Average Dietary Calcium Intake Research Articles

Structural changes and calcium bioaccessibility of calcium fortified milk containing CaCO3 loaded solid-in-oil-in-water emulsion during simulated in vitro digestion.

In most regions around the globe, average dietary calcium intake is relatively low. Consumers increasingly supplement calcium with milk. However, commercial high-calcium milk has the problem of low calcium bioaccessibility. This study was to explore calcium fortified milk containing calcium carbonate (CaCO3 ) loaded solid-in-oil-in-water emulsion as a potential novel calcium fortified milk with higher calcium bioaccessibility. The CaCO3 loaded solid-in-oil-in-water (S/O/W) emulsion with good physical stability (zeta potential -33.34 ± 0.96 mV, mean particle size 4.49 ± 0.02 μm) and high calcium bioaccessibility (32.34%) was prepared when the concentration of xanthan gum was 4 g L-1 . Furthermore, the physicochemical properties and gastrointestinal fate of calcium fortified milk (calcium contents, 1.25 mg mL-1 , 1.35 mg mL-1 , and 1.45 mg mL-1 ) with different proportions of CaCO3 loaded S/O/W emulsion and pure milk were investigated. The calcium fortified milk (calcium content, 1.25 mg mL-1 ) with a small amount of CaCO3 loaded S/O/W emulsion did not significantly affect the physicochemical properties of pure milk and had similar rheological properties and higher calcium bioaccessibility to commercial high-calcium milk. Excessive calcium ion (Ca2+ ) weakens the electrostatic interaction of milk sample system and causes aggregation of colloidal particles, which was attributed to more insoluble calcium soap formation. This study showed that the S/O/W emulsion delivery system improved the dispersion stability and bioaccessibility of CaCO3 . These findings contribute to the development of calcium fortified milk with improved physicochemical properties and higher calcium bioaccessibility. © 2023 Society of Chemical Industry.

Calcium and Vitamin D Supplementation in Boys with Risperidone-Induced Hyperprolactinemia: A Randomized, Placebo-Controlled Pilot Study.

The chronic use of antipsychotics has been associated with impaired bone mineralization, partially mediated by hyperprolactinemia. We examined if calcium and vitamin D supplementation promote bone mineral accrual in boys with risperidone-induced hyperprolactinemia. Between February 2009 and November 2013, medically healthy, 5- to 17-year-old boys were enrolled in a 36-week double-blind, placebo-controlled study, examining the skeletal effects of supplementation with 1250 mg calcium carbonate and 400 IU of vitamin D3 in risperidone-induced hyperprolactinemia. Anthropometric, dietary, physical activity, and psychiatric assessments were conducted at baseline and week 18 and 36. Plasma prolactin and vitamin D concentrations were measured at baseline and week 36. Total body less head bone mineral content (BMC) and radius trabecular bone mineral density (BMD) were measured at baseline, week 18, and week 36, using dual-energy X-ray absorptiometry and peripheral quantitative computed tomography, respectively. Linear mixed-effects regression analysis examined the longitudinal effect of treatment on skeletal outcomes. Forty-seven boys (mean age: 11.0 ± 2.6 years) were randomized and 38 completed the study. At study entry, the average dietary calcium intake was below the recommended limit, but the average vitamin D concentration was normal. Calcium and vitamin D supplementation failed to significantly increase BMC or trabecular BMD. It also failed to affect several other skeletal and anthropometric outcomes, including plasma vitamin D concentration. In this 9-month long pilot study, supplementation with a modest dose of calcium and vitamin D did not increase bone mass accrual in risperidone-treated boys with hyperprolactinemia. Alternative approaches should be investigated to optimize bone health in this population to prevent future morbidity and premature mortality. ClinicalTrials.gov Identifier: NCT00799383.

Educational Intervention Impact on Osteoporosis Knowledge, Health Beliefs, Self-Efficacy, Dietary Calcium, and Vitamin D Intakes in Young Adults.

Successful prevention of osteoporosis begins early in life. Adequate intake of calcium and vitamin D plays a role in this prevention along with knowledge, health beliefs, and self-efficacy related to preventive dietary behaviors. The purpose of this theory-based study was to examine young adults' knowledge of osteoporosis, health beliefs, self-efficacy, dietary calcium, and vitamin D intakes as measures of preventive behaviors. A pre-/posttest design was used to determine knowledge, health beliefs, and self-efficacy. A convenience sample of young adults (n = 153) was obtained at a Midwestern college. Participants completed pre- and postquestionnaires that included an osteoporosis knowledge test, health belief scale, self-efficacy scale, and 3-day food records. Health beliefs were a significant predictor of dietary calcium intake and vitamin D intake. Both interventions increased osteoporosis knowledge and health beliefs but not self-efficacy. No differences were found between genders. Both interventions did not significantly alter dietary behavior; however, average dietary calcium intake met current recommendations. Either educational method could be implemented in courses or community education to increase knowledge and health beliefs.

