Randomised Controlled Trial of Nutritional Supplement on Bone Turnover Markers in Indian Premenopausal Women

Nutrients. 2021 Jan 26;13(2):364. doi: 10.3390/nu13020364.


Young Indian women may be at risk of poor bone health due to malnutrition. The aim of this study was to examine the effects on bone metabolism of a nutritional supplement in women aged 25 to 44. The nutritional supplement was a protein-rich beverage powder fortified with multi-micronutrients including calcium (600 mg), vitamin D (400 IU), and vitamin K (55 mcg) per daily serving, while a placebo supplement was low-protein non-fortified isocaloric beverage powder. This 6-month randomised, controlled trial showed favorable changes in bone turnover markers (decreased) and calcium homeostasis; such changes in older adults have been associated with slowing of bone loss and reduced fracture risk. For example, serum CTX decreased by about 30% and PINP by about 20% as a result of the increase in calcium intake. There were also changes in the ratio of carboxylated to undercarboxylated osteocalcin and such changes have been linked to a slowing of bone loss in older subjects. For example, the ratio increased by about 60% after 3 months as a result in the improvement in vitamin K status. Finally, there were improvements in the status of B vitamins, and such changes have been associated with reductions in homocysteine, but it is uncertain whether this would affect fracture risk. The product was generally well tolerated. This study shows the nutritional supplement holds promise for improved bone health among young Indian women.

Keywords: bone turnover markers; folate; osteoporosis; vitamin B12; vitamin B6; vitamin D; vitamin K.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Bone Diseases, Metabolic / prevention & control
  • Bone Remodeling*
  • Calcium / administration & dosage
  • Calcium, Dietary / administration & dosage
  • Dietary Supplements*
  • Double-Blind Method
  • Female
  • Folic Acid / administration & dosage
  • Fractures, Bone / prevention & control
  • Homeostasis
  • Humans
  • India
  • Osteocalcin / blood
  • Osteoporosis / prevention & control
  • Premenopause*
  • Vitamin B 12 / administration & dosage
  • Vitamin D / administration & dosage
  • Vitamin K / administration & dosage


  • Calcium, Dietary
  • Osteocalcin
  • Vitamin K
  • Vitamin D
  • Folic Acid
  • Vitamin B 12
  • Calcium