Daily Calcium Intake Research Articles

Nano-calcium Powder Properties from Six Commercial Fish Bone Waste in Indonesia

Low daily calcium intake in Asia, especially in Indonesia, is still a serious problem. The abundant fish bone waste from the fishery fillet industries in Indonesia, can be employed as an alternative source of calcium to meet daily calcium needs. This research aimed to determine which of the six fish species (tilapia, catfish, grouper, snapper, tuna, kingfish mackerel) produces the best quality and the most cost-effective nano-calcium powder for a recommendation to the stakeholders. The calcium was extracted using an alkali treatment. The properties of the produced nano-calcium powders were analyzed for: proximate composition, calcium and phosphorus levels, color brightness level, XRD, FTIR, particle size, and SEM-EDX image analysis. The tilapia bone had the finest particle size of calcium (87.37 nm), while the grouper bone had the biggest particle size (281.4 nm). The brightness of all yields varied from 83.83 (beige-kingfish mackerel) to 90.64 (white-tilapia). The average calcium content from EDX analysis varied from 21.51% (snapper) to 34.37% (grouper). The average phosphorus levels ranged from 10.73% (kingfish mackerel) to 15.99% (grouper). The EDX Ca/P molar ratio was 1.41-1.66 across all samples. The FTIR spectra showed that all samples contained PO, CH, CO, NH, and OH groups. The XRD spectra pattern determined that the two main components of the fish bone nano-calcium powder were 90% hydroxyapatite and halite. All fish bone samples have the potential to be used as raw material for nano-sized calcium. However, grouper bone with the highest calcium content and the highest nano-calcium yield was the best choice for further study.

Associations of dietary intakes of calcium, magnesium and soy isoflavones with osteoporotic fracture risk in postmenopausal women: a prospective study.

The role of dietary factors in osteoporotic fractures (OFs) in women is not fully elucidated. We investigated the associations between incidence of OF and dietary calcium, magnesium and soy isoflavone intake in a longitudinal study of 48 584 postmenopausal women. Multivariable Cox regression was applied to derive hazard ratios (HRs) and 95 % confidence intervals (CIs) to evaluate associations between dietary intake, based on the averages of two assessments that took place with a median interval of 2⋅4 years, and fracture risk. The average age of study participants is 61⋅4 years (range 43⋅3-76⋅7 years) at study entry. During a median follow-up of 10⋅1 years, 4⋅3 % participants experienced OF. Compared with daily calcium intake ≤400 mg/d, higher calcium intake (>400 mg/d) was significantly associated with about a 40-50 % reduction of OF risk among women with a calcium/magnesium (Ca/Mg) intake ratio ≥1⋅7. Among women with prior fracture history, high soy isoflavone intake was associated with reduced OF risk; the HR was 0⋅72 (95 % CI 0⋅55, 0⋅93) for the highest (>42⋅0 mg/d) v. lowest (<18⋅7 mg/d) quartile intake. This inverse association was more evident among recently menopausal women (<10 years). No significant association between magnesium intake and OF risk was observed. Our findings provide novel information suggesting that the association of OF risk with dietary calcium intake was modified by Ca/Mg ratio, and soy isoflavone intake was modified by history of fractures and time since menopause. Our findings, if confirmed, can help to guide further dietary intervention strategies for OF prevention.

Temporal Trends of Dietary Risk Factors after a Diagnosis of Kidney Stones.

