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Bone mineral density and calcium metabolism of Hong Kong Chinese postpartum women—a 1-y longitudinal study

European Journal of Clinical Nutrition volume 59, pages 868–876 (2005)Cite this article

Abstract

Objective:

This paper reports longitudinal changes in bone mineral density (BMD), calcium homeostasis and dietary calcium intake in a group of Hong Kong breastfeeding women during the first year postpartum.

Design and subjects:

Nine mothers who breastfed exclusively or almost exclusively for at least 3 months and 14 formula feeding mothers aged 20–40 y were interviewed after delivery, 2 and 6 weeks, 3, 6 and 12 months postpartum. BMD at L2–L4 lumbar spine (LS), trochanter (Tro) and femoral neck (FN), serum intact parathyroid hormone (iPTH), serum bone-specific alkaline phosphatase (b-ALP), urinary deoxypyridinoline (Dpd), serum and urinary calcium (Ca) and phosphorus (P) and dietary intake of macronutrients were assessed.

Results:

Compared to the formula feeding group, BMD assessed at LS, Tro and FN decreased significantly in the breastfeeding group over the first 6 months, with rebound to approximate baseline values at 12 months for the latter two sites. Serum iPTH increased in both groups, whereas serum b-ALP was consistently higher in the breastfeeders. Urinary Ca and P excretion decreased early postpartum in both groups, but the breastfeeders had higher excretion at 3 and 6 months. Breastfeeding mothers consumed significantly more Ca than the formula feeding mothers in the early postpartum.

Conclusions:

Increased calcium requirement during early lactation is affected through mobilisation of bone and renal calcium conservation. Bone mineral loss during lactation is temporary. Further studies are warranted to investigate the effects of diet and other hormonal factors on the calcium homeostasis during lactation.

Sponsorship:

CSM was supported by a research studentship from the Research Grants Council, Hong Kong.

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Acknowledgements

We thank all the subjects for their commitment to the study; Jannis WS Yau and Roselle HY Li for their assistance in recruiting and scheduling subjects; Dr Warren TK Lee, Catherine SK Cheung and Vivian WY Hung for their valuable comments and assistance with BMD measurements and laboratory work; Peggo KW Lam for his valuable advice on appropriate methods for statistical analysis.

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Authors and Affiliations

  1. Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong

    S M Chan, E A S Nelson & S S F Leung

  2. Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong

    J C Y Cheng

Authors
  1. S M Chan
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  2. E A S Nelson
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  3. S S F Leung
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  4. J C Y Cheng
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Corresponding author

Correspondence to E A S Nelson.

Additional information

Guarantor: EAS Nelson.

Contributors: SSF Leung and SM Chan initiated and designed the study. Most of the subjects' recruitment, data collection, laboratory analysis and data analysis were performed by SM Chan. All authors contributed to the original manuscript and the subsequent revisions of the paper.

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Chan, S., Nelson, E., Leung, S. et al. Bone mineral density and calcium metabolism of Hong Kong Chinese postpartum women—a 1-y longitudinal study. Eur J Clin Nutr 59, 868–876 (2005). https://doi.org/10.1038/sj.ejcn.1602148

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