the

carbonate to

KEY

WORDS

(r

saturation

(r

109

women

capacity

n saturation,

were over

daily

at baseline,

plasma

in

r

serum

or percent iron concen-

inabsolute

does

iron.

P

-0.42,

=

and mg Ca

appear

to be detri-

premenopausal

calcium

carbonate.

bone

In light

ofthe

recent

an

An

investigated

important

body

retention ingestion

and

calcium

in orange

source

between

dietary

variable

results.

to reduce

iron

with reported

by

of59Fe

juice

An

and

United

of impaired

.,lfll

y to pre-

a test

meal

However,

States,

undergoing

blood

was

oral

nated

blood the

starting

tablets

the effect

and

iron

status and

and 4.9%,

1992:56:1045-8.

of calcium

women

Lahol’atorl’

iron-deficiency respectively, Printed

in USA.

I

supplemen-

ofchildbearing The anemia in children

Written

aged area

informed

this

study

had

a usual

urinary calcium red blood cell

< 6.2 indices.

any ofthe following diseases: infection history of metabolically active nephgastritis, resection,

peptic ulcer, or parathyroid

treatment

with

contraceptives,

and

none

or calcium-containing

or during

the

during

the

and

or had > 50 mL study. In addition,

sprue, previous disease. No

glucocorticoids

or iron-

before

assays tests

and

study

blood drawn no subjects

cIi’tarj’

ofblood

laboratory

age

prevalence has

been

ages

© 1992 American

From

or policies

milk, by CCM

of childbearing

anemia.

for a 24-h normal

allowed

the

US

Center on Aging 2 The contents

lowered

phosphate,

women

women Boston

study.

Donation

no subject

of

had

in the 2 mo were known

do-

before to be

methods.

assess?nt’nt

and

urine Urinary

were

performed

calcium

was

by standard measured

by

been

whole-

not

the

intake

women.

(2, 3) but

study.

for 2 mo not

Screening

in humans

was significantly

risk for iron-deficiency

to be 9.6%

J C/in Nutr

children

calcium

calcium

(CCM)

has

by 0-73%

from

carbonate.

be at

pregnant.

for

calcium

elevated

utilization

in postmenopausal

malate

(3).

are at the greatest reported

of calcium

study

of calcium citrate

iron

tation on the iron status of free-living age has yet to be determined. In the

was

clinical

In a controlled

(2-9).

in the recommended

women.

interaction

has been

increase

for both loss of

for calcium for women ages 19-24 ( 1 ). supplements can be expected

increasingly

menopausal

women

therefore

and the research protocol Human Investigation Re-

selected

mg/d, 32%, and

subjects had inflammation,

estrogen.

this

each subject University

1000




were

treatment

healthy, free-living, 1992;56:1045-8.

Ferritin,

and taking

premenopausal

Subjects

n concentra-

the

period,

meals

20.0%

even greater risk for iron-deficiency anemia. In this study we examined the effect ofdaily supplementation with 1000 mg elemental Ca, as calcium carbonate, on iron stores in

heme-iron (r = 0.19,

(TIBC,

between

a 12-wk

with

iron stores AinJC/inNutr

and 57 took with each of

hemoglobi

observed

who

0.31, P = 0.001), and P = 0.02), and negatively

0.22,

=

1 1 y and

( 10). Women

in free-

=

differences concentrations,

transferri Thus,

mental women.

Of

In all subjects

iron-binding

or hematocrit

control

use on iron study

positively correlated with serum iron concentration

< 0.001). No significant changes in plasma ferritin

trations.

supplement controlled

52 were in the control group 250 mg Ca as the carbonate

concentrations

=

ofcalcium

in a randomized

completed two tablets femtin intake

effect

examined

concentrations

Davison-Hughes

Bess

The

was

ferritin

5-

Society

of the

Department

ofAgriculture

at Tufts University, ofthis publication US

Department

Human

Nutrition

Boston. do not necessarily of Agriculture.

nor

reflect does

Research

the views mention

of

trade names. commercial products. or organizations imply endorsement by the US Government. 3 Supported by the USDA Human Nutrition Research Center on Aging at Tufts University (contract no. 53-3K06-5-lO). 4 Address reprint requests to B Dawson-Hughes. USDA Human Nutrition Research Center on Aging at Tufts University. 7 1 1 Washington Street. Boston. MA 021 I 1. Received January 21. 1992. Accepted for publication July 9. 1992. for Clinical

Nutrition

1045

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Calcium supplementation and plasma in premenopausal women4

SOKOLL

1046 TABLE Clinical

AND

DAWSON-HUGHES Elkhart,

1

characteristics

and dietary

intakes

ofcontrol

and treatment

IN)

groups5

tablet. to the 33

31 ± 9 [52]

610

± 21 1 [49]

15.4

±

0.69

±

10.0

14.7 ±

(mg/d)

Protein

intake (g/d) Fiber intake (g/d) Ascorbic acid intake (mg/d)

7 1.6 20.1 239.5

14.8 0.59

10.3 [53] 0.45 [53]

± ±

14.2

[46]

10.2 [53]

±

Sample

6 (Beckman

Instruments,

measured from

with

Immo

TIBC

Chemicals

CA).