Diet is an important contributor to kidney stone formation, but there are limited data regarding long-term changes in dietary factors after a kidney stone. We analyzed data from three longitudinal cohorts, the Health Professionals Follow-Up Study and Nurses' Health Study I and II, comparing changes in dietary factors in participants with and without kidney stones during follow-up. The daily intake of dietary calcium, supplemental calcium, animal protein, caffeine, fructose, potassium, sodium, oxalate, phytate, vitamin D, vitamin C, sugar-sweetened beverages, fluids, net endogenous acid production, and Dietary Approaches to Stop Hypertension score were assessed by repeat food frequency questionnaires and computed as absolute differences; a difference-in-differences approach was used to account for temporal changes using data from participants without kidney stones from the same calendar period. Included were 184,398 participants with no history of kidney stones, 7095 of whom became confirmed stone formers. Several intakes changed significantly over time in stone formers, with some showing a relative increase up to 8 years later, including caffeine (difference in differences, 8.8 mg/d; 95% confidence interval [95% CI], 3.4 to 14.1), potassium (23.4 mg/d; 95% CI, 4.6 to 42.3), phytate (12.1 mg/d; 95% CI, 2.5 to 21.7), sodium (43.1 mg/d; 95% CI, 19.8 to 66.5), and fluids (47.1 ml/d; 95% CI, 22.7 to 71.5). Other dietary factors showed a significant decrease, such as oxalate (-7.3 mg/d; 95% CI, -11.4 to -3.2), vitamin C (-34.2 mg/d; 95% CI, -48.8 to -19.6), and vitamin D (-18.0 IU/d; 95% CI, -27.9 to -8.0). A significant reduction was observed in sugar-sweetened beverages intake of -0.5 (95% CI, -0.8 to -0.3) and -1.4 (95% CI, -1.8 to -1.0) servings per week and supplemental calcium of -105.1 (95% CI, -135.4 to -74.7) and -69.4 (95% CI, -95.4 to -43.4) mg/d for women from Nurses' Health Study I and II, respectively. Animal protein, dietary calcium, fructose intake, Dietary Approaches to Stop Hypertension score, and net endogenous acid production did not change significantly over time. After the first episode of a kidney stone, mild and inconsistent changes were observed concerning dietary factors associated with kidney stone formation.

Clinical presentation, etiological factors, and outcome in children diagnosed with urolithiasis in Ghaziabad, Uttar Pradesh

Background: Children with urolithiasis (UL) are often encountered in general pediatric practice. Its rising incidence, high recurrence rate, serious long-term consequences, and paucity of data on pediatric UL led to the present research work. Recurrence usually remains unaltered unless dietary restrictions are followed stringently, so the emphasis in the present research was on the analysis of the diet consumed by participants. Materials and Methods: Children with UL were enrolled from the general pediatrics outpatient department of an urban hospital over 22 months in a prospective study. Data were collected on clinical profile, 24 h dietary details, blood and urine investigations, and ultrasound (USG) abdomen. Attempts were made to get basic metabolic work-up in as many children as possible. Results: Abdominal pain alone or with symptoms of urinary tract infection (UTI) was found in 40 (83.3%) and 22 (45.8%) participants. Important etiological associations found were UTI (30, 62.7%), positive family history of UL (22, 45.8%), and obesity (5, 10.4%). Idiopathic hypercalciuria, hyperuricosuria, and hyperoxaluria were found in 9 (18.7%), 2 (4.2%), and 12 (25%) participants. Daily intake of liquids and calcium was low in 38 (79%) and 35 (72.9%) children, respectively. Intake of both salt and proteins was high in 30 (62.5%) children. The persistence of symptoms was found in 28 (58.3%) participants. Recurrence was found in 7 (14.5%) participants. Conclusion: Having a high index of suspicion of UL in all children presenting with recurrent unexplained UTI and/or recurrent abdominal pain and advocating USG abdomen early in such children can aid in the timely diagnosis of UL. Simple dietary manipulations such as adequate daily fluid and calcium intake along with avoiding high salt and animal protein diet may be beneficial by decreasing the recurrence rate of UL.

Bariatric surgery and skeletal health: A narrative review and position statement for management by the European Calcified Tissue Society (ECTS).

