Consumption Of Calcium-rich Foods Research Articles

Nugget Processing with Addition of Egg Shell Flour in Kotabaru Village, Jambi

Calcium is an essential micronutrient for children to the postmenopausal women. In practice, consumption of calcium-rich foods sourced from animal protein foods for family members, especially children, is still low. Egg shells contain calcium which can be fortified into nuggets to produce calcium-rich nuggets. Thus, the high benefits of egg shells will be obtained and reduce the negative environmental waste impact. Kota Baru Village, Geragai Subdistrict, Tanjung Jabung Timur Regency was chosen as the location for community service because apart from being an UNJA’s integrated laboratory village, this area is one of the location for stunting reduction in Jambi Province. This community service project has target of producing nugget products with the addition of egg shell flour, as well as increasing the knowledge and skills of village business group members. Evaluation of participants' knowledge and skills was carried out using pre-test and post-test questionnaire and checklist of nugget-making procedures. The results of this community service showed that there was a difference in 10 participants' knowledge compared to before the training (test score from 72 to 88). The hedonic test showed that more participants really liked the eggshell and carrot nuggets formulation in terms of smell, texture, and taste. Processing of nuggets with the addition of eggshell flour can be an alternative local food source of animal protein which is also of economic value.

Effect of emotion-based nutrition messages on consumption of calcium-rich foods among early adolescents in Ogbomoso, Nigeria.

Calcium is a vital micronutrient for several physiological processes, yet it remains one of the significant shortfall nutrients among Nigerian adolescents. This study was designed to assess the effect of emotion-based nutrition messages on the consumption of calcium-rich foods among early adolescents in Ogbomoso, Nigeria. The quasi-experimental study involved 220 adolescents (experimental: 110 and control: 110) selected using a three-stage sampling procedure. A semi-structured, interviewer-administered questionnaire was used to collect socio-demographic characteristics, dietary practice, calcium-rich foods consumption pattern, calcium intake, and anthropometric parameters. Second, calcium-rich foods consumption pattern was assessed using a food frequency questionnaire, and intake was evaluated using the multi-pass 24-hour dietary recall to define adequacy at intake level ≥1,300 mg per day. Third, the experimental group had five weeks of nutrition education using emotion-based nutrition messages. Data were analyzed using descriptive statistics and the Chi-square test at p < 0.05. The age of respondents (years) in experimental (12.88±1.41) and control (13.4±1.03) groups was similar. Primary dietary calcium sources were meat, chicken, egg, white beans, cheese, soy milk, oranges, and locust beans at baseline. At post-intervention, intake of other calcium-rich foods such as milk, yogurt, ice cream, okra, sardine, and unripe plantain increased, however, calcium intake remains similar in both control (238.41±92.4 mg; 235.40±92.92 mg) and experimental groups (239.76±51 mg; 241.46±100.89 mg) at baseline and post-intervention, respectively. The overall calcium intake of the adolescents remains below the recommended intake level of 1,300 mg. Emotion-based nutritional messages did not significantly increase the total calcium intake among early adolescents.

Knowledge and Assessment of Calcium Intake among Medical Students at the Faculty of Medicine and Pharmacy in Agadir

Despite being aware of the significance of maintaining a well-balanced diet abundant in calcium, medical students frequently struggle with discipline and exhibit subpar adherence to this dietary practice, leading to inadequate nutrition. The study sought to evaluate the medical students’ knowledge and identify its impact on their daily calcium consumption. The study was carried out at the Faculty of Medicine and Pharmacy in Agadir (FMPA) over a period of one year using a cross-sectional design. A self-administered online questionnaire consisting of three sections, namely socio-demographic information, knowledge assessment, and calculation of students' daily calcium intake, was employed. A total of 254 students participated in the survey, with an average age of 20.2 +/- 1.96 years. Out of these, 164 (64.6%) were female and 90 (35.4%) were male. The majority of participants (94.9%) were single, and 186 (73.2%) lived with their families. Regarding the study population, 199 students (78.3%) demonstrated a good level of knowledge regarding calcium. However, the median daily calcium intake was 559 +/-143 and only seven students (2.8%) met the recommended intake of &gt; 1000mg/day according to GRIO guidelines. The results of the study indicated that, despite the heightened awareness among medical students regarding their dietary and lifestyle choices and their good knowledge about calcium intake, there is a disparity between awareness and actual daily calcium consumption. To bridge this gap, it is crucial to enhance awareness further and implement a comprehensive program during their academic years that focuses on promoting increased consumption of calcium-rich foods.