Magic

Phase

[53]

P

Magic

the

were

measured

with

(Monroe,

CT),

assay

kits

which

nutrients

Diagnostic

adapted

(Roche calculated

TABLE Baseline

assessed

questionnaire

with

the

for use

Instruments, by dividing

randomly Ca

assigned

mean were ofO

group. Those as calcium

subjects (two ment test

differences

performed for heme

per group

and with

Tukey

in the control group, group, 155%) were ( I 4) and

were

estimated

the two transformed to 0.019 the

the

whether

groups.

Sta-

data. according

Two to

3 mo

analyses.

Three of

was

the three

and percent

change

over

Characteristics in

Table

between in which

.

the two groups or in calcium intakes intake was quantitated. In those

the Willett in

intakes Baseline

ofthe control and treatment groups are shown was no significant difference in mean ages

1 There

food

frequency

ofprotein, plasma

questionnaire

for the subjects

(ii

99),

=

102 subjects completing no differences

iron, fiber, or ascorbic acid were femtin and serum iron concentrations.

semiquan-

tocrit were

were

not different

Hemoglobin

values in the 107 subjects also not different (Table

between

concentrations

observed. TIBC, the control and

hema-

in whom data were available 2). In all subjects, there was

Plasma ferritin (g/L) Serum iron (j.imol/L) Total-iron-binding capacity (Mmol/L) Transferrin saturation Hemoglobin (g/L) Hematocrit SD: percent

change

in

parentheses.

47.2

± 42.3

16.7

± 7.8

(14.8

(2.6

56.1

± 7.7

(0.9

relationship between baseline plasma ferritin concenand heme-iron intake (r - 0.2 1 P = 0.04), but not ferritin and any other dietary component measured.

Baseline

plasma

,

positively

correlated

ferritin

concentrations

with

baseline

were serum

iron

found

to be

concentrations

also

(r

Treatment

0.30 136 0.40

± 0.15 ± 8 (0.6 ±

n

(14.0

39,7)5

52

34.9

± 27.6

±

61.3)

52

15.4

±

52

58.2

± 7.8

52

0.27

±

± 61.7)

± 4.7)

0.03 (-0.8

Baseline

±

± 10.5)

50 ± 6.2)

a

positive trations between

12 wk

Baseline

no

subjects

2

iron status

150

>

in the treatby Grubb’s

There

or not

a

control used to

was taken.

over

a the

assuming Unpaired

200%, and one to be outliers

from

for a

of detecting of I 5% in

Results

saturation

500 Inc.

and determined

Control

S

and blinded

between 1 test was

the logarithm

220

excluded

groups.

in the calcium group took carbonate (BioCal, Miles,

within

in ferritin

difference in the study results were included in the analyses.

treatment

or a cal-

differences Student’s

time

changes

transfemn

a control

over

( 1 3) before

percent

and

( 12).

were

an 80% chance concentrations

on logarithmically iron were changed

and

Willett

to either

subjects

question( 1 1 ). Intake

dt’.tvi were

cium-supplement mg elemental

was

frequency

Lvp(’rinu’?ual Women

regression

from

were

serum iron concentration by TIBC. Calcium intake was assessed with a food frequency naire specific for calciumand vitamin D-rich foods food

the

38 plasma 4 to 667 g/ The two kits

and

on the Cobas-Fara centrifugal analyzer Belleville, NJ). Transferrmn saturation was

titative

assess

Kits, from kits.

0.0001)

kits

To

determined to be Magic Ferritin = 0.803 zg/L Phase femtin. The two samples from each subject and analyzed in the same assay run. Serum iron

Limited

ofadditional

was

Radioimmunoassay

and

=

Span

ferritin

MA).

of 60

Student’s t test was used to compare and treatment groups and paired

a Spectra

Plasma

concentration by using both

0.998,

=

with

(Medfield,

Immo

(r

correlated

equation was + 1.01 5 Immo were batched and

and

ranging in ferritin Kit), were assayed

strongly

Alto.

Diagnostics of the

specimens, L (Magic

Palo Phase

Ciba-Corning

comparability

spectroscopy

sizes

group as compared with control subjects, of 0.3 1 in log of ferritin concentrations.

tistics values emission

were

test to have at least decrease in ferritin

Mosteller plasma

at baseline

analyses

0.05-level significant

186.7

[53]

#{149}#{231} ± SD: ii in brackets.

direct-current

daily placebo

Statistics

evaluate S

evaluated

meals any

assignments.

±

22.6 215.3

were

treatment variability

± 8.3

[49]

treatment-group

of two

did not take

laboratory

I 1.8 [53]

70.3 ± 30.5

± 329.7

status

conducting

±

± 2 1.9 [49]

[49]

of iron

Staff

at each

group

8 [57]

±

559 ± 229 [53]

10.0 [46] 0.49 [46]

tablets

50

135 0.40

± ±

ii

(-2.2

5.5 (8.5 (1.8

± 38.4)

57

±

61.9)

57

±

10.5)

57

0.10 (6.3 ± 56.5) 9 (1.0 ± 4.7) 0.03 (-0.4 ± 6.1)

57 57 57

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Age (y) Calcium intake (mg/d) Total iron intake (mg/d) Heme-iron intake (mg/d) Nonheme iron intake

250-mg

in the control

Measures

1 2 wk later.

Treatment

Control

in two

for 12 wk. Women

CALCIUM =

P

0.19.

0.04),

=

and hemoglobin with TIBC (r Percent

transferrin

-

changes

in Table control

and

were

Calcium supplementation and plasma ferritin concentrations in premenopausal women.

The effect of calcium supplement use on iron stores was examined in a randomized controlled study in free-living, healthy, premenopausal women. Of 109...
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