Numerous studies have demonstrated detrimental skeletal consequences following bariatric surgery. A working group of the European Calcified Tissue Society (ECTS) performed an updated review of existing literature on changes of bone turnover markers (BTMs), bone mineral density (BMD), and fracture risk following bariatric surgery and provided advice on management based on expert opinion. Based on observational studies, bariatric surgery is associated with a 21-44% higher risk of all fractures. Fracture risk is time-dependent and increases approximately 3years after bariatric surgery. The bariatric procedures that have a malabsorptive component (including Roux-en-Y Gastric bypass (RYGB) and biliopancreatic diversion (BPD)) have clearly been associated with the highest risk of fracture. The extent of high-turnover bone loss suggests a severe skeletal insult. This is associated with diminished bone strength and compromised microarchitecture. RYGB was the most performed bariatric procedure worldwide until very recently, when sleeve gastrectomy (SG) became more prominent. There is growing evidence that RYGB is associated with greater reduction in BMD, greater increase in BTMs, and higher risk of fractures compared with SG but RCTs on optimal management are still lacking. In all patients, it is mandatory to treat vitamin D deficiency, to achieve adequate daily calcium and protein intake and to promote physical activity before and following bariatric surgery. In post-menopausal women and men older than 50years, osteoporosis treatment would be reasonable in the presence of any of the following criteria: i) history of recent fragility fracture after 40years of age, ii) BMD T-score≤-2 at hip or spine, iii) FRAX score with femoral neck BMD exceeding 20% for the 10-year major osteoporotic fracture probability or exceeding 3% for hip fracture. Zoledronate as first choice should be preferred due to intolerance of oral formulations and malabsorption. Zoledronate should be used with caution due to hypocemia risk. It is recommended to ensure adequate 25-OH vitamin D level and calcium supplementation before administering zoledronate. The bariatric procedures that have a malabsorptive component have been associated with the highest turnover bone loss and risk of fracture. There is a knowledge gap on osteoporosis treatment in patients undergoing bariatric surgery. More research is necessary to direct and support guidelines.

Hot Flashes in Adolescence and Young Adult Females: a Link to Vitamin D and Calcium.

Background:Menopause is a stage in life when a woman stops having menstruation and the ovaries produce less estrogen. Hot flashes (HFs) are the classical symptoms for menopausal transition and cessation of menses. Increased anxiety had been reported as a significant risk factor of HFs. Vitamin D deficiency and low daily dietary calcium intake may be associated with the occurrence of hot flashes (HFs) in adolescents and young females that are not related to hormonal changes of menopausal transition.Objective:The aim of this study is to validate this hypothesis.Methods:A case-control study was conducted. Thirty-eight females (38) with HFs aged 18-40 years, and 38 age-matched healthy controls with no HFs were involved. Participants answered questions about HFs symptoms. Psychological symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). Serum vitamin D, Follicle Stimulating Hormone, Estradiol, and Prolactin were measured.Results:Vitamin D deficiency, psychological symptoms, and Musculoskeletal pain (MSP) were more prevalent in cases versus controls. About 73.68% of females had HFs on a daily basis, 73.7% of them reported that their HFs associated with excessive sweating. Spearman correlation revealed that number of daily HFs were correlated positively and significantly with anxiety scores (r2= -0.278, p=0.045), and average MSP pain (r2=-0.536, p=<0.001). Binary logistic regression showed that, Anxiety score and vitamin D status, (OR=1.33(1.104-1.7), p=0.02, and OR=0.89(0.79-0.99, p=0.03) respectively were the predictors for HFs.Conclusion:This study showed that adolescents and young females may experience HFs that are not related to hormonal changes of menopausal transition. The predictors for HFs were vitamin D deficiency and anxiety.

