Daily Calcium Research Articles

Influence of Calcium and Vitamin D Intakes on Body Composition in Children and Adolescents

Identifying nutritional strategies to maintain a healthy body weight and reduce the comorbidities associated with obesity is extremely important. We aimed to investigate whether calcium and vitamin D intakes are associated with body composition measurements in a population of children and adolescents. A cross-sectional study was conducted involving 1,060 children and adolescents (65.8% females; 34.2% males) aged 9 to 19 years. Fat mass, percentage of fat mass, and fat-free mass were measured using a body composition analyzer (TANITA BC-418MA®). The mean dietary calcium and vitamin intakes were 829.66 ± 328.34 mg/day and 200.78 ± 400.91 IU/day. Linear regression analysis revealed a lack of significant association between daily calcium and vitamin D intakes and body composition measurements, after adjusting the model for age, sex, maturation status, and energy intake. Dietary calcium and vitamin D intakes do not appear to be associated with higher adiposity measurements in children and adolescents.

The Association of Calcium Intake with Osteoporotic Vertebral Fractures and QCT Bone Mineral Density in a Large Chinese Cohort

Background Calcium is widely recognized as an effective intervention for the prevention of osteoporosis. However, some recent studies and meta-analyses indicate that calcium supplements may be ineffective to prevent fracture. The association of dietary calcium intake with vertebral fracture and spinal volumetric bone mineral density (vBMD) in low calcium intake population is unknown. Methods China Action on Spine and Hip Status (CASH) study is a multi-center, community-based cohort study of 3,457 participants from 12 centers across China from March 2013 and August 2017. We documented their baseline dietary calcium intake using validated food frequency questionnaires with a median of 10 years before the spine CT screening of CASH study. Vertebral fracture of CT images was defined as the primary outcome and the main measures included volumetric bone mineral density at participants' median of 10 years visit and dietary calcium intake at baseline. Odds ratio (OR) and 95% confidence interval (CI) were obtained for the associations of vertebral fracture with dietary calcium from ordinal logistic regression models (if outcome defined as three categories) or dichotomous logistic regression models (when mild, moderate, or severe fracture were combined and defined as prevalent fracture and no fracture as reference group). Because only 14.5% reached Chinese Dietary Reference Intakes (CDRI) calcium target of ≥800 mg/day, we selected 500, 600, 700, 800 mg/day of calcium intake from food as cutpoints for modeling, respectively. Findings Of the 3457 CASH participants, 3273 (94.7%) were used for analysis including 2052 women (mean [SD] age, 52.1 [9.0] years) and 1221 men (53.3 [9.1] years). Total vertebral fracture prevalence was 16.5% (n=551). The mean daily calcium intake from the FFQ was calculated as 517.0±266.4 mg. 8% reduction of fracture risk was observed per 100 unit increase of calcium intake from food among females (OR, 0.92; 95% CI, 0.87-0.97), but results among males were not significant (OR, 0.98; 95% CI, 0.92-1.04). No interaction was detected between vBMD and calcium intake from food (P>0.05). When high calcium intake groups had enough sample sizes (i.e. calcium ≥500 or ≥600 mg/day), negative assciations of fracture risk with calcium intake were found among females (≥500 vs. <500 mg/day: OR, 0.62; 95% CI, 0.47-0.80; ≥600 vs. <600 mg/day: OR, 0.59; 95% CI, 0.44-0.79), but this trend as not shown when cutpoints of calcium intake were set as 700 or higher. The same regressions were performed for male participants, but no siginificance was found. A positive correlation of calcium intake and vBMD was observed for females (P=0.01), but there was a non-significant negative trend for males (P=0.16). Interpretation Higher dietary calcium intake was associated with lower vertebral fracture among healthy women with low calcium intake. Further, higher calcium intake in women was related to a modestly greater volumetric spine BMD. Among men, more data are required and our results could not provide evidence to support a possible overall benefit of a higher calcium intake in reducing the risk of vertebral fractures. Funding: The foundation from the capital health research and development of special (no. 2014-2-1122), Beijing Bureau of Health 215 Program (No. 2009-2-03), the Ministry of Science and Technology of the China (Grants 2012BAI10B02). This work was also sponsored by the China government grants from CAMS Innovation Fund for Medical 19 Sciences (CIFMS, 2016-I2M-2-004) and Construction of Basic Information Technology Support System and Platform for National Prevention and Treatment of Cardiovascular Diseases. Declaration of Interest: We declare no competing interests. Ethical Approval: The protocol and informed consent for the CASH study were reviewed and approved by the institutional review board of Beijing Jishuitan Hospital (approval number No. 201210-01; No. 201512-02).

