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The Effects of Calcium and Glutamine Co-supplementation on Body Composition and Bone Mineral Density in Young Female Athletes: A Randomized Clinical Trial
Open accessAbstract
Background: Female athletes who experience menstrual disorders have an energy imbalance due to dietary restrictions and training. A significant problem arising from the daily training of such athletes is the imbalance between energy intake and energy expenditure, leading to fractures due to osteoporosis, amenorrhea, diabetes, and cardiovascular disease. The purpose of this study was to investigate and compare the complementary effect of calcium (Ca), Glutamine (Gln), and Ca+Gln supplements on bone mineral density (BMD), body composition, and physiological and biochemical symptoms of young female athletes with menstrual disorders during 90 days of the training program. Methods: In this randomized clinical trial (RCT), participants were classified into four groups: Ca supplementation group (Ca), Gln supplementation group (Gln), Ca+Gln supplementation group, and placebo group. Ca supplement containing 500 mg elemental Ca was given to the recipient groups daily. Gln supplement was given at the dose of 10,000 mg. The control group received maltodextrin (similar to Gln powder) as a placebo. BMD, serum Ca and vitamin D 3 , mid-arm upper circumference (MUAC), weight, and body mass index (BMI) were recorded in the four groups pre and post intervention. Results: Our study found that BMD differences in the three intervention groups were significant ( P < 0.05). Results showed that Ca+Gln and Ca supplementation significantly improved BMD. This effect was observed in the Gln supplementation group too; however, it was lower than that of the Ca and Ca+Gln groups. Serum Ca was significantly elevated in the Ca group ( P < 0.05). Conclusions: Ca+Glu supplement improves BMD in female athletes.
Overview
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TL;DR
In a 90-day randomized clinical trial of 40 young female athletes with menstrual disorders, calcium and calcium+glutamine supplementation significantly improved bone mineral density (BMD) and serum calcium, while body composition measures did not differ significantly. Calcium+glutamine appeared most effective for BMD, and the paper reports that Ca and Ca+Gln groups shifted from oligomenorrhea to normal menstrual cycles.
Key findings
- BMD changed significantly pre- to post-intervention in the Ca group (t = −2.641, P = 0.02687) and Ca+Gln group (t = −2.9088, P = 0.01735), but not in the control or Gln groups (P > 0.05); ANOVA showed a significant treatment effect for BMD (P < 0.01).
- Serum calcium increased significantly in the Ca group (t = −3.7204, P = 0.004768) and Ca+Gln group (t = −2.2953, P = 0.04736); ANOVA showed a significant treatment effect for serum calcium (P < 0.05).
- No significant differences were found among groups for vitamin D3, MUAC, body weight, or BMI (all non-significant in Tables 2 and 3).
- The paper reports that 100% of participants had a history of oligomenorrhea in the preceding 6 months, and that athletes in the Ca and Ca+Gln groups significantly changed from oligomenorrhea to normal menstrual cycles.
Methods
- Randomized clinical trial with 40 female athletes aged 18–24, recruited from Balewadi’s Shri Shiv Chhatrapati Athletics Stadium in Pune, India; inclusion required at least 2 years of athletics, participation in at least two international games, and gynecologist-diagnosed menstrual disorder (amenorrhea or oligomenorrhea); 10 participants per group.
- Four groups: Ca (500 mg elemental calcium daily), Gln (10,000 mg/day, divided into 5,000 mg twice daily after physical activity), Ca+Gln, and placebo (maltodextrin); intervention lasted 90 days with follow-up every 2 weeks.
- Outcomes measured pre- and post-intervention included BMD by DEXA, serum calcium, vitamin D3, MUAC, weight, BMI, general health/medical questionnaires, and a 3-day food recall; analysis used R 3.6.2 with paired t-tests, ANOVA, and Duncan test at P < 0.05.
Limitations
- The paper does not include a dedicated limitations section. It states that studies on Gln and BMD were scarce and that sample size was based on muscle mass because no prior data existed on Gln’s effect on BMD.
- Limitations evident from the text: small sample (n = 40, 10 per group), single site, and short 90-day intervention; no blinding or allocation concealment is described, and compliance/adverse events are not reported.
- Body composition outcomes (MUAC, weight, BMI) showed no significant differences, so the study’s conclusions about body composition are limited; the abstract/conclusion also uses “Ca+Glu” while the intervention is described as Ca+Gln.
Model-written summary. Check it against the paper before relying on it.
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Claims the paper makes
0 Valid · 0 Not valid · 10 Not checked · 19 Own results and interpretations
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The Ca (t = −3.7204, P = 0.004768) and Ca+Gln (t = −2.2953, P = 0.04736) intake significantly increased the serum calcium levels [Table 2].”
- Also stated in: § Results: · plain
“Serum Ca was significantly elevated in the Ca group (P < 0.05).”
