Calcium Food Frequency Questionnaire Research Articles

Calcium to Magnesium Ratio Higher Than Optimal Across Age Groups (P10-100-19)

ObjectivesThe ratio of calcium to magnesium (Ca: Mg) intake has gained immense attention in recent years, since a ratio above 2:1 has been associated with increased risk of metabolic, inflammatory and cardiovascular disorders. The objective of this study was to assess Ca: Mg ratios across age groups and to determine the relationship between Ca: Mg ratios and markers of inflammation. MethodsAdult men and women, 18 to 60 years of age, completed a demographic form, a magnesium food frequency questionnaire and a calcium food frequency questionnaire. In a subset of individuals, biochemical assays were completed for inflammation markers such as interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), C-reactive protein (CRP) and matrix metallopeptidase 9 (MMP-9). Means, standard deviations, medians and interquartile ranges were calculated, and Pearson’s correlations were conducted to determine the relationship between Ca: Mg ratio and markers of inflammation. ResultsFifty-six adults were included in this analysis, and were categorized into four age categories: 18 to 29 years, 30 to 39 years, 40 to 49 years and 50 to 59 years. On average, participants were 28.87 ± 10.16 years of age, with a body mass index of 24.54 ± 3.72 kg/m2. Mean magnesium intake, calcium intake and Ca: Mg ratio for each age group were: 249.08 mg, 763.89 mg and 3.37 for the 18–29 years group, 226.59 mg, 730.50 mg and 3.58 for the 30 to 39 years group, 252.63 mg, 731.29 mg and 3.19 for the 40 to 49 years group and 286.03 mg, 595.03 mg and 2.79 mg for the 50 to 59 years group. All study groups had lower magnesium and calcium intakes compared to the Recommended Daily Allowances for these nutrients; however, the Ca: Mg ratio was higher than the optimal ratio of 2:1 in all age groups. In a subset, Ca: Mg ratio was significantly associated with IL-6 (r = 0.626, P = 0.017). ConclusionsAll age groups had a high Ca: Mg ratio above the optimal 2:1 ratio and in a subset of participants, a higher Ca: Mg ratio was associated with greater inflammation. Interventional studies should target lowering the Ca: Mg ratio in the diet and assess the effect of lowering Ca: Mg ratio on changes in metabolic markers. Funding SourcesNone.

Vitamin D Supplementation does not Effect Adiposity in Healthy Adults

Introduction: Vitamin D is crucial for skeletal and extraskeletal health outcomes as Vitamin D binding receptors are located through out body, and epidemiological data supports its link with many conditions. Data on vitamin D levels and especially Vitamin D supplementation in U.A.E. is essentially inadequate.Design: Subjects (n=20) in this 1 month prospective study were given 2000 IU of daily Vitamin D without any special dietary or physical activity changes. Anthropometrics (weight, waist circumference, hip circumference), Vitamin D/ Calcium food frequency questionnaire and 24 –Hour recall were collected.Results: Mean age of subjects was 28.7 years, and baseline mean serum Vitamin D level of 17.5 ng/mL ±6.47. It increased Vitamin D serum levels by a mean of 6.76 ng/mL. Hip Circumference also reduced statistically significantly by moderate 2% (p 0.03 ±0.59),Conclusion: Vitamin D supplementation moderate dose daily can be pivotal in acquiring health benefits and reducing adiposity related factors. However, this surely calls for further investigation for longer period.

Dietary sources of calcium among parents and their early adolescent children in the United States by parent race/ethnicity and place of birth.