Risk Factors, Manifestation, and Awareness of Osteoporosis among Patients of Various Specialists in Switzerland: Results of a National Survey.

Osteoporosis is the most common chronic metabolic bone disease, known to be underdiagnosed and undertreated in parts of the Swiss population. Due to expected rise in new fragility fractures, adequate awareness of associated risk factors and diagnostic and therapeutic options will be essential for the management of osteoporosis. We therefore explored these aspects in a nationwide survey of Swiss specialists and their patients. A total of 262 physician questionnaires and 9065 patient questionnaires were analyzed, mainly from general practitioners (64.9%), followed by rheumatologists (16.8%), gynecologists (12.2%), and endocrinologists (6.1%). Around 20% of patients were under medication and/or had a medical condition increasing the risk of osteoporosis. Further risk factors, such as low consumption of calcium-rich foods, smoking, elevated alcohol intake, and insufficient physical activity, were present across regions and medical fields. 53.9% of patients did not take calcium/vitamin D supplements; 3.5% reported having fragility fractures, and 7.3% received treatment for osteoporosis. Only 38.5% of surveyed patients knew of the chronic nature of osteoporosis, indicating rather low awareness in this population. Despite generally perceived relevance of osteoporosis for daily practice, aspects of its prevention and management varied across regions and medical fields. Raising awareness among patients and physicians will be vital for addressing osteoporosis on a national scale.

Influence of breakfast and meal frequency in calcium intake among pregnant adolescents.

Calcium is an essential micronutrient that plays a role in growing and pregnancy, and its necessity is increased during pregnancy in adolescence. Thus, the aim of the study is to describe the daily calcium intake and its associations with dietetic habits, sociodemographic data and perinatal outcomes among pregnant adolescents. A prospective cohort study was conducted among primiparous adolescents who started prenatal care before 20 weeks of gestation. Sociodemographic data, weight and height, 24‐h dietary recall (24hRec) and perinatal outcomes were collected over four meetings (three during pregnancy and one in puerperium). All 24hRecs were analysed by the Nutrition Data System for Research (NDSR)® programme, and descriptive analysis and univariate and multivariate logistic regression were done. A total of 150 pregnant adolescents were included, with a mean of daily calcium intake of 659.9 mg (50% of recommended intake). Adolescents who ate more than three meals per day (89.3%), and ate breakfast every day (69.3%), were shown to have higher daily calcium intake, odds ratio (OR CI 95%) of 3.4 (1.0, 11.0) and 16.8 (1.0, 302.1), respectively. No correlation was observed between calcium daily intake and sociodemographic data or perinatal outcomes. Dairy products were the foods that mostly contributed to achieving recommended daily calcium intake. In our cohort, pregnant adolescents had a low daily calcium intake. They should be advised to eat more than three meals per day, eat breakfast in particular, increase the consumption of calcium rich‐foods, such as dairy products and green leafy vegetables, and consider calcium supplementation.

Lead Exposure Reduces Academic Performance: Intensity, Duration, and Nutrition Matter

We leverage a natural experiment, where a large national automotive racing organization switched from leaded to unleaded fuel, to study how ambient lead exposure and nutrition impact learning in elementary school. This provides quasi-experimental evidence linking measured quantities of lead emissions to decreased test scores, information essential for policies addressing ambient lead and emission sources. We find increased levels and duration of exposure to lead negatively affect academic performance, shift the entire academic performance distribution, and negatively impact both younger and older children. Exposure to 10 additional kilograms of lead emissions from lead-fuel races reduces standardized test scores by 0.06 standard deviations, where the average race emitted more than 10 kilograms of lead — a quantity similar to the annual emissions of an airport or a median lead-emitting industrial facility in the United States. This corresponds to an average income reduction of $2,600--$4,000 per treated student in present value terms, an effect size similar to improving teacher value added by one-sixth of a standard deviation, reducing class size by 3 students, or increasing school spending per pupil by $500. The marginal impacts of lead are larger in impoverished, non-white counties, and among students with greater duration of exposure, even after controlling for the total quantity of exposure. Factors correlated with better nutrition — most notably consumption of calcium-rich foods like milk — are associated with smaller negative effects of lead exposure. These results suggest that improved child nutrition can help combat the negative effects of lead, addressing several prominent social issues including racial test gaps, human capital formation across income groups, and disparities in regional environmental justice. Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.