THE RISK OF OSTEOPOROTIC FRACTURES IN PATIENTS WITH RHEUMATOID ARTHRITIS: RESULTS OF THE PROGRAM «OSTEOSCREENING RUSSIA»

Rheumatoid arthritis (RA) and the use of glucocorticoids (GCs) are proven risk factors for osteoporosis (OP) and osteoporotic fractures (OPF). There are also other reasons for increased fracture risk in RA.Objective: to determine the rate of RA in an epidemiological sample of persons aged 50 years and older and to identify those in need of antiosteoporotic therapy among the patients with RA in order to prevent OPF.Subjects and methods. The epidemiological sample included 18,018 people aged 50 years and older (13,941 women and 4,077 men; mean age, 62±10 years). The survey consisted of a unified questionnaire, measurement of daily dietary calcium intake, and calculation of a 10-year fracture risk using the FRAX® algorithm.Results and discussion. The prevalence of RA in the epidemiological population sample aged 50 years and older was 1.7% (1.9% in women and 1.2% in men; p=0.0047). The mean FRAX® values for major OPF in RA patients were significantly higher than those in non-RA individuals: 18.4±10 and 13.2±7.9%, respectively (p=0.0001) for women and 8.9±6.4 and 6.2±3.7%, respectively (p=0.0001) for men. 42% of the patients with RA were at high risk for OPF. Thus, 48% of the women with RA had FRAX® values above the therapeutic intervention threshold; and the non-RA group needed antiosteoporotic therapy significantly less (31%; p=0.00001). At the same time, the detection rate of high-risk OPF in men with and without RA did not differ significantly (8 and 5%, respectively; p&gt;0.05). The most common risk factors (RFs) for OP and OPF in RA patients included previous fractures (33%), secondary causes of OP (30%), GC use (18%), and, additionally, smoking (33%) in male patients with RA. The female patients with RA significantly more frequently took GCs (17%) and had other secondary causes of OP and OPF (33%) than those without RA (7.7% (p=0.0001) and 23% (p=0.0004, respectively). The male patients with RA versus to the population-based control showed significant differences when they only used GCs (20 and 5%, respectively; p = 0.0001); the remaining RFs were encountered at the same frequency. Less than half of the normal daily calcium intake was observed in 20% of men and 16% of women (p=0.53).Conclusion. 42% of the RA patients aged 50 years and older were at high risk for OPF and needed antiosteoporotic therapy. Every third woman with RA had at least one other comorbidity or condition associated with the increased risk of OPF. In the male patients with RA, the FRAX® algorithm could reveal only 8% of persons at high risk for fractures, while 58% of them had two or more additional RFs that can negatively affect bone mineral density and increase the risk of fracture. To identify those who require prevention and treatment of OP and OPF, it is preferable to perform bone densitometry of the axial skeleton among male patients with RA.

Increased Risk of Osteoporosis in Gastric Cancer Survivors Compared to General Population Control: A Study with Representative Korean Population.

PurposeAlthough several studies have suggested that osteoporosis is common in survivors of gastric cancer (GC), no study to date has directly assessed the risk for osteoporosis in GC survivors compared to matched controls. Thus, we aimed to investigate the relative risk for osteoporosis in survivors of GC compared to general population.Materials and MethodsWe used the Korea National Health and Nutrition Examination Survey data (2008-2011). Patients with a history of GC (n=94) were defined as case among 8,142 individuals over 50 years old who were evaluated by dual-energy X-ray absorptiometry. Controls (n=470) were matched to cases by age and sex in a 1:5 ratio. Osteopenia (–2.5 < T-score < –1.0) and osteoporosis (T-score ≤ –2.5) were defined.ResultsThe prevalence of osteoporosis in GC survivors was 30.2%, which was significantly greater than that of controls (19.7%). In total, GC survivors had a 3.7-fold increased risk for osteoporosis compared to controls (p=0.021). In addition, the risk for osteoporosis of the total proximal femur total (TF) and femur neck (FN) was significantly increased among GC survivors compared to controls (adjusted relative risk, 4.64; 95% confidence interval, 1.16 to 18.6 in TF and adjusted relative risk, 3.58; 95% confidence interval, 1.19 to 10.8 in FN). Furthermore, we found sub-optimal daily calcium intake and mean serum levels of 25-hydroxy-vitamin D in both groups.ConclusionGC survivors are at significantly increased risk for osteoporosis, especially in the femur. Clinically, our finding supports the importance of screening bone health and adequate nutrient supplementation in survivors of GC.