Calcium and dairy products consumption and association with total hip bone mineral density in women from kosovo.

Background and objective:There is paucity of evidence in southeastern Europe and Kosovo regarding dairy products consumption and association with bone mineral density (BMD). Therefore, the objective of present study was to assess calcium intake and dairy products consumption and to investigate relationship with total hip BMD in a Kosovo women sample.Methods:This cross-sectional study included a sample of 185 women divided into respective groups according to total hip BMD. All the study participants completed a food frequency questionnaire and underwent dual-energy X-ray absorptiometry (DEXA) to estimate BMD. Nonparametric tests were performed to compare characteristics of the groups.Results:The average dietary calcium intake was 818.41 mg/day. Only 16.75% of the subjects met calcium recommended dietary reference intakes (DRIs). There were no significant differences between low BMD group and normal BMD group regarding average dietary calcium intake, but it was significantly higher in BMDT3 subgroup than in BMDT2 and BMDT1 subgroups.Conclusions:The results of this study demonstrate significant relationship of daily dietary calcium intake with upper BMD tertile. Further initiatives are warranted from this study to highlight the importance of nutrition education.

Dietary Calcium but Not Elemental Calcium from Supplements Is Associated with Body Composition and Obesity in Chinese Women

ObjectiveWe assessed whether dietary calcium intake or calcium supplements associated with body composition and obesity in a Chinese population.MethodsA cross-sectional survey was performed in a population of 8940, aged 20 to 74 y. 8127 participants responded (90.9%). Height, weight, fat mass (FM), waist circumference (WC) and hip circumference were measured. Obesity definition: body mass index (BMI) ≥28 kg/m2 (overall obesity); WC ≥85 cm for men or ≥80 cm for women (abdominal obesity І) and waist hip ratio (WHR) ≥0.90 for men or ≥0.85 for women (abdominal obesity П). The data on dietary calcium and calcium supplements were collected using food-frequency questionnaire and self-report questionnaire. Multivariate linear and multivariable logistic regressions were used to examine the associations between dietary calcium intake or calcium supplements and body composition and obesity.Principal FindingsThe average dietary calcium intake of all subjects was 430 mg/d. After adjusting for potential confounding factors, among women only, negative associations were observed between habitual dietary calcium intake and four measures of body composition (β, −0.086, P<0.001 for BMI; β, −0.072, P<0.001 for WC; β, −0.044, P<0.05 for WHR; and β, −0.058, P<0.01 for FM, respectively) and both measures of abdominal obesity (Odds Ratio [OR] = 0.86, 95% Confidence Interval [CI], 0.80–0.93; P<0.001, for abdominal obesity I; OR = 0.92, 95% CI, 0.86–0.99; P = 0.026, for abdominal obesity II). These associations were not observed among men (P>0.05). Similarly, among both men and women, we did not observe significant associations between calcium supplements and any measures of body composition or abdominal obesity (P>0.05).ConclusionsDietary calcium from food rather than elemental calcium from calcium supplements has beneficial effects on the maintenance of body composition and preventing abdominal obesity in Chinese women.