Dietary calcium sources may differ by race/ethnicity and dietary acculturation. A cross-sectional, convenience sample including 587 United States (US) Asian, Hispanic and non-Hispanic White parent-child (10-13 years) pairs completed a calcium food frequency questionnaire. Calcium sources were ranked by mean percent contribution to total adjusted calcium intake, and compared by ethnic group and parents' location of birth. Five foods (fluid milk, cheese, milk on cereal, yogurt, and lattes) represented 49% of total calcium intake for parents. The same foods (except lattes) represented 55% of total calcium for early adolescent children. Fluid milk provided the largest mean percentage of intake for all race/ethnic groups among parents and children. Several food sources of calcium were greater for foreign-born versus US-born Asian or Hispanic parents and children. Understanding calcium food sources and changes in dietary patterns that affect calcium intake among parents and children is important to better promote adequate intake.

Reproducibility and Intermethod Reliability of a Calcium Food Frequency Questionnaire for Use in Hispanic, Non-Hispanic Black, and Non-Hispanic White Youth

BackgroundA dietary assessment instrument designed for use in a nationally representative pediatric population was required to examine associations between calcium intake and bone mineral accrual in a large, multicenter study. ObjectiveTo determine the reproducibility and intermethod reliability of a youth calcium food frequency questionnaire (FFQ) in a multiracial/ethnic sample of children and adolescents. DesignReproducibility (n=69) and intermethod reliability (n=393) studies were conducted by administering repeat FFQs and three unannounced 24-hour dietary recalls to stratified random samples of individuals participating in the Bone Mineral Density in Childhood Study. Participants/settingChildren and adolescents ages 5 to 21 years. Main outcome measuresCalcium intake estimated from the FFQ and 24-hour dietary recalls. Statistical analysisReproducibility was assessed by the intraclass correlation coefficient (ICC). Intermethod reliability was assessed by deattenuated Pearson correlations between the FFQ and 24-hour recalls. Attenuation factors and calibration corrected effect estimates for bone density were calculated to determine the potential influence of measurement error on associations with health outcomes. ResultsThe ICC (0.61) for repeat administrations and deattenuated Pearson correlation between the FFQ and 24-hour recalls (r=0.60) for all subjects indicated reproducibility and intermethod reliability (Pearson r=0.50 to 0.74 across sex and age groups). Attenuation factors were ≤0.50 for all sex and age groups and lower for non-Hispanic blacks (λ=0.20) and Hispanics (λ=0.26) than for non-Hispanic whites (λ=0.42). ConclusionsThe Bone Mineral Density in Childhood Study calcium FFQ appears to provide a useful tool for assessing calcium intake in children and adolescents drawn from multiracial/ethnic populations and/or spanning a wide age range. However, similar to other FFQs, attenuation factors were substantially <1, indicating the potential for appreciable measurement error bias. Calibration correction should be performed and racial/ethnic differences in performance considered when analyzing and interpreting findings based on this instrument.

PMO-032 Validation of a food frequency questionnaire for estimating calcium intake in young female adults

IntroductionThe relatively low cost and low respondent burden of a Food Frequency Questionnaire (FFQ) that effectively and rapidly identifies individuals with low calcium intakes would be a valuable asset to...

Repeatability of a Short Food Frequency Questionnaire to Assess Calcium Intake in Older Australians

Objective. To assess the repeatability of the validated Flinders Calcium Food Frequency Questionnaire (FFQCA) for estimating dietary calcium intake in a sample of community dwelling older Australians. Methods. A test-retest repeatability study involving 100 subjects (≥65 years) living independently in metropolitan Adelaide, Australia. Estimates of daily calcium intake from the first (FFQCA1) and repeated administration (FFQCA2) were calculated from two versions (35-item and 15-item) of the FFQCA. The intraclass correlation coefficient (ICC) was used to assess the repeatability. Results. Moderate and comparable ICC values (r = 0.5, r = 0.6) were found across the two versions of the FFQCA. Conclusion. Both FFQCA versions demonstrated moderate repeatability, supporting the results of previous studies.

