Differential Impact of Calcium and Vitamin D on Body Composition Changes in Post-Menopausal Women Following a Restricted Energy Diet and Exercise Program.

Chad M Kerksick,Christopher J Rasmussen,Jacqueline Dove,Michael D Roberts,Richard B Kreider,Ashli Lee,Melyn M Galbreath,Lemuel W Taylor,Colin D Wilborn,Jennifer W Bunn,Bill I Campbell

doi:10.3390/nu12030713

Abstract

Vitamin D and calcium supplementation have been posited to improve body composition and different formulations of calcium may impact bioavailability. However, data are lacking regarding the combinatorial effects of exercise, diet, and calcium and/or vitamin D supplementation on body composition changes in post-menopausal women. Herein, 128 post-menopausal women (51.3 ± 4.5 years, 36.4 ± 5.7 kg/m2, 46.2 ± 4.5% fat) were assigned to diet and supplement groups while participating in a supervised circuit-style resistance-training program (3 d/week) over a 14-week period. Diet groups included: (1) normal diet (CTL), (2) a low-calorie, higher protein diet (LCHP; 1600 kcal/day, 15% carbohydrates, 55% protein, 30% fat), and (3) a low-calorie, higher carbohydrate diet (LCHC; 1600 kcal/day, 55% carbohydrates, 15% protein, 30% fat). Supplement groups consisted of: (1) maltodextrin (PLA), (2) 800 mg/day of calcium carbonate (Ca), and (3) 800 mg/day of calcium citrate and malate and 400 IU/day of vitamin D (Ca+D). Fasting blood samples, body composition, resting energy expenditure, aerobic capacity, muscular strength and endurance measures were assessed. Data were analyzed by mixed factorial ANOVA with repeated measures and presented as mean change from baseline [95% CI]. Exercise training promoted significant improvements in strength, peak aerobic capacity, and blood lipids. Dieting resulted in greater losses of body mass (CTL −0.4 ± 2.4; LCHC −5.1 ± 4.2; LCHP −3.8 ± 4.2 kg) and fat mass (CTL −1.4 ± 1.8; LCHC −3.7 ± 3.7; LCHP −3.4 ± 3.4 kg). When compared to LCHC-PLA, the LCHC + Ca combination led to greater losses in body mass (PLA −4.1 [−6.1, −2.1], Ca −6.4 [−8.1, −4.7], Ca+D −4.4 [−6.4, −2.5] kg). In comparison to LCHC-Ca, the LCHC-Ca+D led to an improved maintenance of fat-free mass (PLA −0.3 [−1.4, 0.7], Ca −1.4 [−2.3, −0.5], Ca+D 0.4 [−0.6, 1.5] kg) and a greater loss of body fat (PLA −2.3 [−3.4, −1.1], Ca −1.3 [−2.3, −0.3], Ca+D −3.6 [−4.8, −2.5]%). Alternatively, no significant differences in weight loss or body composition resulted when adding Ca or Ca+D to the LCHP regimen in comparison to when PLA was added to the LCHP diet. When combined with an energy-restricted, higher carbohydrate diet, adding 800 mg of Ca carbonate stimulated greater body mass loss compared to when a PLA was added. Alternatively, adding Ca+D to the LCHC diet promoted greater% fat changes and attenuation of fat-free mass loss. Our results expand upon current literature regarding the impact of calcium supplementation with dieting and regular exercise. This data highlights that different forms of calcium in combination with an energy restricted, higher carbohydrate diet may trigger changes in body mass or body composition while no impact of calcium supplementation was observed when participants followed an energy restricted, higher protein diet.

Highlights

The overweight and obesity pandemic poses a global burden, with as many as 1.5 billion people, or roughly 20% of the world population being affected [1] while a 2019 report stating that by the year2030 50% of U.S adults will have obesity [2]
The randomization was completed in a block format with two times (2:1:1) the people being assigned to LCHP and LCHC to account for anticipated greater attrition in these groups
These findings indicate that calcium supplementation may operate most effectively to induce favorable changes in body composition when combined with a hypoenergetic diet that contains a greater proportion of carbohydrate versus protein

Summary

Introduction

The overweight and obesity pandemic poses a global burden, with as many as 1.5 billion people, or roughly 20% of the world population being affected [1] while a 2019 report stating that by the year2030 50% of U.S adults will have obesity [2]. The overweight and obesity pandemic poses a global burden, with as many as 1.5 billion people, or roughly 20% of the world population being affected [1] while a 2019 report stating that by the year. Many reports have highlighted the fact that this dilemma poses severe economic consequences [3,4]. In this regard, obese persons bear medical and prescription medicine costs that are approximately 30% greater than normal-weight peers [5]. Lost quantity of lifetime in obese persons has been estimated to be as high as 20 years compared to normal-weight peers [7]. The causes of obesity stem from environmental and genetic factors, post-menopausal women may be at increased risk due to factors such as reductions in circulating sex hormones [8,9], decrements in whole-body metabolism due to the lack or irregular presence of a menstrual cycle [10]

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Conclusion