Effects of Consuming Calcium-Rich Foods on the Incidence of Type 2 Diabetes Mellitus.

The effect of calcium consumption in the prevention of type 2 diabetes mellitus (T2DM) remains controversial, and depends on food calcium sources. This prospective study aimed to evaluate the association between calcium-rich food consumption and T2DM incidence among Korean adults. We analyzed the data of 8574 adults aged 40–69 years, without a history of T2DM, cardiovascular disease, and cancer at the baseline from the Korean Genome and Epidemiology Study. The consumption of calcium-rich foods was assessed using a validated semi-quantitative food frequency questionnaire. T2DM-related data were collected using biennial questionnaires, health examinations, and clinical tests. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression models. In the multivariate-adjusted model, yogurt intake was inversely associated with T2DM risk (HR: 0.73; 95% CI: 0.61–0.88 in the fourth quartile as compared to the first quartile). However, the intakes of other calcium-rich foods, including milk and anchovies, were not significantly associated with T2DM risk. Yogurt may provide protective effects against T2DM in Korean adults, owing to the beneficial effects of probiotics. Further prospective large-scale cohort studies should be conducted to validate these findings.

Relationships between bone mass and dietary/lifestyle habits in Japanese women at 3–4 months postpartum

ObjectivesThe relationships between calcaneal bone mass and dietary/lifestyle habits in women at 3–4 months postpartum were examined in the context of osteoporosis prevention. Study designCross-sectional survey. MethodsWe measured bone mass using calcaneal ultrasound in mothers who brought their 3- to 4-month-old babies to healthcare centers in Japan for health examination and administered a self-report questionnaire on physical characteristics and dietary/lifestyle habits to those who agreed to participate in the survey. Valid data were available for 1220 women (valid response rate, 97.5%). ResultsBased on their stiffness score, a measure of bone mass, 70.9% (n = 865) of the participants were classified as ‘no apparent abnormality (stiffness score ≥78.8)’ (low-risk group), 18.2% (n = 222) as ‘guidance required (≥70.1–<78.8)’ (intermediate-risk group), and 10.9% (n = 133) as ‘complete examination required (<70.1)’ (high-risk group), according to the criteria for osteoporosis screening test results. The percentage of individuals with a history of fracture was higher in the guidance required/complete examination required than in the no apparent abnormality group (P = 0.016). The analysis of relationships between the consumption frequency of certain foods, such as calcium-rich foodstuffs, and bone mass found that women who reported lower frequencies of milk and dark-colored (beta-carotene rich) vegetables for breakfast consumption had a significantly lower bone mass than those who consumed these foods more often. Furthermore, the guidance required/complete examination required group had a significantly lower calcium intake than the no apparent abnormality group (P = 0.022). ConclusionsThese results indicate the need to provide postpartum women with dietary education programs to promote healthy eating habits, such as increased consumption of calcium-rich foods, and prevent osteoporosis.

Knowledge, Attitude and Nutritional Behavior of Female High School Students about Consumption of Calcium-Rich Foods in Khorramshahr City, South West of Iran

Background: Calcium is the most abundant mineral in the human body. This mineral is provided only by the consumption of foods containing calcium that it is recommended to use at least1300 mg daily for adults. This study is aimed to investigate the nutritional behavior of female high school students about Consumption of Calcium-Rich Foods.Materials and MethodsAt a descriptive-analytical study, the method of sampling was based on multi-stage random clustering that 168 students were selected from 3 school (each school 56 female students). The data were collected by a research-made questionnaire containing questions in 4 parts including: the demographic features, the knowledge and attitude of students about consumption of calcium-rich foods and the fourth part included semi-quantitative food frequency table (FFQ) that was taught to the subjects and the correct understanding of the education was evaluated. The data were analyzed by SPSS-17.Results: The mean age of girls participated was 16+ 0.738 years. There were significant relationship between all demographic variables such as job, education and monthly income and consumption of calcium-rich foods (P<0.05). The knowledge of students about Consumption of Calcium-Rich Foods were 28% (poor), 50.6% (moderate) and 21.4% (good) respectively; and attitude of them were: 29.2%(poor), 47.6% (moderate) and 23.3% (good) respectively. Moreover, 57.1% of the students had not consumed enough calcium in their regimes. There was a significant correlation between students attitudes and their behavior of the consumption of calcium-rich foods (P<0.05; r=0.181).Conclusion: The current study indicated that in female students, the improvement of students' attitude and knowledge about consumption of calcium-rich foods can be achieved using focused group discussion and suitable education. According to the results of this study, students’ knowledge and attitude of students about consumption of calcium-rich foods are not acceptable.