Development and Evaluation of a Brief Calcium Assessment Tool for Adolescents

Adolescence is a critical time to achieve peak bone mass. However, results of national surveys suggest that young people are not consuming adequate amounts of calcium. A simple calcium self-assessment tool with low respondent burden could provide immediate feedback that may encourage calcium consumption. This study used data reduction methods to shorten a previously evaluated calcium-specific food frequency questionnaire to the 15-item Brief Calcium Assessment Tool (BCAT). Sample 1 was a cross-sectional sample of 1,426 students in sixth and 11th grades (April 2002 to February 2003) who completed the calcium food frequency questionnaire. Sample 1 was divided into two matching samples (Group 1 and Group 2). Sample 2 was a cross-sectional sample of 745 girls in sixth grade that completed the calcium food frequency questionnaire (July 2002 to February 2005). The development of the BCAT and its calcium score used two unique samples (Group 1 of Sample 1 and Sample 2) followed by confirmation of the score in a second sample (Group 2 of Sample 1). Bone mineral content was measured among the girls in Sample 2. The BCAT calcium score was associated with total hip bone mineral content (β=.014, P=0.003) and femoral neck bone mineral content (β=.002, P=0.006) while adjusting for covariates. Sample 3 (n=265), a subsample of Sample 2, completed bone measures 12 months later. The BCAT calcium score at the baseline was a predictor of total body bone mineral content (β=.279, P=0.041) at 12 months. The correlation of BCAT scores 1 week apart was .76 ( P<0.001) among a convenience sample of 41 boys and girls aged 9 to 17 years (October 2005 to December 2005). The BCAT took about 5 minutes to complete. The significant relationship between bone mass and the BCAT calcium score supports the use of BCAT as a tool to assess food calcium intake among adolescents, especially Asian, Hispanic, and non-Hispanic white girls. The reliability and low respondent burden of the BCAT make the tool useful for large-scale studies and community-based programs.

Validation of Two Food Frequency Questionnaires for Dietary Calcium Assessment

Easily utilized questionnaires estimating dietary calcium intake would be a valuable asset to promoting skeletal health as well as a helpful research tool. Two calcium questionnaires, one online and one printed, were each compared with dietary calcium intake measured by a 3-day diet record. Women completed the questionnaires in a randomized order and kept a 3-day food record at home, returning it by mail. The ethnicity of the 140 female study participants was 102 white, 12 African American, 16 Asian, and 10 Latina. The mean age (±standard deviation) was 49±15 years, with a range of 22.7 to 89.9 years. Measures used included an online calcium quiz, a printed calcium food frequency questionnaire, and one 3-day diet record. Data analysis was done using Pearson correlation coefficients. Sub-analyses were conducted by ethnicity. The correlation between each questionnaire and the daily calcium intake from the diet records was 0.37, P<0.001. Among the ethnic subgroups, the correlations were highest for African-American women, followed by white women. There was also a trend toward higher correlations in younger women. These simple calcium assessment tools, taking fewer than 5 minutes to complete, have correlation values with diet records similar to more complex food frequency questionnaires reported in the literature. These questionnaires may provide valuable tools to estimate calcium intake in research, clinical, and community settings.

Short food frequency questionnaire can discriminate inadequate and adequate calcium intake in Croatian postmenopausal women

Abstract Valid and cost-effective instruments are needed for measuring dietary calcium intake in clinical or epidemiologic studies as well as for education. A food frequency questionnaire (FFQ) is the dietary assessment tool most often used for such purposes; but FFQs are population-, age-, and sex-specific, so each FFQ must be tested for its validity in the population of concern. The aim of this study was 2-fold: to develop and validate a short FFQ for assessing calcium intake in postmenopausal Croatian women. The development of the short calcium FFQ was based on a previous FFQ, after conducting a pilot study in 100 women and including in the short FFQ only those food items that cumulatively accounted for 95% of the total calcium intake by the previous FFQ. The short FFQ (27 items) was then tested in 333 women and compared against a single multipass 24-hour recall. The Pearson and Spearman correlation coefficients between the 2 methods were 0.70 and 0.64, respectively. The weighted κ was 0.43. Cross-classification showed that 55.3% of subjects belonged to the same third. Predictive value of the FFQ at a cutoff of 1200 mg calcium per day was 94.4%. In conclusion, the FFQ can discriminate low or inadequate ( 1000 mg calcium) intakes; but the Bland-Altman method showed that the FFQ is not appropriate for the assessment of individual calcium intake.

