Calcium plus vitamin D supplementation during pregnancy interacts with polymorphisms in the promoter region of the VDR gene to affect postpartum bone mass of Brazilian adolescent mothers: A randomized controlled trial

Normando, Paula; Diogenes, Maria Eduarda L; Cabello, Pedro Hernán; Cabello, Giselda M. K.; Donangelo, Carmen M.; Bezerra, Flávia Fioruci

doi:10.1016/j.nut.2016.03.002

Cited by 10 publications

(9 citation statements)

References 27 publications

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“…For example, in the present study, CYP2R1 rs10741657 A>G polymorphism emerged as the most common significant covariate in the linear mixed models examining associations between vitamin D biomarkers and maternal/fetal bone turnover markers. In addition, others have reported that polymorphisms in the VDR gene influenced changes in bone measurements among adolescent pregnant women consuming supplemental vitamin D and calcium [44]. …”

Section: Discussionmentioning

confidence: 99%

Maternal vitamin D biomarkers are associated with maternal and fetal bone turnover among pregnant women consuming controlled amounts of vitamin D, calcium, and phosphorus

Park

Brannon

West

et al. 2017

Bone

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Vitamin D plays a central role in calcium homeostasis; however, its relationship with bone turnover during pregnancy remains unclear due to a lack of studies that have rigorously controlled for other nutrients known to influence bone metabolism. Similarly, prior investigations of the effect of pregnancy on bone turnover relative to the nonpregnant state may have been confounded by varying intakes of these nutrients. Nested within a controlled intake study, the present investigation sought to quantify associations between maternal vitamin D biomarkers and biochemical markers of bone turnover among pregnant (versus nonpregnant) women and their fetuses under conditions of equivalent and adequate intakes of vitamin D and related nutrients. Changes in markers of bone turnover across the third trimester were also examined. Healthy pregnant (26–29 wk gestation; n=26) and nonpregnant (n=21) women consumed 511IU vitamin D/d, 1.6g calcium/d, and 1.9g phosphorus/d for 10 weeks while participating in a controlled feeding study featuring two choline doses. Based on linear mixed models adjusted for influential covariates (e.g., BMI, ethnicity, and season), pregnant women had 50–150% higher (P<0.001) concentrations of bone resorption markers than nonpregnant women. Among pregnant women, increases in maternal 25(OH)D across the study period were associated (P<0.020) with lower osteocalcin and deoxypyridinoline at study-end, and higher fetal osteocalcin. In addition, maternal free 25(OH)D, 1,25(OH)2D, and 24,25(OH)2D tended to be negatively associated (P≤0.063) with maternal NTx at study-end, and maternal free 25(OH)D and 24,25(OH)2D were positively associated (P≤0.021) with fetal CTx. Similarly, maternal 3-epi-25(OH)D3 was negatively related (P≤0.037) to maternal NTx and deoxypyridinoline at study-end. These declines in bone resorption markers resulting from higher vitamin D biomarker concentrations among pregnant women coincided with increases in their albumin-corrected serum calcium concentrations, indicating that calcium transfer to the fetus was uncompromised. Notably, none of these associations achieved statistical significance among nonpregnant women. Overall, our study findings suggest that achieving higher maternal concentrations of vitamin D biomarkers might attenuate third-trimester bone resorption while ensuring sufficient calcium delivery to the fetus.

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Section: Discussionmentioning

confidence: 99%

Maternal vitamin D biomarkers are associated with maternal and fetal bone turnover among pregnant women consuming controlled amounts of vitamin D, calcium, and phosphorus

Park

Brannon

West

et al. 2017

Bone

View full text Add to dashboard Cite

show abstract

“…However, infant body weight and its increment were higher in the supplemented group [ 38 ]. Another study of pregnant adolescents in Brazil aged 13–19 yrs reported that changes in bone mass by Ca supplementation were dependent on the genotype of the vitamin D receptor (VDR) [ 39 ]. In a study of short-term interventions in adult pregnant women, participants in their first trimester of pregnancy who received either 1,200 mg/day Ca or placebo were followed through 1-mon postpartum.…”

Section: Resultsmentioning

confidence: 99%

“…Small studies suggest a potential benefit of Ca on these outcomes [ 49 51 ], but well-designed clinical trials are lacking. In pregnant and lactating women, recent evidence [ 38 39 40 41 ] in addition to those reviewed in 2015 [ 75 76 77 78 79 80 81 82 83 ] indicates a possible need for additional Ca intake compared to that for non-pregnant or non-lactating women. Although the development of technical devices shows that BMD may recover after pregnancy or weaning, micro structures may remain deteriorated [ 84 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, results are inconclusive, and more research must be conducted. Due to genetics, ability, and personal preferences, nutrition is not “one size fits all.” Studies have shown that the effect of Ca supplementation on bone may differ on the genotype of the VDR [ 39 ]. Our current knowledge on personalized nutrition is still developing.…”

Section: Discussionmentioning

confidence: 99%

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Perspectives on the systematic review for the 2020 Dietary Reference Intakes for Koreans for calcium