Prevalence and risk factors for hypercalcemia among non-dialysis patients with chronic kidney disease-mineral and bone disorder.

To examine the prevalence and risk factors for hypercalcemia among non-dialysis chronic kidney disease (CKD) patients with mineral and bone disorder (MBD). A retrospective cohort study was conducted in Singapore General Hospital, involving all CKD stage 4 and 5 pre-dialysis patients who were on treatment for MBD in June 2016. Each patient was followed up for 1 year and screened for hypercalcemia episodes.Mild, moderate and severe hypercalcemia were defined as corrected calcium of 2.47-3.00, 3.01-3.50 and ≥ 3.51mmol/l respectively. Patients who were on dialysis, post-renal transplant, post-parathyroidectomy or had no calcium levels taken during the study period were excluded. Details related to patients' clinical information and hypercalcemia episodes were collected. Multivariate logistic regression analysis was performed to evaluate risk factors for hypercalcemia. Of 557 patients, 75 (13.4%) patients developed hypercalcemia. There were 120 (97.6%) mild and 3 (2.4%) moderate hypercalcemia episodes. The daily elemental calcium intake from phosphate binders and usage of vitamin D analogues did not differ between patients with and without hypercalcemia (p > 0.05). After adjusting for covariates, lower baseline iPTH level [odds ratio (OR) 0.96, 95% CI 0.93-0.99], history of hypercalcemia in past 1year (OR 11.11, 95% CI 3.36-36.75) and immobility (OR 3.34, 95% CI 1.34-8.40) were associated with increased hypercalcemia risk. Hypercalcemia affects a significant proportion of pre-dialysis patients with MBD. More studies should be undertaken to evaluate other risk factors associated with hypercalcemia.

Increased prevalence of asymptomatic vertebral fractures in HIV-infected patients over 50years of age.

Vertebral fractures (VF) are the hallmark of osteoporotic fractures. Our objective was to determine the prevalence of asymptomatic VF and associated factors in HIV-infected patients over 50years, and the role of FRAX equation. In a cross-sectional study, a diagnosis of VF was established by the semiquantitative method of Genant in thoracic and lumbar radiographs. Simultaneously, a dual X-ray absorptiometry (DXA), bone and kidney-related analytical, calcium intake, physical exercise, HIV-related factors, and FRAX estimation were evaluated. Overall, 128 patients (35 women, 27%) were included. Mean age was 57years. Hypophosphatemia and tubular renal dysfunction were observed in 13 and 21%. DXA scan showed osteopenia and osteoporosis at hip in 65 and 7% of patients, and in spine in 39 and 34%, respectively. VF were observed in 26 patients (20%), with a trend to be associated with lower serum phosphate, increased alkaline phosphatase, and with lower daily calcium intake. In a multivariate analysis, older age (OR 1.2 per year; 14% of VF at 50-55; 44% at 65-70), male sex (26 vs 6%), longer time since HIV diagnosis, and renal and tubular dysfunction were the associated factors. VF were not related with osteoporosis at lumbar spine, and could not be predicted by the FRAX equation. The prevalence of asymptomatic vertebral fractures is high in HIV-infected patients older than 50years, and is not identified by the presence of osteoporosis in spine neither predicted by the FRAX equation. Spine and lumbar X-rays should be routinely performed in this aging population.

Quantitative Mineralogical Composition of Calculi and Urine Abnormalities for Calcium Oxalate Stone Formers: A Single-Center Results.

