Effects of Usual Nutrient Intake and Vitamin D Status on Markers of Bone Turnover in Swiss Adolescents

Eur J Clin Nutr. 2004 Sep;58(9):1257-65. doi: 10.1038/sj.ejcn.1601959.


Objective: To evaluate the effects of nutrient intake and vitamin D status on markers of type I collagen formation and degradation in adolescent boys and girls.

Design: Cross-sectional study.

Setting: Canton of Vaud, West Switzerland.

Subjects: A total of 92 boys and 104 girls, aged 11-16 y. Data were collected on height, weight, pubertal status (self-assessment of Tanner stage), nutrient intake (3-day dietary record) and fasting serum concentration of 25-hydroxyvitamin D (25OHD), and markers of collagen formation (P1NP) and degradation (serum C-terminal telopeptides: S-CTX).

Results: Tanner stage was a significant determinant of P1NP in boys and girls and S-CTX in girls. Of the nutrients examined, only the ratio of calcium to phosphorus (Ca/P) was positively associated with P1NP in boys, after adjustment for pubertal status. 25OHD decreased significantly at each Tanner stage in boys. Overall, 15% of boys and 17% of girls were identified as being vitamin D insufficient (serum 25OHD <30 nmol/l), with the highest proportion of insufficiency at Tanner stage 4-5 (29%) in boys and at Tanner stage 3 (24%) in girls. A significant association was not found between 25OHD and either bone turnover marker, nor was 25OHD insufficiency associated with higher concentrations of the bone turnover markers.

Conclusions: The marked effects of puberty on bone metabolism may have obscured any possible effects of diet and vitamin D status on markers of bone metabolism. The mechanistic basis for the positive association between dietary Ca/P ratio and P1NP in boys is not clear and may be attributable to a higher Ca intake per se, a critical balance between Ca and P intake or higher dairy product consumption. A higher incidence of vitamin D insufficiency in older adolescents may reflect a more sedentary lifestyle or increased utilisation of 25OHD, and suggests that further research is needed to define their requirements.

Sponsorship: Nestec Ltd and The Swiss Foundation for Research in Osteoporosis.

MeSH terms

  • Adolescent
  • Bone and Bones / metabolism*
  • Calcium / administration & dosage
  • Calcium / blood
  • Child
  • Collagen / metabolism*
  • Cross-Sectional Studies
  • Diet Records
  • Feeding Behavior*
  • Female
  • Humans
  • Male
  • Nutritional Requirements
  • Nutritional Status
  • Peptide Fragments
  • Phosphorus / administration & dosage
  • Phosphorus / blood
  • Procollagen
  • Puberty / metabolism*
  • Switzerland
  • Vitamin D / administration & dosage
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood*
  • Vitamin D / metabolism*
  • Vitamin D Deficiency / diagnosis
  • Vitamin D Deficiency / epidemiology*


  • Peptide Fragments
  • Procollagen
  • procollagen type I carboxy terminal peptide
  • Vitamin D
  • Phosphorus
  • Collagen
  • 25-hydroxyvitamin D
  • Calcium