Choi

et al. 2022

Nutr Res Pract

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An accurate assessment of the recommended calcium (Ca) intake may contribute to reducing the risk of fractures and chronic diseases, ultimately improving quality of life. This review was performed to summarize key findings of Ca studies, investigate the effect of Ca intake on health outcomes, and determine the adequacy of evidence to revise the 2015 Dietary Reference Intakes for Koreans (KDRIs) for Ca in 2020. Databases were searched for intervention studies that assessed health outcomes by providing Ca in diets or as supplements. The framework of the systematic review comprised conducting literature searches, data extraction, quality assessment of the literature, and summarizing key findings relevant to set the Estimated Average Requirement (EAR) and Tolerable Upper Intake Level (UL) for Ca for the 2020 KDRI. The final search was performed in June 2019. A total of 13,309 studies were identified through databases and manual search. Sixtyfive studies were included in the final quality assessment and were summarized according to health indicators. As bone health was used as an indicator of the EAR for Ca, literature reports on bone health were further categorized by the life-cycle stage of the participants. This systematic review did not find new evidence that could be applied to the general Korean adult population, including postmenopausal women, for defining a new EAR for Ca in the 2020 KDRIs. Evidence in most of the reviewed literature was considered weak; however, some evidence was found that could improve the criteria on how the EAR for Ca was determined in children and adolescents. A review of the literature for the 2020 KDRIs for Ca did not find strong evidence in order to change the recommended values of the 2015 KDRIs. More clinical interventions are required among Koreans to strengthen the body of evidence to warrant the revision of the KDRIs.

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“…A total of eight studies that met the inclusion criteria in this systematic study provided interventions in the form of nutritional supplements and diet (seven nutritional supplements and one diet) with the RCT design. From seven articles published related to nutritional supplementation, three articles from one RCT study provided calcium and vitamin D3 supplements with different outcomes (Diogenes et al, 2013(Diogenes et al, , 2015Normando et al, 2016). There was only one study in each study that provided vitamin D3 supplements (Best et al, 2018), iron and folate supplements (Meier, Olson and Berg, 2003) and zinc and iron supplements (Castillo-Duran et al, 2001).…”

Section: Nutritional Supplementationmentioning

confidence: 99%

Nutrition intervention of pregnant adolescents: a systematic review

Diana

Rachmah

2020

NFS

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Purpose This paper aims to evaluate the effectiveness of nutrition interventions conducted in pregnant adolescents and their implications for future research. Design/methodology/approach The papers in this systematic study were searched through PubMed, PMC, the Cochrane Library (Trial), ScienceDirect and Google Scholar that were published from 2000 to 2019. An experimental study using a randomized controlled trial (RCT) or non-RCT among pregnant adolescents aged 10-19 years were inclusion criteria for this study. While exclusion criteria were studies published before 2000, non-experimental study and non-English-language studies. Findings A total of 14 studies were identified in this review. Six studies provided interventions in the form of nutrition and health education and seven studies provided interventions in the form of nutritional supplementation (calcium, vitamin D, iron-folate, lipid-based nutrient supplements and multi-micronutrient powder. One study provided dietary intervention. The interventions in pregnant adolescents in the form of education and nutritional supplementation effectively increased the knowledge and nutrition of pregnant adolescents and decreased low birth weight (LBW) and premature birth. The impact on birth outcomes was still quite diverse. Some of the studies in this review were conducted without a comparison group, a small sample size and conducted in health-care facilities. Conclusion This systematic review implies a future nutrition intervention for pregnant adolescents is needed to improve nutritional status of pregnant adolescents and birth outcome. Future research using double blind RCT method with bigger sample size and various nutritional outcome are wide open to be developed. Originality/value Interventions in pregnant adolescents effectively increased the knowledge and nutrition of pregnant adolescents and decreased LBW and premature birth. The program implementation in the community needs to be improved so that the effectiveness of the program remains optimal as in healthcare facilities.

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Calcium plus vitamin D supplementation during pregnancy interacts with polymorphisms in the promoter region of the VDR gene to affect postpartum bone mass of Brazilian adolescent mothers: A randomized controlled trial

Abstract: Calcium plus vitamin D supplementation during pregnancy interacted with polymorphisms in the VDR gene promoter region affecting postpartum bone loss. The increased supply of calcium and vitamin D appeared to minimize postpartum bone loss particularly in adolescents with 1521 GG/1012 AA.

Cited by 10 publications

References 27 publications

Maternal vitamin D biomarkers are associated with maternal and fetal bone turnover among pregnant women consuming controlled amounts of vitamin D, calcium, and phosphorus

Maternal vitamin D biomarkers are associated with maternal and fetal bone turnover among pregnant women consuming controlled amounts of vitamin D, calcium, and phosphorus

Perspectives on the systematic review for the 2020 Dietary Reference Intakes for Koreans for calcium

Nutrition intervention of pregnant adolescents: a systematic review

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