Consumption Of Calcium Supplements Research Articles

A Pharmacovigilance Study on Steroid Induced Osteoporosis

Background: In elderly people, osteoporosis and low bone density are significant risk factors for morbidity and death. Low bone strength distinguishes these illnesses, which are correlated to an increased risk of fractures from even minor traumas. Objectives: To study pharmacovigilance on steroid induced osteoporosis. Methods: A total of 950 individual who were diagnosed with osteoporosis. These individuals were deemed to be at a high risk of osteoporosis. Patients were given information regarding the risks of steroid-induced osteoporosis, as well as a handout. The patient's steroid duration and any medicines used to control the risks of steroid-induced osteoporosis were the focus of the initial evaluation. Following that, evaluations of the pharmacological therapy being examined. Any problems found were discussed with the patient and/or the prescribing practitioner. Data was gathered at the start of the study and again after 6 months of observation. Results: Glucocorticoids (prednisolone) was the main prescription drug of the entire study sample. Family history of Osteoporosis was reported in 20% of the cases. The history of fracture was reported in 30% of the cases. Low calcium diet was reported in 35% of the cases. Osteoporosis was diagnosed in 17% of the cases, Osteopenia in 22% of the cases. In 88% of the cases the drug prescribed was >5mg daily. The duration of CS intake was high. This shows that the CS drug is being abused mostly in history of allergies and asthma as its easily available OTC leading to an increased risk of osteoporosis. Around 26% were prescribed antiosteoporosis treatment with Bisphosphonate. Estrogen therapy was prescribed in 16% of the cases. Calcium supplement consumption was increased by 17%. There was significant reduction in BMD, Glucocorticoid’s usage and daily dosage and result was statistically significant. Conclusion: Because all cells employ the same glucocorticoid receptor, corticosteroids' antiinflammatory effects cannot be distinguished from their metabolic effects; thus, precautions should be taken when corticosteroids are given. Clearly, the risk of serious adverse effects rises as the amount and duration of therapy increases, thus the smallest dose required to control the condition should be provided.

Maternal nutrition intervention and maternal complications in 4 districts of Bangladesh: A nested cross-sectional study.

BackgroundMaternal morbidity is common in Bangladesh, where the maternal mortality rate has plateaued over the last 6 years. Maternal undernutrition and micronutrient deficiencies contribute to morbidity, but few interventions have measured maternal outcomes. We compared reported prevalence of antepartum, intrapartum, and postpartum complications among recently delivered women between maternal nutrition intervention and control areas in Bangladesh.Methods and findingsWe conducted a cross-sectional assessment nested within a population-based cluster-randomized trial comparing a nutrition counseling and micronutrient supplement intervention integrated within a structured home-based maternal, newborn, and child health (MNCH) program to the MNCH program alone in 10 sub-districts each across 4 Bangladesh districts. Eligible consenting women, delivering within 42–60 days of enrollment and identified by community-level health workers, completed an interviewer-administered questionnaire detailing the index pregnancy and delivery and allowed review of their home-based care register. We compared pooled and specific reported antepartum, intrapartum, and postpartum complications between study groups using hierarchical logistic regression. There were 594 women in the intervention group and 506 in the control group; overall, mean age was 24 years, 31% were primiparas, and 39% reported facility-based delivery, with no significant difference by study group. There were no significant differences between the intervention and control groups in household-level characteristics, including reported mean monthly income (intervention, 6,552 taka, versus control, 6,017 taka; p = 0.48), having electricity (69.6% versus 71.4%, p = 0.84), and television ownership (41.1% versus 38.7%, p = 0.81). Women in the intervention group had higher recorded iron and folic acid and calcium supplement consumption and mean dietary diversity scores, but reported anemia rates were similar between the 2 groups (5.7%, intervention; 6.5%, control; p = 0.83). Reported antepartum (69.4%, intervention; 79.2%, control; p = 0.12) and intrapartum (41.4%, intervention; 48.5%, control; p = 0.18) complication rates were high and not significantly different between groups. Reported postpartum complications were significantly lower among women in the intervention group than the control group (33.5% versus 48.2%, p = 0.02), and this difference persisted in adjusted analysis (adjusted odds ratio [AOR] = 0.51, 95% CI 0.32–0.82; p < 0.001). For specific conditions, odds of retained placenta (AOR = 0.35, 95% CI 0.19–0.67; p = 0.001), postpartum bleeding (AOR = 0.37, 95% CI 0.15–0.92; p = 0.033), and postpartum fever/infection (AOR = 0.27, 95% CI 0.11–0.65; p = 0.001) were significantly lower in the intervention group in adjusted analysis. There were no significant differences in reported hospitalization for antepartum (49.8% versus 45.1%, p = 0.37), intrapartum (69.9% versus 59.8%, p = 0.18), or postpartum (36.1% versus 29.9%, p = 0.49) complications between the intervention and control groups. The main limitations of this study are outcome measures based on participant report, non-probabilistic selection of community-level workers’ catchment areas for sampling, some missing data for variables derived from secondary sources (e.g., dietary diversity score), and possible recall bias for reported dietary intake and supplement use.ConclusionsReported overall postpartum and specific intrapartum and postpartum complications were significantly lower for women in intervention areas than control areas, despite similar rates of facility-based delivery and hospitalization for reported complications, in this exploratory analysis. Maternal nutrition interventions providing intensive counseling and micronutrient supplements may reduce some pregnancy complications or impact women’s ability to accurately recognize complications, but more rigorous evaluation is needed for these outcomes.