Assessment of calcium intake in Costa Rica and Panama with the International Osteoporosis Foundation calcium calculator

Introduction: calcium intake is fundamental over the whole life cycle; despite this, the world consumption of calcium is deficient. In Central America, there is little data on calcium intake. Objective: to evaluate daily calcium intake in the adult population of Costa Rica and Panama. Methods: an adult's population (> 18) survey was conducted in both countries. A questionnaire specifically design for the study was applied to subjects that were willing to participate after they signed of the informed consent form. The International Osteoporosis Foundation (IOF) calcium calculator was used to quantify their calcium intake. Results: the study included 1189 participants, 50 % were men. The median calcium intake was 862 mg/d (IQR, 650.5 to 1115) in Costa Rica and 825.5 mg/d (IQR, 579.75 to 1029.2) in Panama. Significant differences were found between calcium intake and age group in Costa Ricans, while in the Panamanian population differences were found in calcium intake according to educational level. Conclusion: this study is the first one conducted in Central America using the IOF calcium intake calculator. The study shows that calcium intake is deficient in Costa Rica and Panama. It is necessary to establish educational campaigns in both countries to correct this deficiency.

Nutritional Deficiencies and Features of Nutritional Provision in Primary School Children

Nutritional Deficiencies and Features of Nutritional Provision in Primary School Children

Study of the association of the nutritional profile of pregnant women with the birth weight of newborns in Morocco.

Low birth weight (LBW) is an important predictor of neonatal morbidity and mortality. It reflects the nutritional status of the mother and the quality of health care services during pregnancy. The objective of this study is to determine the factors associated with low birth weight of children born to Moroccan pregnant women in the province of El Jadida. This cross-sectional case-control study was carried out in the maternity ward of El Jadida provincial hospital on 344 parturient women, half of whom had given birth to children with an LBW and the other half of children with normal weight (NW) at birth. Information on maternal gestational and socioeconomic characteristics as well as eating habits was collected using a questionnaire and anthropometric measurements were taken on the newborns. The study identified 172 parturient who gave birth to newborns with LBW and 172 parturient who gave birth to newborns of NW. The proportions of LBW are greater in first-time mothers (50.6%) and professionally inactive (86.6%). The mean weight of LBW newborns is 2013.95 ± 372.95g compared to 3380 ± 217.59g for NW newborns. The determined factors associated with LBW are the low socio-economic level (OR = 3.18; 95% CI: 1.09-9.23), insufficient monitoring of prenatal consultation (OR = 2.91; 95% CI: 1, 71-4.95), origin from rural areas (OR = 0.52; 95% CI: 0.30-0.91) and lack of nutritional education (OR = 0.17; 95% CI: 0, 09-0.34). The daily calcium intake in mothers of newborns with LBW is 33.82% of the recommended daily allowance (RDA), the daily iron requirement coverage was 50%, folates 66, 16% and zinc 87.72% of the RDA. Well-targeted and coordinated education and awareness-raising actions on early pregnancy and feeding pregnant women could have a positive impact on improving the birth rate of children with a weight deficit.

The Relationship between Modern Fad Diets and Kidney Stone Disease: A Systematic Review of Literature.

Objectives: Kidney stone disease (KSD) has a strong association with diet metabolic syndrome. This review aims at exploring the lithogenic risk posed by the current most popular diets. Our approach was to search for the effect of each diet type on the major urinary risk factors, to try to draw conclusions regarding the association of a specific diet type and KSD. Methods: This systematic review searched for the available literature exploring the association between the existing popular fad diets and KSD. Articles in English, French and Spanish were included, without restriction of the search period with the final search done in August 2021. Results: Total number of studies and studies for each diet type was as follows: 22 articles for the low carbohydrate diet, 20 articles for high protein diets, 26 articles for vegetarian and vegan diets. There exists a substantial variability in different low carbohydrate and high protein diets, and considerable overlap between modern popular fad diets. High carbohydrate intake might increase urine uric acid, calcium and oxalate levels. High protein diets increase urine calcium and uric acid and lower urine pH and citrate. Consumption of fruits and vegetables increases the urinary volume and urinary citrate. In vegan diets, sufficient daily calcium intake is important to avoid possible secondary hyperoxaluria. Conclusions: Few studies evaluated the direct relationship between modern fad diets and KSD. In general, the reduction of carbohydrate in the diet, and counterbalancing protein rich diets with sufficient intake of fruits and vegetables, seem to play a protective role against KSD formation. Maintaining sufficient calcium intake in vegan and vegetarian diets is important. Additional research is needed to directly evaluate the link between KSD and each diet type.

