Which of the following is a nutrition-related mechanism by which chronic steroid use can contribute to osteopenia?

• A. Steroids interfere with calcium and vitamin D metabolism
• B. They increase protein synthesis
• C. They promote calcium absorption
• D. They accelerate bone formation

Answer: (A)

Chronic steroid use contributes to osteopenia mainly through a nutrition-related pathway involving calcium and vitamin D metabolism. Steroids blunt intestinal calcium absorption by interfering with vitamin D action in the gut and increase calcium excretion in the urine. This creates a negative calcium balance, prompting the body to raise parathyroid hormone to maintain blood calcium, which accelerates bone resorption and lowers bone mineral density over time. Calcium and vitamin D are nutrients; when their metabolism is disrupted by steroids, bone health suffers.

Other options describe effects that don’t align with this nutrition-focused mechanism: the idea of increased protein synthesis doesn’t explain reduced bone density, and promoting calcium absorption or accelerating bone formation would tend to support, not hinder, bone health.