{
  "abstract": "Calcium supplements are often prescribed with osteoporosis medications without considering dietary adequacy. In calcium-replete older women, calcium supplements had little effect on the response to antiresorptives, whereas low protein intake blunted their benefits. Calcium supplementation may be unnecessary when intake is adequate, and nutrition should be optimized for osteoporosis treatment.\n\nPurpose: Osteoporosis medications (OM) are commonly prescribed with calcium supplements (CaS) without considering dietary adequacy. We investigated whether calcium and protein intakes influence the effect of OM on total hip bone mineral density (BMD) and strength in calcium-replete women.\n\nMethods: Data from 586 women (median age 67 years) from the Geneva Retirees Cohort were analyzed: 101 on menopausal hormone therapy (MHT), 67 on antiresorptives (AR) (bisphosphonates, denosumab or raloxifene), and 418 without OM. Annual changes in total hip BMD, strength, and structure were assessed over a median 3.5 years using 2D/3D-DXA and finite element analysis. Calcium and protein intakes were assessed by food frequency questionnaire; CaS use was recorded at baseline and follow-up.\n\nResults: Total calcium intake (diet + supplements) was 1503 mg/day; 71% women met recommendations (≥ 1200 mg/day), 51% used CaS, and 70% vitamin D. MHT or AR increased total hip BMD and strength versus no OM. Neither total calcium intake (above or below 1200 mg/day) nor CaS use significantly affected bone outcomes. However, in women with low calcium intake (< 800 mg/day), no difference in changes of BMD or bone strength was observed between women with and without OM in the absence of CaS. In women with protein intake < 0.8 g/kg/day, AR effects were blunted, with reduced improvements in trabecular BMD (P = 0.009) and total hip strength (P = 0.040).\n\nConclusion: In calcium-replete older women, protein intake rather than CaS influences total hip bone changes with OM. These findings question routine CaS in women with adequate calcium intake and emphasize the importance of sufficient protein intake for optimal osteoporosis management.\n\nClinical trial registration: GERICO http://www.isrctn.com/ISRCTN11865958\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00198-026-08154-8.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland",
    "ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Maria Papageorgiou"
    },
    {
      "affs": [
        1
      ],
      "name": "Yvan Gugler"
    },
    {
      "affs": [
        0
      ],
      "name": "Serge Ferrari"
    },
    {
      "affs": [
        0
      ],
      "name": "René Rizzoli"
    },
    {
      "affs": [
        1
      ],
      "name": "Philippe Zysset"
    },
    {
      "affs": [
        0
      ],
      "name": "Emmanuel Biver",
      "orcid": "0000-0001-6174-1951"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/12arb1knb9ypa.bib",
  "cited_by": 0,
  "doi": "10.1007/s00198-026-08154-8",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13710645/",
  "id": "12arb1knb9ypa",
  "issns": [
    "0937-941X",
    "1433-2965"
  ],
  "landing_url": "https://doi.org/10.1007/s00198-026-08154-8",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2732|Bone health and osteoporosis research"
    ]
  ],
  "openalex": "W7168779032",
  "pdf_url": "https://link.springer.com/content/pdf/10.1007/s00198-026-08154-8.pdf",
  "pmcid": "PMC13710645",
  "pmid": "42463975",
  "published": "2026-07-17",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/12arb1knb9ypa.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:21:34Z",
      "native_id": "PMC13710645",
      "source": "pmc",
      "url": "https://doi.org/10.1007/s00198-026-08154-8"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2732|Bone health and osteoporosis research",
      "subfield": "surgery"
    }
  ],
  "title": "Dietary and supplemental calcium intake and bone changes during antiresorptive osteoporosis treatment in older women: a longitudinal observational study",
  "title_text": "Dietary and supplemental calcium intake and bone changes during antiresorptive osteoporosis treatment in older women: a longitudinal observational study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:21:34Z",
  "url": "https://research.draconitic.com/paper/12arb1knb9ypa",
  "venue": "Osteoporosis International",
  "versions": []
}