Differences in Fat-Free Mass According to Serum Vitamin D Level and Calcium Intake: Korea National Health and Nutrition Examination Survey 2008-2011.

We analyzed the differences in fat-free mass (FFM) according to serum vitamin D level (VitD) and daily calcium intake (Ca) in 14,444 adults aged over 19 years. We used data from the 4th and 5th Korea National Health and Nutrition Examination Surveys (2008–2011). FFM was measured using dual-energy X-ray absorptiometry. VitD was classified as insufficient or sufficient (cutoff: 20 ng/mL). Ca was classified as unsatisfactory or satisfactory (recommended daily intake: 700 mg). In men, the FFM of group 2 (VitD ≥ 20 ng/mL; Ca < 700 mg), group 3 (VitD < 20 ng/mL; Ca ≥ 700 mg) and group 4 (VitD ≥ 20 ng/mL; Ca ≥ 700 mg) was 0.50 kg (95% confidence interval (CI), 0.084–0.92), 0.78 kg (95% CI, 0.26–1.29) and 1.58 kg (95% CI, 0.95–2.21) higher than that of group 1 (VitD < 20 ng/mL; Ca < 700 mg), respectively. In women, a 1 ng/mL increase in VitD was associated with a 0.023 kg increase in FFM (95% CI, 0.003–0.043) and a 1 g increase in Ca was associated with a 0.62 kg increase in FFM (95% CI, 0.067–1.16). High VitD and Ca were associated with a high FFM.

135 VITAMIN D FORTIFIED MILK—EFFECT ON VITAMIN D STATUS IN OLDER ADULTS

Abstract Background Vitamin D fortified milk is used by some older adults to boost vitamin D status. Combined vitamin D/calcium supplements often cause gastrointestinal upset which reduces adherence. Consumption of fortified milk may be a more consistent and reliable way of increasing serum 25 hydroxyvitamin D [25(OH)D], though studies of it’s efficacy in older adults are limited. Methods We examined the vitamin D status of users of vitamin D fortified milk in participants of a longitudinal study of community dwelling Irish adults aged &amp;gt;60 yrs. Patients taking vitamin D supplements were excluded and independent effects were explored in multinomial regression models. Vitamin D deficiency was defined as a 25(OH)D level &amp;lt; 30 nmol/l. Results 2496 participants were identified: mean age was 70.5 ± 7.0 years (range 60–96 yrs) and 145 (5.8%) reported using vitamin D fortified milk. In those who consumed fortified milk, there was a lower prevalence of vitamin D deficiency (17.9 vs 34.5%, P &amp;lt; 0.001). Vitamin D fortified milk also predicted less deficiency after adjusting for age, gender, season, BMI and physical frailty (OR 0.30. CI 0.19–0.48, P &amp;lt; 0.001). Conclusion Vitamin D fortified milk was associated with a 70% reduction in the risk of vitamin D deficiency in older adults not taking vitamin D supplements. Findings support the use of vitamin D fortified milk as an effective means of improving vitamin D status. Fortified milk also contains additional calcium and so can be used to augment daily calcium intake.

