{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:49:30Z","timestamp":1755218970891,"version":"3.43.0"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"Background<\/jats:title>Postmenopausal calcium loss increases osteoporosis risk in middle-aged and older women. While dairy products are a known calcium source that supports bone health, limited research addresses their specific effects on osteoporosis prevention in this population.<\/jats:p><\/jats:sec>Methods<\/jats:title>A one-year randomized controlled trial recruited 97 postmenopausal women, randomly assigned to a high-calcium milk group (HCM, 51), consuming 400 mL nutrient-enriched fresh milk daily, or a control milk group (CM, 46), consuming 400 mL of regular fresh milk.<\/jats:p><\/jats:sec>Results<\/jats:title>A one-year randomized controlled trial showed that the high-calcium milk group significantly increased lumbar spine bone mineral density (L1-4 BMD), slowed bone loss in the left hip and femoral neck, elevated serum phosphorus and 25-hydroxyvitamin D levels, and modulated the bone formation marker procollagen type I N-terminal propeptide compared with the regular milk group at 6 months. 16S ribosomal ribonucleic acid sequencing showed that high-calcium milk significantly altered the \u03b2<\/jats:italic>-diversity of the intestinal flora, increasing the abundance of beneficial bacteria such as Bacteroides<\/jats:italic>, Oscillibacter<\/jats:italic>, and Subdoligranulum<\/jats:italic>, while decreasing the abundance of Firmicutes and Weissella<\/jats:italic> at 12 months. Metabolomics analysis revealed that high-calcium milk improved bone quality by modulating steroid hormone biosynthesis and arachidonic acid metabolic pathways, and that L1\u20134 BMD was positively correlated with Faecalibacterium<\/jats:italic> spp. and adenine nucleotide.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Our study suggests that high-calcium milk can effectively delay postmenopausal osteoporosis by regulating intestinal flora and metabolic pathways, providing a new target for osteoporosis intervention.<\/jats:p><\/jats:sec>Clinical trial registry number<\/jats:title>ChiCTR2200064825 (https:\/\/www.chictr.org.cn\/bin\/home<\/jats:uri>).<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2025.1607968","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T15:34:03Z","timestamp":1754494443000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["High-calcium milk improves osteoporosis in postmenopausal women by regulating intestinal flora and steroid hormone biosynthesis"],"prefix":"10.3389","volume":"12","author":[{"given":"Yanyan","family":"Zhao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianping","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanpin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qishan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junying","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hang","family":"Pan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huo","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weicang","family":"Qiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Jin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lijun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1038\/nrrheum.2009.260","article-title":"Osteoporosis: 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