Abstract
Evidences from clinical trials and meta-analyses of calcium supplementation in linear growth have given conflicting results, and few longitudinal studies have investigated the long-term associations between dietary calcium and linear growth, especially in the population with low-calcium plant-based diets. We investigated the prospective associations of low habitual dietary calcium with adult height and height-for-age z-score (HAZ) from adolescence to adulthood among 2019 adolescents from the China Health and Nutrition Survey (CHNS). The average dietary calcium intakes were 426(standard deviation: 158) mg/d in boys and 355(134) mg/d in girls during adolescence. During a median follow-up of 7.0 (interquartile range: 5.9–9.0) years, boys reached an average of 169.0(6.7) cm and girls reached 158.4(5.8) cm in adulthood. After adjusting for other potential confounders, non-linear regression found that boys with dietary calcium intakes below 327 mg/d had shorter adult stature, and those taking over 566 mg/d had faster height growth whether adjusting for physical exercises level or not. No significant associations were found in girls. Our study suggests that in boys with plant-based diets, higher dietary calcium intake during adolescence is associated with faster height growth, but not with adult height; calcium intake below 300 mg/d may result in shorter adult stature.
Highlights
MethodsThe current analyses included 2019 participants from 226 urban and rural communities in nine provinces in China, after excluding participants with neither adolescent height nor adult height, or with implausible or missing values for height, total energy intake, or dietary calcium (the upper and lower 0.5% of the intakes) (Fig. 1)
In this context, we investigated prospective associations of low habitual dietary calcium during adolescence with adult height and height growth using longitudinal growth data from the China Health and Nutrition Survey (CHNS)
After adjusting for physical exercises level, we found a threshold dietary calcium intake of about 400 mg/d, and boys whose intakes fell below 327 mg/d during puberty were significantly shorter than those with intakes above this level (Fig. 3C)
Summary
The current analyses included 2019 participants from 226 urban and rural communities in nine provinces in China, after excluding participants with neither adolescent height nor adult height, or with implausible or missing values for height, total energy intake, or dietary calcium (the upper and lower 0.5% of the intakes) (Fig. 1) Body heights of both children and their biological parents were measured by trained health workers following standard procedures in each wave[15]. To learn more about dietary patterns of the participants, we calculated the edible weights of raw food consumed by individuals at baseline and subsequent follow-ups during adolescence and divided them into 24 food groups (i.e., cereals, tubers, starches, soybean, mixed beans, vegetables, fungi and algae, fruit, nuts and seeds, meat, poultry, milk, eggs, seafood, infant foods, ethnic foods, fast foods, beverages, alcohol, sugars and preserves, animal oil, vegetable oil, condiments, and others), according to the classification system of foods adopted by the China FCT 2002 & 200421, 22. A two-sided P value of less than 0.05 was considered as the significant level for all analyses
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