The Effect of Ongoing Vitamin D and Low-Fat Milk Intake on Bone Metabolism in Female High-School Endurance Runners

BACKGROUND: Vitamin D and calcium are essential nutrients for bone health. In addition, vitamin D suppresses inflammatory cytokines and increases bone resorption. Therefore, improvements in bone health by calcium and vitamin D supplementation have the potential to not only improve calcium metabolism but also suppress inflammation associated with exercise training. The purpose of this study was to determine whether ongoing vitamin D supplementation and low-fat milk intake by female high-school endurance runners would improve bone metabolism by suppressing inflammatory cytokines and the parathyroid hormone (PTH). METHODS: Twenty female high-school runners were assigned to a vitamin D supplement and low-fat milk intake group (MKD) or a control group (CON). Participants in the MKD group consumed a vitamin D supplement (1,000 IU/day) and low-fat milk (Ca 315 mg/day) for 6 months. Bone mineral density measurements, blood samples, and questionnaires (regarding menses and diet) were carried out. The UMIN Clinical Trials Registry number is UMIN000027854. RESULTS: The 25-hydroxyvitamin D (25(OH)D) concentration in MKD was sustained and PTH concentration was decreased regardless of the state of menses. The correlation coefficients of 25(OH)D or PTH concentrations and bone metabolism markers were analyzed by partial correlation coefficient via adjusting the model for frequency of menses. CTX and 25(OH)D concentration were significantly and inversely correlated at baseline (r = -0.61, P < 0.01), 3 months (r = -0.54, P = 0.02), and 6 months (r = -0.53, P = 0.02). CTX and PTH were significantly and positively correlated at 3 months (r = 0.63, P < 0.01) and 6 months (r = 0.52, P = 0.02). The bone alkaline phosphatase (BAP)/CTX ratio and 25(OH)D concentration were significantly and positively correlated at 3 months (r = 0.59, P = 0.01) and 6 months (r = 0.56, P = 0.01). The BAP/CTX ratio and PTH were significantly and inversely correlated at 3 months (r = -0.59, P = 0.01) and 6 months (r = -0.58, P < 0.01). CONCLUSIONS: This study suggested that vitamin D and low-fat milk supplementation improves bone metabolism by sustaining the 25(OH)D concentration and decreasing the PTH concentration in female high-school endurance runners regardless of the state of menses.