100 YEARS OF VITAMIN D: Dietary intake and main food sources of vitamin D and calcium in Colombian urban adults.

Data on dietary calcium and vitamin D intake from Latin America are scarce. We explored the main correlates and dietary sources of calcium and vitamin D in a probabilistic, population-based sample from Colombia. We studied 1554 participants aged 18–75 from five different geographical regions. Dietary intake was assessed by employing a 157-item semi-quantitative food frequency questionnaire and national and international food composition tables. Daily vitamin D intake decreased with increasing age, from 230 IU/day in the 18–39 age group to 184 IU/day in the 60–75 age group (P -trend < 0.001). Vitamin D intake was positively associated with socioeconomic status (SES) (196 IU/day in lowest vs 234 in highest SES, P-trend < 0.001), and with educational level (176 IU/day in lowest vs 226 in highest education level, P-trend < 0.001). Daily calcium intake also decreased with age, from 1376 mg/day in the 18–39 age group to 1120 mg/day in the 60–75 age group (P -trend < 0.001). Calcium intake was lowest among participants with only elementary education, but the absolute difference in calcium intake between extreme education categories was smaller than for vitamin D (1107 vs 1274 mg/day, P-trend = 0.023). Daily calcium intake did not correlate with SES (P -trend = 0.74). Eggs were the main source of overall vitamin D, albeit their contribution decreased with increasing age. Dairy products contributed at least 48% of dietary calcium in all subgroups, mostly from cheese-containing traditional foods. SES and education were the key correlates of vitamin D and calcium intake. These findings may contribute to shape public health interventions in Latin American countries.

Association of blood pressure with dietary intake, physical activity, and anthropometric measurements in Turkish adolescents.

Determining high blood pressure in childhood is an important step to reduce the risk of occurrence of high blood pressure-related diseases in adulthood. This study aimed to assess the association of blood pressure with dietary intake, physical activity, and anthropometric measurements in Turkish adolescents. This cross-sectional study included 370 students (202 females, 168 males) aged 14 to 18 years from one private and one public school in Kayseri, Turkey. Some anthropometric measurements and 24-hour dietary recall of the students were obtained. Their blood pressures were measured, and the International Physical Activity Questionnaire and the Mediterranean Diet Quality Index (KIDMED) were used. The body mass index (BMI) mean and waist/height ratio of the hypertensive group were significantly higher than those of the prehypertensive group, whereas their daily potassium, calcium, and magnesium intakes were significantly lower than those of the normotensive group. The percentage of individuals with very low diet quality was higher in the hypertensive group than in the normotensive group (P > 0.05). The percentage of participants with sufficient physical activity was higher in the normotensive group than in the prehypertensive and hypertensive groups. Factors such as high BMI and waist/height rates; low calcium, magnesium, and potassium intakes with diet; insufficient physical activity; and low quality of diet might cause an increase in the blood pressure.

Prevention of hypoparathyroidism with the use of calcium-rich foods in the total thyroidectomy pre-operative period

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Transient hypocalcemia after total thyroidectomy (TT) is a common surgical complication. Authors used calcium supplements in different doses and periods, mainly after TT to try to avoid hypocalcemia. Indistinct use has been challenged due to complications. Currently, the risk of hypocalcemia was assessed by measuring parathormone (PTH) after TT; however, without a consensus on the best time and amount to consider. The objectives of this study were to evaluate the incidence of hypoparathyroidism with the use of calcium-rich foods in the pre-operative period of TT, followed by a measurement of PTH performed 12 hours after such procedure&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A preliminary study with 31 patients earmarked for TT. Patients were divided into two groups: (A) without calcium-rich foods intake in the TT pre-operative period; and (B) with the intake of calcium-rich foods, in the TT pre-operative period. These foods composing different menus have been suggested, based on the need for daily calcium intake, according to the age group and nutritional data of the Dietary reference intake (DRI). Beginning of the use of these foods has been standardized as being seven days before surgery, due to the slower calcium intestinal absorption process. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Group B, when compared to A, showed a significant difference between PTH values, before and after surgery (p value &amp;lt;0.001).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Calcium-rich foods intake in the conditions reported may be associated with lower rates of hypoparathyroidism.&lt;/p&gt;

Identifying Clinical Characteristics of Hypoparathyroidism in Turkey: HIPOPARATURK-NET Study.