The Relationship of Vitamin D and Calcium level with Preeclampsia Severity: A Case- control Study

Background Vitamin D deficiency is associated with physiologic changes that are similar to pathogenesis of preeclampsia. Although association of vitamin D and preeclampsia has been studied previously, their results are not consistent. The aim of this study was to investigate the relationship of serum vitamin D and calcium with preeclampsia severity. Materials and Methods: This case- control study was conducted in 75 healthy pregnant women and 74 pregnant women with preeclampsia (46 mild preeclampsia and 28 severe preeclampsia) in Qazvin, Iran in 2015. Serum vitamin D, calcium, and albumin were measured; corrected calcium was also calculated. Hypocalcemia and vitamin D deficiency were compared between the groups. Logistic regression analysis was used to study the independent association of hypocalcemia and hypovitaminosis D with preeclampsia. Results Mean serum vitamin D level was 27.7±15.3, 22.9±15.9, and 27.6±16.6 in normal, mild preeclampsia, and severe preeclampsia groups (P> 0.05); also vitamin D deficiency was not different between the groups. Hypocalcemia in severe preeclampsia group was more frequent than normal group (25.9% vs. 6.6%, P: 0.017). Hypocalcemia was associated with severe preeclampsia after adjustment for age, parity, and calcium supplement consumption (OR: 6.7, 95% CI: 1.45-30.79; P: 0.015). Conclusion There was not any association between vitamin D deficiency and preeclampsia in the present study, however low corrected serum calcium was associated with about six times increased risk of sever preeclampsia. More studies are needed to determine the role of hypocalcemia and vitamin D in preeclampsia.

Do Calcium Supplements Predispose to Urolithiasis?

The purpose of this study was to investigate the role of calcium supplements, with or without vitamin D, in urinary stone formation in healthy population and in osteoporotic patients as well. Moreover, this review aims to clarify whether or not, and above which dose, they are associated with the risk of lithiasis. A research in Medline, Embase, and Scopus databases up to September 2015 was conducted using the following keywords: calcium, supplements, vitamin D, complications, lithiasis, and urinary stone. All types of studies were taken into account (cohort studies, reviews, meta-analyses), and in case they fulfilled the inclusion criteria, they were included in our review. The analysis of the data showed that calcium supplements, probably in association with anti osteoporotic treatment, do not create a predisposition towards lithiasis formation among women suffering from osteoporosis, neither among non-osteoporotic older men. In healthy postmenopausal as well as younger women, the supplements might increase susceptibility to urinary stone formation in long-term basis. The consumption of calcium supplements with the meals could play a protective role in women and younger males. There is certain evidence that supplements containing citrate may be more beneficial over the rest of calcium supplements, particularly when consumed during the meal. Osteoporotic women and healthy men are not at risk of stone formation. On the contrary, healthy women should be aware of the potential risk of developing urinary lithiasis in long-term basis.

The Relation between Calcium Supplement Consumption and Calcific Shoulder Tendonitis

Background: Calcific tendonitis is a common cause of non-traumatic shoulder pain. Previous studies have suggested a relation between minerals and endocrine and calcium deposition. Thus, hypercalcemia is probably related to calcific tendonitis. This study aims at evaluating the relation found between calcium supplement consumption and calcific shoulder tendonitis. Methods: This analytical-descriptive study was conducted on 250 patients with shoulder pain referring to clinics and emergency department of Shohada Orthopedics Hospital during one year for considering calcific shoulder tendonitis and calcium supplement consumption. Patients with calcific tendonitis were treated and their functional ability was evaluated using DASH questionnaire, pain severity and range of motion (ROM) before and after treatment and their correlation with calcium supplement consumption. Results: Calcific tendonitis and calcium consumption were generally seen in 30 (12%) and 73 (29.2%) cases, respectively. Calcium consumption frequency in patients with calcific tendonitis was significantly higher than the patients who did not consume calcium supplements (76.7% vs. 22.7%). Patients with calcific tendonitis who did not consume calcium supplements suffered from significantly longer periods of shoulder pain. All patients having consumed calcium supplement were female. The group who consumed calcium supplement had significantly severe pain and higher DASH score before and after treatment, while there was no significant difference in number of impaired ROM before and after treatment. Also, there was a negative correlation between calcium supplement consumption, pain severity and DASH score before and after treatment. Conclusion: Calcium supplement consumption is related to calcific tendonitis and is also accompanied with more pain and lower functional ability in patients with calcific tendonitis. Keywords: Calcific tendonitis; Shoulder; Calcium supplement; Pain