Does Participation in Organized Sports Impact Calcium Intake, Physical Activity, or Television Viewing of Children?

It has been suggested that children who play organized sports may participate in more physical activity and have better eating habits than children not involved in sports. PURPOSE: To compare the calcium intake, minutes of physical activity, and hours of television viewing among sport involved and non-sport involved boys and girls. METHODS: Questionnaires were administered through individual interviews with each child in the presence of a parent. Calcium intake was estimated with either: (1) calcium food frequency questionnaire or (2) 24-hour recall with calcium intake analyzed using Nutritionist IV. Participation in physical activity was estimated with a seven-day physical activity recall. The physical activity recall also included questions that assessed participation in organized sports and television viewing. A two-way ANOVA was used to determine the interaction of gender and participation in organized sports on calcium intake, participation in physical activity, and television viewing. RESULTS: Participants were 338 boys (n=169) and girls (n=169) aged 5 to 12 yr. Mean (±SD) age, height, and weight were 9.3±1.1 yr, 135.3±10.1 cm, and 36.3±12.1 kg, respectively. The majority of the children were Caucasian (76%) or Hispanic (16%). Average (±SD) calcium intake, physical activity, and television viewing were 1287±592 mg/d, 455±387 min/wk, and 2.0±1.3 hr/d, respectively. Forty-four percent of the children reported participation in organized sports. There was no significant interaction of gender and participation in organized sports on physical activity or television viewing. However, there was a significant main effect of gender on physical activity with boys reporting more activity than girls (522±424 vs. 389±337 min/wk, p<01). There was a significant interaction of gender and sports participation on calcium intake with males in organized sports consuming more calcium than females in organized sports (1449±631 vs. 1144±540 mg/d, p<05). CONCLUSIONS: Children reported similar calcium intakes, minutes of physical activity, and hours of television viewing regardless of participation in organized sports. However, gender differences were observed with boys consuming more calcium and participating in more physical activity than girls.

Reliability and Validity of a Brief Questionnaire to Assess Calcium Intake of Middle-School–Aged Children

Objective Evaluate the validity and reliability of a short (10-item) calcium food frequency questionnaire (FFQ) for use with middle-school−aged (11 to 14 years of age) children. Design The calcium FFQ was completed twice, with 1 week between administrations. Three 24-hour dietary recalls were collected from each participant after the second administration of the calcium FFQ. Subjects/setting Students in an ethnically diverse middle school in Minneapolis, MN (n=248). Main outcome measures Calcium intake estimates from the calcium FFQ and dietary recalls. Statistical analyses Correlations between calcium intake estimates from the first and second questionnaire administrations of the calcium FFQ were calculated and paired t tests were conducted to compare mean calcium intake estimates from each questionnaire administration. Mean intake estimates from the calcium FFQ and the dietary recalls were compared. Also, correlations between intake estimates from the calcium FFQ and the recalls were calculated. Results Correlation between calcium intake estimates derived from the first and second administration of the calcium FFQ was 0.74. Mean calcium intake estimates from the calcium FFQ and the average of the three dietary recalls were 856 mg/day and 993 mg/day, respectively ( P<0.001). The correlation between calcium intake estimates derived from the calcium FFQ and the average of the recalls was 0.43. Conclusions Reliability of the FFQ was found to be good while validity was weaker, with calcium intake from the calcium FFQ moderately associated with estimates from dietary recalls. Where a brief instrument for assessing calcium intake of middle-school−aged children is needed, the calcium FFQ evaluated in this study may be useful.