§ The Effects of Calcium and Glutamine Co-supplementation on Body Composition and Bone Mineral Density in Young Female Athletes: A Randomized Clinical Trial > Results
plainstates a cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Results: · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our study found that BMD differences in the three intervention groups were significant (P < 0.05).”
- Also stated in: § Results · boosted
“The analysis of variance for BMD, serum Ca, vitamin D3, MUAC, weight, and BMI in the four groups and their changes pre and post intervention, which is given in Table 3, demonstrates the significant F value in BMD (P < 0.01) and serum calcium (P < 0.05).”
§ The Effects of Calcium and Glutamine Co-supplementation on Body Composition and Bone Mineral Density in Young Female Athletes: A Randomized Clinical Trial > Abstract > Results:
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Results · boosted
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Compared with the lowest impacts on BMD in the Ca and Gln groups, BMD had more significant changes in Ca+Gln co-supplementation (P < 0.05) [Figure 1].”
§ The Effects of Calcium and Glutamine Co-supplementation on Body Composition and Bone Mineral Density in Young Female Athletes: A Randomized Clinical Trial > Results
plainstates a cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The Ca (t = −3.7204, P = 0.004768) and Ca+Gln (t = −2.2953, P = 0.04736) intake significantly increased the serum calcium levels [Table 2].”
§ The Effects of Calcium and Glutamine Co-supplementation on Body Composition and Bone Mineral Density in Young Female Athletes: A Randomized Clinical Trial > Results
plainstates a cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the present study, 100% of the participants had a history of oligomenorrhea during the last 6 months preceding the survey.”
§ The Effects of Calcium and Glutamine Co-supplementation on Body Composition and Bone Mineral Density in Young Female Athletes: A Randomized Clinical Trial > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ The Effects of Calcium and Glutamine Co-supplementation on Body Composition and Bone Mineral Density in Young Female Athletes: A Randomized Clinical Trial > Abstract > Methods:
“Ca supplement containing 500 mg elemental Ca was given to the recipient groups daily.”
§ The Effects of Calcium and Glutamine Co-supplementation on Body Composition and Bone Mineral Density in Young Female Athletes: A Randomized Clinical Trial > Methods > Supplementation procedure
“Ca supplement contained 500 mg of Ca carbonate (Branson, USA).”
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ The Effects of Calcium and Glutamine Co-supplementation on Body Composition and Bone Mineral Density in Young Female Athletes: A Randomized Clinical Trial > Abstract > Results:
“This effect was observed in the Gln supplementation group too; however, it was lower than that of the Ca and Ca+Gln groups.”
§ The Effects of Calcium and Glutamine Co-supplementation on Body Composition and Bone Mineral Density in Young Female Athletes: A Randomized Clinical Trial > Results
“There were no significant differences among BMD levels in the control and Gln groups before and after the intervention (P > 0.05) [Table 2].”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ The Effects of Calcium and Glutamine Co-supplementation on Body Composition and Bone Mineral Density in Young Female Athletes: A Randomized Clinical Trial > Introduction
“The prevalence of eating disorders in athletes is estimated to be between 0.5% and 1.4%”
§ The Effects of Calcium and Glutamine Co-supplementation on Body Composition and Bone Mineral Density in Young Female Athletes: A Randomized Clinical Trial > Introduction
“which is estimated at 0.5%–1% for anorexia and 1%–4% for overeating.”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ The Effects of Calcium and Glutamine Co-supplementation on Body Composition and Bone Mineral Density in Young Female Athletes: A Randomized Clinical Trial > Methods > Study design
“The study period was 90 days.”
§ The Effects of Calcium and Glutamine Co-supplementation on Body Composition and Bone Mineral Density in Young Female Athletes: A Randomized Clinical Trial > Results
“Table: Table 1 Descriptive statistics of BMD, serum Ca, vitamin D3, MUAC, body weight, and BMI after 12 weeks of intervention among four groups of young female athletes”
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Still being checked.
Metadata
- Authors
- Goodarzizadeh, N., Shahrjerdi, A., Begum, K., & Amani, R.
- Affiliations
- Ahvaz Jundishapur University of Medical Sciences (IR)
- Razi Vaccine and Serum Research Institute (IR)
- University of Mysore (IN)
- Isfahan University of Medical Sciences (IR)
- Corresponding author
- Amani, Reza
- Venue
- International Journal of Preventive Medicine
- Published
- 2026-02
- Volume
- 17
- Pages
- 11-11
- ISSN
- 2008-7802 (ISSN-L)
- 2008-8213
- PMC
- PMC13038277
- OpenAlex
- W7131351132
- Semantic Scholar
- f2e2034d33f98a052d361b2516f3a9c36a7ccd96
- Cited by
- 0
- References
- 38
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- International Journal of Preventive Medicine (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Nursing › Nutrition and Dietetics › Muscle metabolism and nutrition
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
- Keywords
- calcium supplementation, glutamine supplementation, bone mineral density, body composition, female athletes, menstrual disorders, energy imbalance, osteoporosis, serum calcium, vitamin D3, mid-upper arm circumference, body mass index
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