Influence of Oral Calcium Intake During Pregnancy on Blood and Urine Calcium Levels of Newborns

Dear Editor, Pregnancy is a time of increased need for supplementations like calcium. This theory was already supported that maternal calcium supplements during pregnancy was found to bring about a remarkable increase in the density of all the bones in the neonates; this suggests the fact that increased calcium had been actively transferred to the fetus via the placenta (1). In recent years, use of calcium supplements during pregnancy, especially in the last trimester have been recommended to prevent disadvantages of calcium loss by mother and also providing sufficient calcium supplement for the fetus (2, 3). There is a theoretical concern that the excessive consumption of calcium supplements may induce hypocalcaemia in the fetus and neonate, that can be a cause of hypercalciuria, which may be followed by urinary calculi and nephrocalcinosis (4). Recently, we experienced noticeable incidence of hypercalciuria, nephrolithiasis and nephrocalcinosis in healthy newborns. In the present study we investigated the influence of mother’s calcium supplementation in generating hypocalcaemia and hypercalciuria in neonates that were born in hospitals of Yasuj University of medical sciences (south-west of Iran). Between September 2010 and June 2011, seventy pregnant women and their healthy full term newborns were recruited. Mothers were randomly divided into two groups of thirty-five cases while those with any systemic diseases such as diabetes, hypertension, renal or liver diseases, and those who had used medication that would affect calcium metabolism were excluded. The case group received 1000 mg calcium carbonate daily in the last month of pregnancy; the control group with similar conditions consumed their usual diet. At the time of delivery, cord blood was collected to check for total calcium. First urine, in healthy newborns was checked for Ca/Cr ratio by the cresolphthalein complexone spectrophotometric method and kinetic jaffe reaction, respectively (5). Automated analyzer (Hitachi™ 704) was used, and then urinary Ca/Cr (mg/mg) ratio was calculated. Quantitative values between the two groups were determined by Student t tests by SPSS® software (version 17.0, IBM®, USA). Results were reported as Mean ± standard deviation (SD). Values of P ≤ 0.05 were considered as statistically significant. Results demonstrated that average serum calcium in case group was 9.92 ± 1.07 mg/dl (normal level: 8.5-12 mg/dl) and in the control group was 10.05 ± 0.81 mg/dl (normal level: 8.5 - 12.5 mg/dl) which had insignificant difference (P = 0.565) (Table 1). Table 1. Average Serum Calcium (mg/dl; Mean ± SD) of Newborns With and Without Maternal Calcium Supplementation Calcium to creatinin ratio in case group was at a range of 0.05 to 0.21 with average of 0.11 ± 0.05. This ratio in control group was from 0.05 to 0.19 with average of 0.10 ± 0.036, respectively (P = 0.35) (Table 2). Table 2. Urinary Calcium to Creatinin Ratio (mg/mg; Mean ± SD) in Newborns With and Without Maternal Calcium Supplementation Calculated relative risk test of increasing serum calcium was 1.07 with confidence interval of 95%: (0.35, 2.12), and for calcium to creatinin ratio of serum was 1.03 with confidence interval of 95%: (0.21, 2.67). Maternal and fetal skeletal benefits of calcium supplementation, many other advantages have been linked to adequate calcium intake, such as reduced risk of pregnancy-induced hypertension and relative risk of preeclampsia, a decrease in maternal circulating lead, higher newborn weight and bone mineralization (6-9). Literature and clinical experiences declare the fact that investigations are still needed to prove the safety and to find out the possible disadvantages of maternal calcium supplementation in the neonates. Likely, as results of this study revealed, calcium supplementation had no significant impact in increasing the risk of hypercalciuria and hypocalcaemia occurrence in neonates. The present findings imply that percentage of neonates of case-group with normal calcium level was almost similar to control group and no one in both groups had low calcium level. Moreover, high calcium level proportion in both groups was not noticeably different. Percentage of Ca/Cr ratio within and higher than normal range in case group was not remarkably different from that of control group respectively; thus, this was not a causative factor of the recently observed hypercalciuria in our experiences.