Older Black Women Differ in Calcium Intake Source Compared to Age– and Socioeconomic Status–Matched White Women

Racial disparity in osteoporosis between older black and white women is well established; however, less is known regarding daily dietary and supplemental calcium intake in these populations. Moreover, racial differences in calcium intake are confounded by differences in socioeconomic status (SES). The objective of this study was to assess calcium intake and source in older black women (n=33) and white women (n=33), matched in age and SES. Calcium intake and source were evaluated by interview using a 46-item calcium food frequency questionnaire including all food groups and supplements. Black and white women were identical in SES and matched on age (black women 66.9±6.2 years vs white women 67.1±5.5 years [mean±standard deviation], P=0.85). No significant difference existed for dietary calcium intake between black and white women (974±524 vs 1,070±600 mg/day; P=0.65) or total calcium intake between black and white women (1,485±979 vs 1,791±887 mg/day; P=0.15). Dairy foods contributed most to dietary calcium intake in black and white women and differed by race (black women 402±269 mg/day, white women, 603±376 mg/day; P=0.02). Calcium intake from grains differed by race (black women 205±201 mg/day vs white women 130±234 mg/day; P=0.010) and fortified cereals were a major source of calcium for black women. Calcium supplementation contributed substantially to total calcium intake in both groups, with more white women (n=23, 70%) using supplements than black women did (n=19, 58%). However, no racial difference existed in supplemented calcium intake (black women, n=19; 889±605 vs white women, n=23; 1,034±460 mg/day; P=0.20). Our data suggest that total daily dietary and supplemental calcium intakes do not differ, but calcium intake from dairy foods and from grains differ in older black and white women matched in age and SES.

Eating attitudes and habitual calcium intake in peripubertal girls are associated with initial bone mineral content and its change over 2 years.

This 2-year prospective study examined associations among bone mineral acquisition and physical, maturational, and lifestyle variables during the pubertal transition in healthy girls. Forty-five girls, initially 10.5+/-0.6 years, participated. Body composition and bone mineral content (BMC) at the spine and total body (TB) were assessed at baseline and annually thereafter using dual-energy X-ray absorptiometry (DXA). Nutrient intakes were assessed using 3-day diet records and a calcium food frequency questionnaire (FFQ), physical activity by questionnaire, sexual maturation using Tanner's stages of breast and pubic hair maturation, growth by height and weight, and eating attitudes using the children's Eating Attitudes Test (Children's EAT). Mean children's EAT subscale scores (dieting, oral control [OC], and bulimia) were stable over time. Median split of OC subscale scores was used to form high and low OC groups. Groups had similar body composition, dietary intake, activity, and Tanner stage at baseline and 2 years. Using height, weight, and Tanner breast stage as covariates, girls with low OC scores had greater TB BMC at baseline (1452+/-221 g vs. 1387+/-197 g; p = 0.030) and 2 years (2003+/-323 g vs. 1909+/-299 g; p = 0.049) and greater lumbar spine (LS) BMC at 2 years (45.2+/-8.8 g vs. 41.2+/-9.6 g; p = 0.042). In multiple regression analysis, OC score predicted baseline, 2 years, and 2-year change in TB and spinal BMC, contributing 0.9-7.6% to explained variance. Calcium intake predicted baseline, 2 years, and 2-year change in TB BMC, explaining 1.6-5.3% of variance. We conclude that both OC and habitual calcium intake may influence bone mineral acquisition.