Field testing a questionnaire assessing parental psychosocial factors related to consumption of calcium-rich foods by Hispanic, Asian, and Non-Hispanic white young adolescent children

ABSTRACTIntervention strategies to increase calcium intake of parents and young adolescent children could be improved by identifying psychosocial factors influencing intake. The objective was to develop a tool to assess factors related to calcium intake among parents and Hispanic, Asian, and non-Hispanic white young adolescent children (10–13 years) meeting acceptable standards for psychometric properties. A parent questionnaire was constructed from interviews conducted to identify factors. Parents (n = 166) in the United States completed the questionnaire, with seventy-one completing it twice. Two constructs (Attitudes/Preferences and Social/Environmental) were identified and described by eighteen subscales with Cronbach’s alpha levels from .50 to .79. Test-retest coefficients ranged from .68 to .85 (p < .001). Several subscales were statistically significantly associated with parent characteristics consistent with theory and published literature. This tool shows promise as a valid and reliable measure of factors associated with calcium-rich food intake among parents and young adolescent children.

The Effect of Family-Centered Education on Increasing Consumption of Calcium-Rich Foods in the Family Food Basket

Background: Getting enough calcium in growing is necessary to achieve peak bone mass and to prevent osteoporosis in adulthood and aging. Objectives: Given the importance of women's role in arranging and preparing the family food basket, the present study aimed to raise the mothers' knowledge and attitude to increase consumption of calcium-rich foods in family food basket and enhance adolescent girl’s performance in the city of Chabahar. Patients and Methods: This experimental study was performed on mothers of female students in the fifth grade of primary school in selected primary schools of Chabahar city during 2014. The population under study was selected by random sampling multi-stage stratified method. The study comprised 170 eligible mothers including 88 controls and 82 tests, selected on voluntary basis, who provided their written informed consent to participate in the study. Data collection tool was validated and reliable self-administered questionnaire consisting of three sections. These included demographic information and questions related KAP (knowledge, attitudes and practice) model comprising three structures so called knowledge, attitude and practice related to calcium containing foods. The completion of questionnaire was based on self-report and interview in two stages by the researcher, before and three months after educational intervention. The data collected were analyzed by SPSS-16 using descriptive and analytical statistical tests such as paired T-test at α = 0.05. Results: A statistically significant mean score of knowledge and attitude was found after intervention in case group. However, the changes in mean score performance variables after the intervention in the case group were not significant. Conclusions: Designed and implemented educational intervention was effective in increasing the mother’s knowledge and attitude, but was not effective regarding the intake of calcium-rich foods in target group. This weakness can be attributed primarily to the content and type of intervention carried out and secondly to insufficient educational interventions and sample size compatible with acceptable performance that suggested conducting more effective educational and ecological interventions.

Perceived threat predictor of calcium-rich foods in the women of premenopausal age Isfahan - Iran in 2013-2014

Background:During women lives, frequently face the challenge of calcium reduction and absorption. Decreased calcium absorption followed by a decrease in estrogen at perimenopausal ages, low average per capita calcium intake among women, wrong nutritional behavior, household income reductions and make them more susceptible to osteoporosis and related complications. The aim of this study was to evaluate the relationship between the health belief model constructs and consuming calcium-rich foods in menopausal age women.Materials and Methods:This study was descriptive-correlation study. The questionnaires were completed by 210 menopausal women who had referred to health centers. The research data were analyzed using: Frequency distribution, mean score, Pearson correlation coefficients and multivariate regression. Significant level of P < 0/05 were considered.Results:The mean and standard deviation of the scores for perceived susceptibility and severity of the threats of consumption and complications of inadequate intake were respectively: (62.1 and 38.9, and 60.2 and 39.9) and (59.6 and 37.9 and 56.3 and 36.5). The relationship between the number of units of calcium intake with perceived susceptibility and severity calcium intake and complications caused by the inadequate intake of calcium were (P < 0.001, r = 0.581, r = 0.651) and (P < 0.001, r = 0.634, r = 0.567).Conclusions:The obtained results indicate that perceived threat is the prognostic factor for the intake of calcium-rich foods and the increase of perceived threat in the health promotion programs may be associated with the increase in the consumption of calcium-rich foods in the women of premenopausal age.