Early Aortic Bioprosthetic Valve Deterioration in an Octogenarian

We experienced extremely early aortic bioprosthetic valve deterioration with leaflet calcification and stiffening 2 1/2 years after aortic valve replacement in a female octogenarian. We could not identify the possible reason for this devastating complication; however, daily calcium supplement consumption may play a role of acceleration of calcium deposition in the leaflets of implanted bioprosthetic heart valves.

Lead from calcium supplements contributes minimally to blood lead concentrations

We undertook a study using lead isotopes to determine the contribution of lead to blood from consumption of calcium supplements approximating the recommended daily intakes over a 6 month period. Subjects were subdivided into three groups. One treatment group (n=8) was administered a complex calcium supplement (carbonate/phosphate/citrate) and the other treatment group (n=7), calcium carbonate. The control group (n=6) received no supplementation. The lead isotopic compositions of the supplements were completely different from those of the blood of the subjects. Lead isolopic compositions for the complex supplement showed minimal change during treatment compared with pre-treatment. Lead isotopic compositions in blood for the calcium carbonate supplement showed increases of up to 0.5% in the 206 Pb/ 204 Pb ratio, and for all isotope ratios there was a statistically significant difference between baseline and treatment (p <0.005). Blood lead concentrations showed minimal changes.

Contribution of lead from calcium supplements to blood lead.

We conducted a case-control study to determine the contribution of lead to blood from consumption of calcium supplements approximating the recommended daily intakes over a 6-month period. Subjects were males and females ages 21 to 47 years (geometric mean 32 years) with a geometric mean blood lead concentration of 2.5 microg/dL. They were subdivided into three groups. One treatment group (n = 8) was administered a complex calcium supplement (carbonate/phosphate/citrate) and the other treatment group (n = 7) calcium carbonate. The control group (n = 6) received no supplement. The lead isotopic compositions of the supplements were completely different from those of the blood of the subjects, allowing us easily to estimate contribution from the supplements. The daily lead dose from the supplements at 100% compliance was about 3 microg Pb. Three blood samples were taken at 2-month intervals before treatment to provide background values, and three were taken during treatment. Subjects in the treatment group were thus their own controls. Lead isotopic compositions for the complex supplement showed minimal change during treatment compared with pretreatment. Lead isotopic compositions in blood for the calcium carbonate supplement showed increases of up to 0.5% in the (206)Pb/(204)Pb ratio, and for all isotope ratios there was a statistically significant difference between baseline and treatment (p < 0.005). The change from baseline to treatment for the calcium carbonate supplement differed from that for both the control group and the group administered the complex supplement. Blood lead concentrations, however, showed minimal changes. Variations in blood lead levels over time did not differ significantly between groups. Our results are consistent with earlier investigations using radioactive and stable lead tracers, which showed minimal gastrointestinal absorption of lead in the presence of calcium (+/- phosphorus) in adults. Even though there is no discernible increase in blood lead concentration during treatment, there are significant changes in the isotopic composition of lead in blood arising from the calcium carbonate supplement, indicating a limited input of lead from diet into the blood. Because calcium carbonate is overwhelmingly the most popular calcium supplement, the changes we have observed merit further investigation. In addition, this type of study, combined with a duplicate diet, needs to be repeated for children, whose fractional absorption of lead is considerably higher than that of adults.

Calcium supplementation and iron status of females

Iron balance is regulated in part by the level of iron absorption, which is influenced by iron stores and the level of erythropoietic activity. In short-term absorption studies, dietary calcium and supplemental doses of calcium chloride or calcium carbonate inhibited iron absorption from concomitantly consumed meals. In contrast, several long-term intervention studies of the effect of calcium supplementation on iron status in populations at potentially high risk for compromised iron status failed to show reductions in various indicators of iron status including serum ferritin levels. The evidence suggests that long-term consumption of calcium supplements does not affect overall iron status. An adaptive response, possibly involving an upregulation in the efficiency of iron absorption, has been suggested as a possible explanation for the disparity between the results from short- and long-term studies.

Oyster Shell and Insoluble Grit Consumption of Breeder Turkeys

Feed consumption data of turkeys of different ages and for different periods are commonly reported. Data on grit and calcium supplement consumption on the other hand are very difficult to find. Scott (1966), Marsden (1949), Lucas et al. (1949), Barnett et al. (1958), reported feed consumption for growing turkeys but made no mention of calcium supplement or grit consumption. Cline (1939), Berryman and Buchanan (1944), Anderson (1964), Robblee and Clandinin (1959), Dymsza et al. (1954), reported feed consumption for turkey breeders. Grit and calcium supplement consumption was not reported.This report includes data kept on consumption of mash, oyster shell and grit when comparing reproductive performance of breeders fed ad libitum mash versus birds fed eighty percent of the quantity consumed on full-feed. Granite grit and oyster shell were fed free choice in all pens.Three pens containing 30 Broad Breasted White turkey hens each were fed ad libitum, and .