Validation of the Tufts Calcium Food Intake Frequency Questionnaire as a Measure of Calcium Intake in Men 65 Years of Age and Older

84 healthy male outpatients were screened for a dietitian's interview during an osteoporosis prevention trial. Each participant had his dietary calcium separately analyzed using the HHHQ, Tufts and 3-Day food record. Demographic data were available in all 84 men, whereas dietary information was available for 82 subjects. Results: Mean value for subject age was 73±5.1yr.(mean±SD, range 65–88yr.), and that for body mass index (BMI) was 26.9 ±3.0kg/m2 (23.1-43). Average daily dietary calcium intake (mg/day) was 986±927 for the HHHQ (range 379–3904), 962±723 for Tufts (140–2712), and 948±711 for the 3-Day food record (213–1845). The average calcium intake using descriptive statistics for these three dietary intake forms were similar. Correlation Matrix revealed direct correlation's of Tufts with the HHHQ (0.523, p<0.0001), of Tufts with the 3-Day Food Record (r=. 497, p<0.000l), and of the 3-Day food record with HHHQ (r=0.418, p<0.0001.Conclusion: These data suggest that the Tufts Calcium Food Frequency Questionnaire is as reliable as the HHHQ and 3-Day Food Record in assessing daily Calcium intake in elderly men. Its advantage in being less time-consuming suggests that it will become a useful instrument in outpatient studies in men as well as in women.

Calcium Intakes in Children with Cystic Fibrosis (CF) and Risk Factors for Poor Bone Health

In cystic fibrosis (CF), increased requirements and malabsorption may lead to malnutrition, in particular during rapid growth and/or with deteriorating lung function. Nutritional intervention includes increased caloric intake and lipid soluble vitamins, however calcium is rarely addressed. Since CF patients, particularly females, are at increased risk for osteoporosis, assessment of risk factors for poor bone health was studied in 31 CF patients (18 male; mean age 13.5 years; range:8-22 years). All patients completed a validated calcium food frequency questionnaire, weight, height, mid-arm circumference, triceps skinfold thickness, bioelectrical impedance analysis (BIA), age-puberty stage, and spirometry. Risk factors included low calcium intake (<1200mg/day), low percentage body fat (<18%), poor lung function (FEV1 < 80% predicted), and delayed puberty (Tanner < Stage 3). Mean Calcium intake was 1675 + 776.9mg/day, body fat was 17.5 + 7.4%, and FEV1 was 73.2 + 23.9% predicted. Stratification according to risk factors for poor bone health identified 1 patient with 3 risk factors, 8 patients with 2 factors, 8 patients with 1 risk factor, and 14 with no risk factors. Patients with > 2 risk factors had lower calcium intakes (902.5 + 614.8mg/day) than those with <2 risk factors (1985 + 648.4mg/day; p<0.05). Similarly lower % body fat and lung function were found in the high risk group. Use of calcium rich food supplements was associated with improved calcium intake and body composition. Stratification of CF patients based on the presence of risk factors for poor bone health will allow for identification of high-risk population.

Validation of a short food frequency questionnaire to assess calcium intake in children aged 3 to 6 years.

To assess the validity of a short calcium food frequency questionnaire (FFQ) for use in young children. Calcium intake from an estimated 4 d diet record (4DDR) was compared with the calcium intake from a 35 item FFQ specifically designed to assess habitual calcium intake and previously validated for adult women. Forty-one girls and 26 boys aged 3-6 y recruited by advertisement for studies of nutrition and bone health. Mean (s.d.) calcium intakes were 798 mg (271) and 942 mg (419) for the 4DDR and FFQ respectively, (r = 0.52). Mean difference (s.d. of difference) in calcium intake between the two methods was 144 mg (355), showing that the FFQ may estimate calcium intakes 565 mg below to 854 mg above diet record values. 84% of subjects when classified by the 4DDR fell into the same or adjacent quartiles when classified by the FFQ. Only two subjects were classified in extreme quartiles for the two methods. The FFQ correctly identified 68% of children with recorded intakes less than 800 mg. The short calcium FFQ tended to overestimate actual calcium intakes in young children, and would not be appropriate for determining calcium intake of individuals. However, the FFQ demonstrated good ability to classify subjects into extremes of calcium intake. Moreover, the predictive value of the FFQ in identifying children with intakes below the current recommended intake of 800 mg was reasonably high (79%).