Question 2
This study used post-menopausal women, ages 50-79 years old. How do you think this study may have differed if the population used were younger, pre-menopausal women?
posted by Samantha McCoy @ 7:10 PM
14 comments
ISU Dietetic Internship Journal Club
Objective: To become familiar with current scientific literature on a variety of nutrition topics and to gain experience in gathering, organizing, critically evaluating, presenting and facilitating group discussion of the literature and the implications to practice.
14 Comments:
The hormone estrogen is produced by the ovaries, and it plays a critical role in the building and maintainence of bone in adolescent and younger women. The reduction in estrogen production during menopause is the major cause of bone loss in women during later life. Since bone mass begins to decline with age, calcium and vitamin D supplementation are important for maintaining bone mass. The use of younger, pre-menopausal women as participants in this study may have created a different outcome. Their bone mass, calcium, and vitamin D stores may have been different due to differences in hormone levels in the body.
One word, estrogen. Different levels for different ages. When it is there you have a better chance to build upon your current status. After you will have bone loss, so it's very important to build when you are younger and still have a good flow of estrogen.
Susan
This would depend if the client is on hormone therapy or not. If the clients are on hormone therapy I would think that they would respond better to the increase of calcium and vitamin D than the group not getting the therapy. With that being said, if a younger group was used they would more than likely respond better to the increase of calcium and vitamin D than the older group. It would also make a difference on how young the groups are. If the group included females in their late teens and early 20’s they would be at a great advantage over the older women. This is because we can only increase our calcium stores until our mid to late 20’s and after that its all about keeping what we have.
Colin-
I thought you brought up a good point when you mentioned the age of the younger participants. Are we talking about teenagers and women in their early 20s...or women in their late 20s, 30s, and early 40s? This would really make a difference in how the body responds to the Ca and Vit D supplements.
If the study had used a different age group the results would have been remarkably different. Younger adults have more time to exercise and are still producing estrogen; both are key components to bone mass. As women age and go through menopause estrogen production drops significantly so encouraging post-menopausal women to consume adequate calcium is very important. You can also point out that adding resistance training, like lifting weights, will help with calcium storage aswell.
Colin,
Good point about if the women were on hormone replacement therapy or not. This would make a difference in the results aswell as the age difference.
One obvious reason is the outcome may have been skewed due to the fact that menopausal women are usually lower in calcium secondary to decreased estrogen levels when compared with premenopausal women.
This study was completed over a long period of time, and especially at a time where bone loss is inevitable (as far as we know). Their bones were still naturally aging, so the Vitamin D and calcium supplementation should have not been expected to build up their bones, but more likely to slow the progression of bone loss. It would be beneficial to complete the study using younger, premenopausal women, following them through menopause and after, to determine if building up their bones prior decreases their rate of bone loss after menopause. Such as, does putting calcium and Vitamin D in the bank early on, esure that you'll have an fracture-less future, and therefore better quality of life?
Carrie I agree with what you said, "It would be beneficial to complete the study using younger, premenopausal women, following them through menopause and after, to determine if building up their bones prior decreases their rate of bone loss after menopause."
I think this would make for a better, more accurate study.
What does everyone else think?
IF a pre-menopausal population was used I'm not sure there would have been much difference in the results. The study was measuring whether supplementing calcium and vitamin D helped affected subjective and objective measures of physical functioning. In a younger population, than was used in the study, you wouldn't necessary expect to see dramatic or noticeable physical changes in the level of functioning.
To determine if there would be a difference if the population were younger would probably require a higher supplementation dose, since the one used in the study is now considered low. And the study would need to be conducted over a longer period of time (more than 7 years) to see if the supplementation would perhaps prevent the physical decline.
Susan,
I agree that estrogen would affect how the calcium supplement was absorbed and utilized by the body, and a lower risk for osteoporosis might occur.
I still don't know if that would have had an affect on the study's proposition that supplementation would have an effect on physical decline.
Myra
Post-menopausal women are at higher risk for calcium deficiency related diseases such as osteoporosis. As age increases and estrogen production decreases a resulting decrease in bone mass occurs. Younger female bodies should be making adequate estrogen which helps them maintain their bone mass, therefore supplementation with calcium/vitamin D on a younger female population would result in significantly different results than if you studied post-menopausal women.
Estrogen is the central theme here, and somehow I didn't think of that. Using this, maybe we could study women who did not make adequate amounts of estrogen pre-menopause (ex: PCOS patients) to see if this affected their loss of bone later in life.
The results would likely have been significantly different - it would be interesting to compare the results from a younger population as the questions suggests. It may make it easier to tailor treatments/preventative actions to the populations who would benefit the most. Anyway, bone density and calcium/vitamin D stores would likely be higher in a younger study population overall. Menopause creates changes hormonal changes in the body that precipitate bone loss. Younger women may be more active, as well, leading to more time outside (sunlight = vitamin D) and a greater amount of physical activity that promotes good bone health.
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