Menopause Live - IMS Updates

Date of release: 24 November, 2014

Calcium-collagen chelate supplementation reduces bone loss in osteopenic postmenopausal women

In spite of the existence of effective drug therapies for osteoporosis, increasing numbers of menopausal women prefer alternative therapies including dietary supplements of calcium, vitamin D or collagen for the prevention and treatment of osteoporosis. Among them, dietary supplements containing calcium-collagen chelate (CC) have previously demonstrated that it may improve bone mineral density (BMD) and blood biomarkers of bone turnover in osteopenic, postmenopausal women in the short term. However, until now a lack of data on the long term has existed. Recently, Elam and colleagues reported the efficacy of CC in reducing bone loss in postmenopausal women with osteopenia in a follow-up study of 12 months [1]. Thirty-nine women were randomly assigned to one of two groups: one receiving 5 g of CC containing 500 mg of elemental calcium and 200  IU vitamin D and the control group receiving 500 mg of calcium and 200 IU vitamin D daily. The study cohort (mean age 55.5 years) had osteopenia with a mean T-score of -1.5. The authors assessed total body, lumbar, and hip BMD and bone turnover markers at baseline, 6 and 12 months. About 40% of recruited women dropped out at month 12, leaving only 10 and 12 women who completed the 1-year trial, respectively. The results discussed relate only to the completers, the compliant participants. The loss of whole body BMD in women taking CC was substantially lower than that of the control group at 12 months. The CC group had significantly reduced levels of sclerostin and tartrate-resistant acid phosphatase isoform 5b (TRAP5b) (p < 0.05), and higher bone-specific alkaline phosphatase/TRAP5b ratio (p < 0.05) than the control group at 6 months. The authors conclude that their results support the use of CC in reducing bone loss in osteopenic postmenopausal women.


Complementary and alternative therapies are preferred over conventional treatment options for many patients due to difficulty in compliance or fear of the adverse events observed with standard pharmacological therapies. On the other hand, it is well known that calcium and vitamin D supplementation alone is not sufficient to prevent the bone loss that occurs with menopause. Therefore the field of more complex 'natural' supplements gains supporters day by day among users and some health-care practitioners.
Among the dietary supplements, collagen is promising with respect to bone health. Collagen is the main extracellular matrix protein that is calcified. It is accepted that the loss of collagen leads to bone loss and a subsequent decline in bone strength and elasticity, increasing the risk of fragility fractures. Collagen hydrolysates have been shown to provide bioavailable, collagen-derived, low-molecular-weight peptides that remain intact following oral ingestion and may contribute to the organic substance of bone, exerting osteoprotective effects [2]. 
The findings of the present study are in agreement with the outcomes of past studies in children [2]; however, related to postmenopausal women with significant bone loss, only two other investigations have been reported, with discordant data. Cuneo and colleagues [3] administered 10 g/day of a collagen hydrolysate to postmenopausal women for a 6-month period. The biochemical analysis of bone biomarkers (bone alkaline phosphatase, C-terminal telopeptide, and osteocalcin) indicated no improvements in bone metabolism in comparison with the controls. On the other hand, Adam and colleagues [4] showed in osteopenic, postmenopausal women a significant reduction in urinary N-terminal telopeptide but no effects on bone mineral content with the combination of 10 g/day of collagen proteins and calcitonin (100 IU twice/week) compared with calcitonin alone. Interestingly, in both studies, the amount of calcium was insufficient. Consequently, the results of the study by Elam and colleagues [1] are of interest since the study provides data on bone turnover and BMD assessed in multiple sites (spine, hip and total body), so correcting this concern and providing support for the use of hydrolyzed collagen as a supplement for reducing bone loss, particularly when given with an adequate amount of calcium. However, in spite of their promising results, it is of note that only 22 subjects (10 in control and 12 in the CC group) completed the 12-month follow-up. Therefore the results from this study should be considered with caution, especially when other studies with postmenopausal women have shown conflicting data.

Camil Castelo-Branco
Ob Gyn Senior Consultant, Hospital Clínic Barcelona, and Full Professor, University of Barcelona, Spain


  1. Elam ML, Johnson SA, Hooshmand S, et al. A calcium-collagen chelate dietary supplement attenuates bone loss in postmenopausal women with osteopenia: a randomized controlled trial. J Med Food 2014 Oct 14. Epub ahead of print

  2. Martin-Bautista E, Martin-Matillas M, Martin-Lagos JA, et al. A nutritional intervention study with hydrolyzed collagen in prepubertal Spanish children: influence on bone modeling biomarkers. J Pediatr Endocrinol Metab 2011;24:14753

  3. Cuneo F, Costa-Paiva L, Pinto-Neto AM, Morais SS, Amaya- Farfan J. Effect of dietary supplementation with collagen hydrolysates on bone metabolism of postmenopausal women with low mineral density. Maturitas 2010;65:2537

  4. Adam M, Spacek P, Hulejova H, Galianova A, Blahos J. Postmenopausal osteoporosis. Treatment with calcitonin and a diet rich in collagen proteins. Cas Lek Cesk 1996;135:748