The paper focuses on the relationship of risk factors and metabolic disorders with mineralogical composition of calculi, age and gender of calcium oxalate stone formers. Stone mineralogical composition, 24 hour biochemistry and pH-profile of urine were examined for sixty four stone formers using powder X-ray diffraction, spectrophotometric and potentiometric techniques. The analysis indicated that 44 % of calculi were composed of pure calcium oxalate monohydrate, whereas other 56 % contained both monohydrate and dihydrate or usually their mixtures with hydroxyl apatite. Hypocitraturia, hypercalciuria and hyperuricosuria were identified as the most frequent disorders. Patients with pure calcium oxalate stones and calcium oxalate mixed with apatite revealed different patterns including age, acid-base balance of urine, calcium, citrate excretion etc.Conclusions: Our results demonstrate that most patients simultaneously reveal several risk factors. The special attention should be paid to normalize the daily citrate, calcium and urate excretion. High risk patients, such as postmenopausal females or stone formers with a high apatite content require a specific metabolic evaluation towards in highlighting abnormalities associated with stone formation.

Determinação de minerais no solo e análise de folhas de couve produzida em Brasília

Resumo A couve de folhas é um alimento com alto teor de vitaminas e minerais, que são fundamentais para a dieta humana. Contudo, informações sobre a influência dos fatores extrínsecos e intrínsecos, durante o seu cultivo, em sua composição são escassas. O objetivo deste trabalho foi quantificar os seguintes minerais em folhas de couves produzidas no Distrito Federal (DF): cálcio, magnésio, potássio, fósforo, zinco, manganês, sódio e ferro, correlacionando os teores verificados com os teores presentes no solo. As amostras de folhas e solo foram coletadas em 16 diferentes propriedades rurais no DF, quando também foram aplicados questionários aos produtores sobre as práticas culturais adotadas durante a produção. Os resultados obtidos de teores médios foliares (base em folhas frescas) por 100 g de alimento foram: cálcio, 222,8 mg; ferro, 1,3 mg; magnésio, 37,6 mg, e zinco, 0,6 mg. Esta composição atende a 28% das necessidades diárias de cálcio em crianças de 4 a 8 anos, sendo também supridos 13% de ferro, 29% de magnésio e 13% de zinco, com base no consumo de 100 g de folhas frescas de couve. Foi verificada correlação negativa para teores de magnésio no solo e na folha, com R = -0,69. Para os outros minerais analisados não se verificou correlação significativa. O conteúdo de fósforo e de potássio nos solos foi considerado alto, enquanto que, contrariamente, foram determinadas concentrações baixas de teores de magnésio. O teor de micronutrientes na couve foi considerado baixo e aventa para um manejo inadequado da adubação, fator corroborado pelas respostas dos questionários sobre práticas culturais. Práticas de manejo que levam ao equilíbrio de nutrientes no solo refletem diretamente na interação solo-planta. Recomendações regionais atualizadas de adubação e correção dos solos poderiam auxiliar agricultores e técnicos, refletindo diretamente na obtenção de teores mais equilibrados de micro e macronutrientes em alimentos de origem vegetal.

Grains Contribute Shortfall Nutrients and Nutrient Density to Older US Adults: Data from the National Health and Nutrition Examination Survey, 2011⁻2014.

Previous data demonstrate grain foods contribute shortfall nutrients to the diet of U.S. adults. The 2015–2020 Dietary Guidelines for Americans have identified several shortfall nutrients in the U.S. population, including fiber, folate, and iron (women only). Intake of some shortfall nutrients can be even lower in older adults. The present analyses determined the contribution of grain foods for energy and nutrients in older U.S. adults and ranked to all other food sources in the American diet. Analyses of grain food sources were conducted using a 24-hour recall in adults (≥51 years old; n = 4522) using data from the National Health and Nutrition Examination Survey, 2011–2014. All grains provided 278 kcal/day or 14% of all energy in the total diet, ranking as the 4th largest contributor of energy compared to 15 main food groups. All grain foods ranked 1st for thiamin (33%) and niacin (23%) intake relative to 15 main food groups. The grain foods category ranked 2nd highest of 15 main food groups for daily dietary fiber (23%), iron (38%), folate (40%), and magnesium (15%) and was the 3rd largest food group contributor for daily calcium intake (13%). When considering nutrients to limit as outlined by dietary guidance, main group of grains contributed 6% total fat, 5% saturated fat, 14% sodium and 9% added sugar. Breads, rolls and tortillas provided 150 kcal/day or 8% of all energy in the total diet, ranking as the 2nd largest contributor of energy compared to 46 food subcategories. Breads, rolls and tortillas ranked 1st of 46 foods for daily thiamin (16%) and niacin (10%) intake and 2nd for dietary fiber (12%), iron (12%), folate (13%), and magnesium (7%). Breads, rolls and tortillas ranked 3rd largest food group contributor for daily calcium (5%) intake. Ready-to-eat cereals provided 47 kcal/day or 2% of all energy in the total diet, ranking as the 20th largest contributor of energy compared to 46 food subcategories. All ready-to-eat cereals ranked 1st for daily iron (19%), 1st for folate (21%), 5th for dietary fiber (7%), 3rd for niacin (9%), 8th for magnesium (4%), and 13th for calcium (2%) intake. Given all grain foods and specific subcategories of grain foods provided a greater percentage of several underconsumed nutrients than calories (including dietary fiber, iron, and folate), grain foods provide nutrient density in the American diet of the older adult.

