Abstract
Calcium deficiency during child growth leads to osteoporosis in later stages of life. Finger millet is one of the calcium dense foods, with three times the level of calcium than milk, and the only cereal that contains high calcium content which is consistent across different varieties (364 ± 58 mg/100 g). Thus, finger millet has potential for addressing calcium deficiency naturally. This study aimed to determine the retention and impact of finger millet calcium on bone turnover through a systematic review and meta-analysis. Three human studies were eligible for systematic review. Of these, only two were eligible for meta-analysis to assess the retention of calcium in children of 9 to 12 years. One study on bone turnover markers was not used in the meta-analysis as at least two studies are required to conduct meta-analysis. Due to the lack of complete data only four studies were eligible for meta-analysis to assess the in vitro bioavailability of calcium from unprocessed and a range of different types of processed finger millet. The result shows that there was significant retention (p < 0.05) of 23.4 ± 2.9% calcium from finger-millet-based diet which could help bone accretion during child growth if finger-millet-based diet is consumed. The bone turnover marker study shows that the resorption of calcium reduced by 28% and 47% among peri and post-menopausal women respectively after feeding the nutria mixed grain ball. However, there is no significant change in bone formation marker. Depending on the type of processing, calcium bioavailability either increased or decreased. One in vitro study showed that calcium bioavailability from finger millet was 28.6% when boiled, whereas three studies on processing show that certain processing can double the calcium bioavailability to 61.4%. Irrespective of the type of processing, finger millets contribute to high calcium retention and extremely high bioavailable calcium and could be useful for healthy growth and in dealing with complications related to calcium deficiency.
Highlights
Calcium is critical for the growth of babies through to adolescents
From these 312 articles, 302 irrelevant articles were removed including articles that had information on nutritional composition of millets but not bioavailable calcium or bioavailability percentage, studies conducted on animals and review articles
Calcium retention in children was significantly high from finger-millet-based diet (p < 0.05) compared to rice-based diet or refined finger-millet-based diet with moderate heterogeneity (I2 = 57%) among studies with standardized mean difference (SMD) of
Summary
Osteoporosis is mainly caused by a deficiency in dietary calcium as well as vitamin D which assists in the absorption of calcium. A safe and sustainable diet-based solution to combat calcium and vitamin D deficiency should start from early childhood, which can be achieved by consuming foods naturally rich in calcium while ensuring sufficient vitamin D status from the sunlight, food, and/or supplementation. It is likely that this will be beneficial for strengthening bones during a child’s growth stage especially during adolescence, when most bone calcium accretion occurs and is crucial for the attainment of high peak bone mass which in turn is important for preventing osteoporosis and bone fractures in later life [4,5]
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