Extra Protection for Pregnant Women: Calcium Supplement Reduces Blood Lead

Lead, like calcium, is stored in bones and generally does not circulate throughout the body. But the demands of pregnancy and lactation trigger the release of calcium, which also releases lead into the maternal blood stream. Researchers previously showed that daily calcium supplementation during lactation reduced maternal blood lead by 15–20% and lead in breast milk by 5–10%. A new study by the same team shows that taking inexpensive calcium supplements daily also reduces blood lead levels during pregnancy [EHP 117:26–31; Ettinger et al.]. Such supplementation could help mitigate the adverse effects of prenatal lead exposure, which include low birth weight, lower intelligence scores, and impaired motor and visual skills. The study included 557 women recruited in the first trimester of pregnancy from prenatal clinics in Mexico City. The women were recruited from 2001 to 2003; Mexico completed the phase-out of leaded gasoline in 1997, so women enrolled in the study had been exposed for many years to high environmental lead levels prior to becoming pregnant. In addition, just over one-third of the women used the traditional lead-glazed pottery that is common in Mexico. Half the women received 1,200 mg of calcium daily and the others received placebos. Blood lead levels were checked in the first (baseline), second, and third trimesters of pregnancy. The Mexican women enrolled in the current study had an estimated average dietary calcium intake of 900 mg per day, which parallels national surveys of U.S. women. (The U.S. Institute of Medicine advises 1,000 mg of calcium daily for pregnant and lactating women aged 19–50 years and 1,300 mg/day for pregnant and lactating women under age 19 years.) Blood lead levels declined more in the second trimester than in the third, with reductions averaging 14% and 8%, respectively. Women who were more compliant with the calcium regimen had higher reductions in blood lead relative to the placebo group. The most compliant women—those who took at least 75% of their calcium supplements—showed a 24% drop in blood lead levels over the course of pregnancy, with the greatest reduction (31%) occurring in women who were most compliant and who also cooked, served, or stored food in lead-glazed pottery, and who had the highest bone lead levels. The investigators conclude that calcium supplements should be considered as a low-risk, cost-effective means for lowering fetal lead exposure.

Growth and Bone Mineral Accretion During Puberty in Chinese Girls: A Five-Year Longitudinal Study

There are few longitudinal data on bone development during puberty in children with low calcium intake. This 5-yr longitudinal study showed that, in Chinese girls, the mean apparent calcium retention efficiency during puberty was 40.9%, PHV occurred at 3-0 yr before menarche, and peak bone mineral accretion occurred 1 yr later than PHV. Chinese girls have high calcium retention efficiency during puberty. There are few longitudinal data on bone development during puberty in children with low dietary calcium intake. The aim of this study was to examine the rate of growth and bone mineral accretion and study the predictors of total body BMC during puberty in a 5-yr longitudinal study with Chinese girls. Ninety-two girls, 9.5-10.5 yr of age at baseline, from the unsupplemented control group of a school milk intervention trial were included in this analysis. Data on anthropometric measurements, total body BMC as assessed by DXA, and calcium intake as assessed by a 3-day food record were obtained at baseline and 1, 2, 4, and 5 yr. The mean age of menarche was 12.1 +/- 1.0 yr. The mean annual rate of bone mineral accretion was 197.4 g/yr during the follow-up period, representing a calcium accretion rate of 162.3 mg/d. This calcium retention rate and the average dietary calcium intake of 444.1 mg/d gave an apparent calcium retention efficiency of 40.9%. Peak height velocity (PHV) occurred at 3-0 yr before menarche. Peak bone mineral accretion occurred 1 yr later than PHV. There was a decrease in size-corrected BMD in the year before menarche. In the linear mixed-effects model analysis containing body size and lifestyle factors, we found that height, body weight, and calcium intake were significant independent predictors of total body BMC. Chinese girls with low habitual dietary calcium intake have high calcium retention efficiency during puberty. Because calcium intake is a significant predictor of total body BMC, increasing dietary calcium intake may have beneficial effects on bone mineral accretion in these girls.

Effects of physical activity and dietary calcium intake on bone mineral density and osteoporosis risk in a rural Thai population.

The objective of the study was to determine the effects of modifiable risk factors on bone mineral density in postmenopausal Thai women. Dietary calcium intake (g/day), energy expenditure (kcal/day), and sunlight exposure (h/day) were assessed in 129 rural Thai women aged 63 years (range 50 to 84 years). Bone mineral density (BMD) at the femoral neck, lumbar spine, and distal radius were measured by dual-energy X-ray absorptiometry (DXA). The average dietary calcium intake was 236 +/- 188 g/day (mean +/- SD), while the energy expenditure was 2,118 +/- 656 kcal/day with 1.1 +/- 1.7 h of sunlight exposure. In multiple linear regression analysis, dietary calcium intake, energy expenditure, and years since menopause were significant and independent predictors of BMD at various sites. The three factors together accounted for between 35% and 45% of the variance of BMD. The prevalence of osteoporosis (defined as BMD T-scores < or =-2.5) was 33% at the femoral neck, 42% at the lumbar spine, and 35% at the distal radius. The risk of osteoporosis was higher in women with lower dietary calcium intake (< or =138 mg/day; prevalence rate ratio [PRR], 1.4; 95% confidence interval [CI], 1.0 to 1.9), lower energy expenditure (< or =1,682 kcal; PRR, 1.7; 95% CI, 1.2 to 2.3), and greater years since menopause (> or =6 years; PRR, 2.6; 95% CI, 1.2 to 5.8). The population attributable risk fraction of osteoporosis risk due to the three factors was 70%. These results suggest that in the Thai population, low dietary calcium intake and low physical activity together with advancing years since menopause were independent risk factors for low BMD.