Hypoparathyroidism is an orphan disease with ill-defined epidemiology that is subject to geographic variability. We conducted this study to assess the demographics, etiologic distribution, treatment patterns and complication frequency of patients with chronic hypoparathyroidism in Turkey. This is a retrospective, cross-sectional database study, with collaboration of 30 endocrinology centers located in 20 cities across seven geographical regions of Turkey. A total of 830 adults (mean age 49.6 ± 13.5years; female 81.2%) with hypoparathyroidism (mean duration 9.7 ± 9.0years) were included in the final analysis. Hypoparathyroidism was predominantly surgery-induced (n = 686, 82.6%). The insulting surgeries was carried out mostly due to benign causes in postsurgical group (SG) (n = 504, 73.5%) while patients in nonsurgical group (NSG) was most frequently classified as idiopathic (n = 103, 71.5%). The treatment was highly dependent on calcium salts (n = 771, 92.9%), calcitriol (n = 786, 94.7%) and to a lower extent cholecalciferol use (n = 635, 76.5%) while the rate of parathyroid hormone (n = 2, 0.2%) use was low. Serum calcium levels were most frequently kept in the normal range (sCa 8.5-10.5mg/dL, n = 383, 46.1%) which might be higher than desired for this patient group. NSG had a lower mean plasma PTH concentration (6.42 ± 5.53 vs. 9.09 ± 7.08ng/l, p < 0.0001), higher daily intake of elementary calcium (2038 ± 1214 vs. 1846 ± 1355mg/day, p = 0.0193) and calcitriol (0.78 ± 0.39 vs. 0.69 ± 0.38mcg/day, p = 0.0057), a higher rate of chronic renal disease (9.7% vs. 3.6%, p = 0.0017), epilepsy (6.3% vs. 1.6%, p = 0.0009), intracranial calcifications (11.8% vs. 7.3%, p < 0.0001) and cataracts (22.2% vs. 13.7%, p = 0.0096) compared to SG. In conclusion, postsurgical hypoparathyroidism is the dominant etiology of hypoparathyroidism in Turkey while the nonsurgical patients have a higher disease burden with greater need for medications and increased risk of complications than the postsurgical patients.

Role of Diet in Renal Stone Disease in Indian Population: A Case Control Study

Background: Renal stone is a multifactorial disease with major risk factors of genetic, demographic, environmental, diet, obesity, and metabolic syndrome. This study was conducted to determine the role of diet in renal stone disease and to identify the disease risk factors.Methods: A case control study was conducted among renal stone patients attending a tertiary hospital, East Delhi, India. Data collection was done using a questionnaire for demographic profle and food frequency questionnaire. Daily intake of calories, proteins, carbohydrates, calcium, oxalate, fber, and salts were determined between cases and controls.Results: The mean age was 34.4 years and the median energy intake was 1176.43 kcal/day. Daily median consumption of carbohydrate, protein, fat, and fber among patients with renal stone was 233.96, 47.20, 10.16, and 6.37 g, respectively. Almost 90% of patients had calcium intake of overweight patients and the protein, potassium, and calcium consumption was higher among males.Conclusion: The daily intake of dietary components was widely distributed in renal stone patients. No clear trends were defned. Intake of calcium and water was less among patients. Further dietary interventional studies among the population with diverse dietary patterns can provide more evidence.

Effects of Calcium Source on Calcium-Metabolic Parameters in Healthy Women and Men