Banking on Strong Bones Curriculum Promotes Behavior Change

The curriculum is designed to increase knowledge/awareness of the role calcium-rich and weight-bearing activities play in building and maintaining strong bones among children and to improve food and beverage choices based on Dietary Guidelines recommendations. Fourth-grade children and their families have participated in the program. Informed by social cognitive theory, this curriculum uses peer modeling, environmental support and goal-setting to promote behavior change. An estimated 70% of pre-teen girls and 60% of pre-teen boys do not meet the daily calcium recommendation, which places them at risk of developing osteoporosis as adults. A 5-lesson curriculum was designed for use in school classrooms during a 5-week time frame. The program includes hands-on activities, calcium tracking, educational displays, follow-up activities for the teacher, participation incentives using “cow coins” and “cow banks”, and optional taste testing activities. Parents/caregivers were provided with weekly newsletters summarizing their child's activities, along with nutrition information, recipes and goal-setting activities. Pre- and post-surveys of children and parents assessed knowledge gain and achievement of nutrition-related goals. Participants (n=9,163; 49.7% male) significantly increased their knowledge of calcium sources, indicated preference for milk over soda/pop, increased their self-reported consumption of calcium-rich foods and decreased their consumption of sweetened beverages (p <.05). About 51% of parents/caregivers reported a positive change in the children's eating habits at home. Classroom nutrition education with parent involvement can promote behavior change to increase calcium consumption.

Impact of a Nutrition Education Program to Increase Intake of Calcium-Rich Foods by Chinese-American Women

Chinese-American women have a high risk of osteoporosis. However, their calcium intake has been reported previously as considerably below the Dietary Reference Intake. Increasing consumption of calcium-rich foods, many of which are also fortified with vitamin D, is a safe way to increase their calcium and vitamin D intake. This study's objective was to pilot-test an intervention to help Chinese-American women incorporate calcium-rich foods into their diet. This intervention was evaluated using a quasi-experimental study with a nested design and pre-, immediate post-, and 3-month follow-up assessments. Calcium and vitamin D intake, Theory of Planned Behavior constructs, and knowledge were measured at three time points. First-generation Chinese-American mothers between 35 and 55 years old (n=141) were recruited from six weekend Chinese schools. Three Chinese schools each were randomly assigned to the experimental (n=71) or control group (n=70). The experimental group received a free heel scan and six weekly interactive lessons designed based on the Theory of Planned Behavior. The control group received six weekly nonrelated financial lessons by mail. Changes for each measure were assessed by linear mixed model with repeated measures adjusted for confounding variables. Compared to the control group, the experimental group improved all measures considerably, except two subjective norm constructs (normative belief and motivation to comply) at post-assessments. The experimental group significantly increased its baseline calcium ( t=7.898, P<0.001) and vitamin D intake ( t=6.609; P<0.001) at posttest and this increase was retained at follow-up. Results suggest that this theory-based intervention is effective for increasing the dietary calcium and vitamin D intake of Chinese-American women.

Partnering with Middle School Health Teachers Promotes Calcium Consumption Among Students

Since 2000, the “Calcium, It's Not Just Milk” program has partnered with middle school science teachers to promote an increase in awareness, knowledge, and skills related to increasing consumption of calcium-rich foods among the target audience.