Gains in hip bone mass from high-impact training are maintained: A randomized controlled trial in children

Objectives: We previously reported significant gains in hip and spine bone mass after 7 months of high-impact training in 89 prepubertal children. Our aim in this investigation was to evaluate the bone response to 7 months of "detraining" in this cohort of children. Study design: Seventy-four boys and girls (n = 37 jumpers, n = 37 controls) from the original cohort completed follow-up testing. Bone mineral content (BMC; g) and bone area (BA; cm2) of the left proximal femoral neck and lumbar spine (L1-4) were assessed by dual-energy x-ray absorptiometry. In addition, anthropometric characteristics, Tanner staging, physical activity, and average dietary calcium intake were assessed. Results: Over 14 months, jumpers maintained 4% greater femoral neck BMC and 4% greater femoral neck BA (P <.05 and P <.01, respectively) than controls. Group differences did not persist at the lumbar spine. Conclusion: Gains in both BMC and BA at the femoral neck from high-impact jumping were retained after an equivalent period of detraining. We conclude that this simple exercise may be useful in promoting bone growth at the hip and, thus, enhance peak bone mass. (J Pediatr 2002;141:357-62)

Calcium Intake in Middle- and Upper-Income Pregnant Women Throughout the Course of Gestation

The average daily calcium intake from food and supplements was determined for a group of middle- and upper-income pregnant women throughout gestation. The daily calcium intake was compared to the newly developed Dietary Reference Intake - Adequate Intake (DRI–AI) of 1000 mg calcium/day for women aged 19-50 years. Fifty-seven women were enrolled at their first prenatal visit, a 24-hour recall was obtained, and a diet instruction was given to ensure that subjects of different obstetricians received consistent nutrition education. A series of 3-day diet records was collected, one for each month of gestation. An additional 24-hour recall was obtained in each trimester. The data were separated into initial 24-hour recall (24 H) which was obtained before the diet instruction, first trimester diet records (T1), and second and third trimester diet records pooled with appropriate 24-hour recalls (T2 and T3, respectively). The average dietary calcium intake (mg) was significantly different between the trimesters (mean±SEM: 24 H=817±54, T1=1127±80, T2=1066±62, T3=1120±95, p<0.05). Of the fifty-seven women, 49 took calcium-containing supplements at least once. Total calcium from food and supplements was significantly different between the trimesters (mean±SEM: 24 H=1015±67, T1=1519±95, T2=1438±103, T3=1443±160, p<0.05). When comparing calcium intake from food, the percentage of women who consumed less than the recommended 1000 mg calcium/day was: 75% in 24 H, 42% in T1, 57% in T2, and 46% in T3. Energy intake and the incidence of nausea were significantly different between trimesters, with an increase in nausea and a decrease in caloric intake in 24 H. In conclusion, calcium intake increased after the initial physician visit, which could be due to a decrease in nausea, an increase in caloric intake, or adjusted intake secondary to the diet instruction.

Calcium Intake and Blood Pressure in Seven Japanese Populations

The relation between dietary calcium and blood pressure was examined in 1,928 men, ages 40-69 years, from five geographic and two occupational populations in Japan. Dietary calcium intake was estimated using 24-hour dietary recall in systematic samples of participants of population-based cardiovascular surveys from 1983 to 1987. The means of daily calcium intake of the study populations ranged from 449 to 695 mg, approximately 300 mg lower than the recommended US dietary calcium intake. Linear regression analyses were used to examine the relation between dietary calcium and blood pressure within each population, controlling for age, body mass index, alcohol consumption, and sodium intake. Total calcium intake was inversely associated with the systolic blood pressure level in each population, and the pooled estimate of the regression coefficients for millimeters of mercury of blood pressure per 100-mg increase in calcium intake was -0.54 (95% confidence interval -0.89 to -0.19). The inverse association between calcium intake and diastolic blood pressure was less consistent, and the pooled estimate did not reach statistical significance (-0.10, 95% confidence interval -0.34-0.14). Inverse associations existed for both dairy and nondairy food sources of calcium when analyzed separately, and the association was significant only for dairy calcium. Although a causal relation between dietary calcium and blood pressure cannot be established, these results suggest a possible public health implication in Japan of increasing calcium intake for the prevention and control of hypertension, where average dietary calcium intake is low.