Background/Objectives: Calcium and vitamin D are important for bone health. We compared 24-hour urinary calcium-excretion (Uca/24hrs), during dietary calcium steady-state condition, for different calcium-sources and effects of vitamin D, age and sex. Subjects/Methods: Fifty-two healthy pre- and postmenopausal women and men completed the regimens: placebo, calcium carbonate (400mg) +18μg vitamin D, calcium carbonate (400mg) +38μg vitamin D and 400mg calcium phosphate (milk). Uca/24hrs was measured during dietary calcium steady state as a surrogate measure of calcium-absorption. Serum-calcium, parathyroid hormone (PTH), 25-hydroxy-vitamin D, Procollagen Type 1 N-terminal Pro- Peptide (P1NP) and C-terminal Telopeptide of type 1 collagen (CTX) were measured. Results: Mean daily intake of calcium for the study group ± SD was 1105 ±396 mg. Mean-Uca ± SD: placebo 5.19 ± 2.04 mmol/24hrs, milk 5.88 ± 2.39 mmol/24hrs, (CaCO3+D) 6.19 ± 2.34 mmol/24hrs and (CaCO3 + DD) 6.26 ± 2.32 mmol/day. Uca were higher for all regimens compared to placebo (p &lt;0.001), no difference was found between regimens. CTX was lower during all regimens compared to placebo (p &lt;0.001): placebo 450 ± 243 μg/L, Milk 377 ± 248 μg/L, (CaCO3+D) 392 ± 266 μg/L and (CaCO3+DD) 361 ± 232 μg/L. Conclusions: Uca was higher during supplementation with calcium compared to placebo. Supplementation with calcium reduced bone resorption significantly without effecting PTH. Menopausal status, sex and supplement with vitamin d demonstrated no effect on calcium excretion.

Low bone mineral density following gastric bypass is not explained by lifestyle and lack of exercise

BackgroundBariatric surgery, Roux-en-Y gastric bypass (RYGBP) in particular, is associated with weight loss as well as low bone mineral density. Bone mineral density relies upon multiple factors, some of which are lifestyle factors. The aim of this study was to compare lifestyle factors in order to eliminate them as culprits of the suspected difference in BMD in RYGBP operated and controls.Materials and methodsStudy participants included 71 RYGBP-operated women (42.3 years, BMI 33.1 kg/m2) and 94 controls (32.4 years, BMI 23.9 kg/m2). Each completed a DEXA scan, as well as survey of lifestyle factors (e.g. physical activity in daily life, corticosteroid use, and calcium intake). All study participants were premenopausal Caucasian women living in the same area. Blood samples were taken in RYGBP-patients.ResultsBMD was significantly lower in RYGBP, femoral neck 0.98 vs. 1.04 g/cm2 compared to controls, despite higher BMI (present and at 20 years of age) and similar physical activity and calcium intake. In a multivariate analysis, increased time since surgery and age were negatively associated with BMD of the femoral neck and total hip in RYGBP patients.ConclusionDespite similar lifestyle, RYGBP was followed by a lower BMD compared to controls. Thus, the reduced BMD in RYGBP cannot be explained, seemingly nor prevented, by lifestyle factors. As the reduction in BMD was associated with time since surgery, strict follow-up is a lifelong necessity after bariatric surgery, and especially important in younger bariatric patients.

Dried small fish provide nutrient densities important for the first 1000 days.

Inadequate nutrient intakes are prevalent among many populations in sub‐Saharan Africa and increasing fish consumption among pregnant/lactating women and children is one strategy to improve diets and address nutrient deficiencies. We report the nutrient content of two fish‐based recipes—fish powder and fish chutney—that contain dried small fish available in local markets in Zambia. The contribution of a serving of each recipe to the recommended daily intakes of iron, zinc, calcium and docosahexaenoic acid (DHA) for pregnant/lactating women and children 6–24 months was calculated because these nutrients are commonly deficient in African diets. We found that one 10‐g serving of fish powder provides 20% or more of the daily calcium recommendation and 37% or more of the daily DHA recommendation for both pregnant/lactating women and children. A 30‐g serving of fish chutney provides over 40% of the daily calcium recommendation for pregnant women and over 50% for lactating women. Additionally, we investigated the nutrient density (nutrients per kilocalorie) of the fish powder and compared it with the nutrient density of a small‐quantity lipid‐based nutrient supplement plus (SQ‐LNS‐plus). SQ‐LNS‐plus is designed to enhance children's diets by providing micronutrients and DHA. Fish powder is similar to SQ‐LNS‐plus in iron and zinc density and even higher in calcium and DHA density. Consuming dried small fish as part of a daily meal can be a viable strategy for combatting nutrient deficiencies in the first 1000 days.