Prevalence of Metabolic Syndrome and Associated Risk Factors in Illinois

To examine the prevalence of metabolic syndrome (MS) in Illinois and associated risk factors to document emerging problems as a basis for preventive and/or therapeutic interventions. The 2005 Illinois Behavioral Risk Factor Surveillance System data were analyzed for prevalence rates and relative risk (RR) of risk factors for MS. Illinois. Representative sample of 5077 noninstitutionalized Illinoisans aged > or = 18. Presence of diabetes, hypertension, hypercholesterolemia, angina, and obesity; adequate fruit/vegetable intake; adequate daily physical activity; routine consumption of calcium-rich foods; smoking; and demographic variables. Prevalence, chi-square, RR, and analyses of variance. MS prevalence was 16.2%. The RR for MS was 8 for those having diabetes; 20 for those with hypertension; 14 for those with hypercholesterolemia; 6 for those with angina; and 7 for those with obesity. Fruit/vegetable intake did not significantly influence the RR (RR = 1.01), but RR was greater when calcium-rich foods were not routinely consumed (RR = 1.61) and with inadequate physical activity (RR = 1.85). MS prevalence was highest in those over 65 years; with incomes < $15,000; and among Blacks. Differences among those with one through five indicators of MS were not significant for fruit/vegetable intake, but were for physical activity, age group, income, and education level (p < .001). These findings reveal that MS prevention should be emphasized for lower-income, older Blacks. Increasing physical activity and calcium-rich foods are areas for community-based education.

Development of a Tool to Identify Psychosocial Factors Associated with Consumption of Calcium Rich Foods Among Parents of Early Adolescents

Development of a Tool to Identify Psychosocial Factors Associated with Consumption of Calcium Rich Foods Among Parents of Early Adolescents

Perspectives on Intake of Calcium-Rich Foods Among Asian, Hispanic, and White Preadolescent and Adolescent Females

Objective Declining calcium intake among adolescents warrants attention. Our objective was to identify influences on adolescents' consumption of calcium-rich foods. Design Focus groups were conducted with girls representing 2 age groups (11 to 12 or 16 to 17 years) and 3 macroethnic groups (Asian, Hispanic, or white). Setting Public schools in 10 states. Participants A convenience sample (n = 200) was recruited through schools. Variables Measured Focus groups (n = 35) were audiotaped and transcribed. Influences relative to consumption of milk or other calcium-rich foods were identified. Analysis Comments were coded as motivators or barriers within each focus group. Content analysis procedures were used to compare ethnic and age groups. Results A barrier to milk consumption that was more common among older girls and Asian groups was the limited expectation within families for drinking milk. Many controlled their own beverage choices, and milk, even if liked, was only one option. Milk was positively associated with strength and bone health, but these attributes were viewed as being more important for boys than girls. Milk was associated with breakfast, school lunches, cereal, and desserts. White girls had the most positive reactions to milk and Hispanic girls the most negative. All groups were positive toward pizza, ice cream, and cheese. Conclusions and Implications To improve calcium intake among teens, interventions should include a family component, stress the benefits of milk for girls, and focus on breakfast.

Factors Influencing the Consumption of Calcium-Rich Foods among Adolescents

The purpose of this study was to identify factors influencing the consumption of calcium - rich foods among adolescents. A total of 96 adolescents divided into twelve focus groups were investigated during April to May 2000 in Busan. Focus group discussions were audio - taped, transcribed and analyzed using a grounded theory approach. Key factors influencing the consumption of calcium - rich foods were taste, food type, body image, and family. Motivators among the factors were taste, food type, body image, health, family and perception, and barriers were taste, food type, location, friends, price, weather and lactose intolerance. Taste, food type, location and weather were found to be both motivators and barriers of consumption of calcium - rich foods according to circumstances. Some of these factors varied in importance by gender and age. Younger adolescents were more strongly influenced by taste and family than older ones. Older adolescents were strongly influenced by body image, convenience and perception. These findings could be used as a guideline for adolescents to consume calciumrich foods.

The role of calcium in health and disease

Skeletal fragility at the end of the life span (osteoporosis) is a major source of morbidity and mortality. Adequate calcium intake from childhood to the end of the life span is critical for the formation and retention of a healthy skeleton. High intakes of calcium and vitamin D potentiate the bone loss prevention effects of hormone replacement therapy in postmenopausal women. Pregnancy and lactation are not risk factors for skeletal fragility, although lactation is associated with a transient loss of bone that cannot be prevented by calcium supplementation. Low calcium intake has been implicated in the development of hypertension, colon cancer, and premenstrual syndrome, and it is associated with low intakes of many other nutrients. Encouragement of increased consumption of calcium-rich foods has the potential to be a cost-effective strategy for reducing fracture incidence later in life and for increasing patients’ dietary quality and overall health. (Am J Obstet Gynecol 1999;181:1560-9.)