Assessment of dietary calcium intake of university students: a pilot study in Turkey.

Calcium is an essential mineral that plays vital roles in metabolism and it is very important to accurately assess the amount of calcium intake on the diet. It was aimed to assess the daily calcium intake of university students by two different food frequency questionnaires (FFQs) developed specifically for evaluating calcium intake, and 24-h recall method. The study was conducted with a total of 183 female university students aged 18-31. In the study, a questionnaire including sociodemographic information, a calcium calculator, IOF FFQ, prepared in seven different languages, and RAM was applied. In addition, 1-day food consumption records were obtained using 24-HR method. The daily average calcium intakes of individuals according to two different food frequency questionnaires (RAM FFQ and IOF FFQ) and 24-h food consumption records are respectively 1594.2 ± 810.9, 897.9 ± 368.4, and 605.6 ± 278.3mg. When the daily average calcium intake was compared with the other two methods, RAM was found to be statistically higher (p < 0.001). There was a moderate positive correlation between the RAM and IOF FFQ methods (Pearson r = 0.528, p < 0.01) and the intra-class correlation coefficient between these two methods was found to be significant and moderate (ICC r = 0.452, p < 0.01). In terms of protecting and improving health, it is important to make suggestions using fast and short tools to ensure adequate calcium intake from young age. It is thought that FFQs are the most appropriate methods in assessing daily calcium intake for this study group because it is observed that the list of foods and the amount of portions in FFQs reduce the problem of remembering at 24-h method to a great extent.

Effectiveness of surgical treatment of primary hyperparathyroidism with urolithiasis: correction of symptoms, laboratory parameters and stone-forming risk

Background. Parathyroidectomy is the only effective method to improve the clinical and laboratory manifestations of the primary hyperparathyroidism (PHPT) and reduce the risk of urinary calculi formation. However, there are controversies about the existence of renal form of PHPT and about the effectiveness of surgery with regard to the risk of stone formation.&#x0D; Aims. To evaluate the effectiveness of PHPT surgical treatment in relation to clinical, laboratory parameters, as well as the risk of stone formation.&#x0D; Materials and methods. In a prospective single-arm observation one-center nonrandomized study we included patients with PHPT in whom parathyroidectomy was performed in 2012–2015. We analyzed clinical and laboratory parameters before and after surgery in a period from 1 to 3 years.&#x0D; Results. The study included 105 patients, of whom 35 (33.3%) had urolithiasis. Blood calcium after the surgery decreased from 2.72 mmol/l [2,56; 2,97] to 2,3 mmol/l [2,2; 2,35], p &lt; 0.001. Blood calcium concentration decreased to normal values in all patients. Parathyroid hormone level decreased from 206 pg/ml [123; 347] to 72,8 pg/ml [30; 113], p &lt; 0.001. Clinical symptoms questionnaire estmation decreased from 4 points [3; 6] to 2 points [1; 4], p &lt; 0.001. In patients with urolithiasis clinical symptoms before treatment were more pronounced – 5 points [3; 7] vs. 4 points [3; 5] (p = 0.015) and decreased more significantly – by 3 points [2; 4] vs 2 points [1; 3]. The daily calcium urine excretion decreased from 11.4 mmol/day [8.9; 13.9] to 5.4 mmol/day [4.1; 6.8], p &lt; 0.001. In 2 cases (5.7%; CI, 0.7–19.2%) we observed the progression of urolithiasis after surgery. The age of patients correlated with daily calcium urine excretion after surgery (r = 0.69; p = 0.028).&#x0D; Conclusions. Parathyroidectomy normalizes blood calcium and parathyroid hormone, improves clinical symptoms and reduces the risk of stone formation.

