Effects of a one-year calcium-enriched permeate supplement on bone health in post-menopausal females: The RENEW randomized controlled intervention trial

Authors: TETENS, INGE - University Of Copenhagen; KISI, SADIME - University Of Copenhagen; PARLESAK, ALEXANDR - University Of Copenhagen; RASMUSSEN, SIDSE - University Of Copenhagen; CRAMON, MAI - University Of Copenhagen; PETERSEN, CAROLINE FILSKO - University Of Copenhagen; Lemay, Danielle; NIELSEN, DENNIS - University Of Copenhagen; BERTRAM, HANNE - Aarhus University; ANDERSEN, HENRIK - Aarhus University; HITZ, METTE - Herlev Hospital

Submitted to: The American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/30/2026
Publication Date: 5/6/2026
Citation: Tetens, I., Kisi, S.B., Parlesak, A., Rasmussen, S.I., Cramon, M.O., Petersen, C.V., Lemay, D.G., Nielsen, D.S., Bertram, H.C., Andersen, H.J., Hitz, M.F. 2026. Effects of a one-year calcium-enriched permeate supplement on bone health in post-menopausal females: The RENEW randomized controlled intervention trial. The American Journal of Clinical Nutrition. https://doi.org/10.1016/j.ajcnut.2026.101339.
DOI: https://doi.org/10.1016/j.ajcnut.2026.101339

Interpretive Summary: After menopause, women commonly experience bone loss that puts them at higher risk for fractures and broken bones, which can be life-threatening. To address this problem, researchers conducted a year-long study with over 400 post-menopausal women to test whether a new calcium supplement made from milk byproducts could protect bones as effectively as the standard calcium pills doctors typically recommend. The study found that women who took 800 mg daily of the milk-derived calcium supplement maintained their bone density and showed healthy bone metabolism markers just as well as those taking traditional calcium carbonate pills, with benefits becoming apparent within just three months. This accomplishment is significant because it provides women and their doctors with an alternative, potentially more natural source of calcium supplementation to help prevent the bone loss that leads to osteoporosis and dangerous fractures, giving patients more options to maintain their bone health as they age.

Technical Abstract: Background: Low bone mineral density (BMD) is a prevalent health concern in post-menopausal women, increasing the risk of osteoporosis, fractures, and premature death. Objective: To assess the effects of daily supplementation of calcium from milk-derived calcium permeate (CP), with or without inulin, and calcium carbonate (CC) on bone mineral density (BMD) and bone turnover biomarkers in vitamin D-sufficient postmenopausal women. Methods: In this 12-month, randomized, double-blind, multi-center trial, postmenopausal women (56.0 ± 4.2 years; BMI 25.5 ± 3.8) received daily placebo (P), 800 mg calcium as CC, CP, or CP-Inu, split into two daily doses with all groups receiving 20 µg vitamin D/day. Primary outcomes were BMD and bone turnover biomarkers (CTX, P1NP). Linear mixed-effects models analyzed fixed and random effects. Results: Of 417 participants, 316 (76%) completed the study with 89 % overall compliance. Placebo was associated with BMD decline (×10'³'g/cm2/month) (spine ß = –1.144, p < 0.0001; femoral neck ß = –0.960, p = 0.0001; proximal femur ß = –0.500, p = 0.0027). In comparison with placebo, CC, CP, and CP-Inu significantly increased BMD across all anatomic regions (ß = 0.666–1.337, p = 0.0198), accompanied by favorable changes in CTX and P1NP and parathyroid hormone. Addition of inulin to CP did not confer additional benefits. Conclusion: Daily supplementation with 800 mg calcium from CP maintained BMD and suppressed bone turnover to a similar extent as CC in vitamin D–sufficient postmenopausal women, with antiresorptive effects apparent from three months. Inulin provided no additional advantage.