Effect of Aerobic Exercise Versus Calcium Supplementation on Serum Calcium Level in Hypocalcemic Children

AbstractBackground: Hypocalcemic child is the presence of low serum calcium levels in the blood. Normal blood calcium level is between 8.5 to 10.5mg/dLin children. Calcium is the most important abundant mineral in the body which is impor-tant for growth bons, teeth and their skeleton.Purpose: To investigate the effect of aerobic exercise versus calcium supplementation on serum calcium level in hypocalcemic children.Subjects and Methods: This study was carried out on 36 hypocalcemic children of both sexes, subdivided into two groups, eighteen in each group. Their ages ranged from 24- 42 months old.Results: Serum free total calcium, gross motor function measure 88score of standing and walking domain measured for all children before and after 12 weeks of intervention. Group (A): Were participated in aerobic exercise program in the form of bicycle ergometer training program 3 time/week for 12 weeks in addition to balanced daily diet calcium supplement. Group (B): Children were be treated by calcium supplementation in form of calcium carbonate (lactose) which was given once daily.Non significant difference in gross motor function measure 88 scoreing of standing and serum calcium level but there was significant increase in gross motor function measure 88 scoreing of walking in Group (A) compared with Group (B).Conclusion: This study concluded that aerobic exercise has benifical effect on walking ability and serum calcium level in children with hypocalcemia.

Knowledge, Attitude, and Behavior Level of Women of Reproductive Age toward Calcium Intake

Background: Women have a higher risk of developing osteoporosis compared to men. Calcium intake is one of the determinant factor which can be modified to prevent osteoporosis. Knowledge, attitude and behaviour are important factors to fulfill the needs of calcium intake. This study aimed to describe knowledge, attitude, and behavior toward calcium intake of woman of reproductive age. Methods: This descriptive study recruited 100 women (aged 20–30 years) in Jatinangor, West Java and was conducted from September to November 2014. Knowledge and attitude measurements used a validated questionnaire consisting of 10 and 9 closed questions respectively. Behavioral aspect was assessed using semi-quantitative Food Frequency Questionnaire (FFQ). Knowledge was classified as high, moderate, and low based on questionnaire scoring results, >75%, 60–75%, and <60% respectively. Attitude was categorized in two: positive and negative. Behaviour category used Recommended Dietary Allowances (RDA) as the cut-off point. If the daily calcium intake is below the RDA it is categorized less and if the daily calcium intake equals to or exceeds the RDA it is categorized sufficient. The collected data were presented in frequency tabulation and percentage. Results: The majority of subjects showed low to moderate level of knowledge toward calcium intake, 66% of subjects showed negative attitude towards calcium intake, and 98% showed calcium intake below the RDA. Conclusions : Subjects of this study have low to moderate level of knowledge, negative attitude toward calcium intake, and low level of behavior toward calcium intake.

Dietary intake of calcium in pre-school and school children in Russia: main food sources and eating occasions

It is known that adequate calcium intake determines formation of skeleton and genetic predisposition of its weight and density peak. Optimal calcium intake in the childhood determines risk reduction of density loss and osteoporosis in the adulthood. This research explored contribution of different food sources, as well as eating occasions on calcium dietary intake among preschool and school children (4-13 years old). Mean daily Calcium intake and dairy products consumption depending on family income have been analyzed. Dietary intake was evaluated by 24-hour recall method. National food composition data tables have been used to estimate mean nutrient intake. Dairy products were classified in accordance with local food grouping system. Percent of children consuming products - sources of calcium, amount per consumer, contribution of eating occasions to Calcium intake, foods consumed at breakfast as well as Calcium intake and dairy products consumption depending on household income has been analysed. Nationally representative sample of preschool and school age children, Russia National Nutritional Survey, was conducted in all regions of Russia in 2013 by state Federal Statistics Service - Rosstat. Sample size was 22 771 children split in four age groups: 4-6 y.o. (n=7303), 7-8 y.o. (n=4391), 9-10 y.o. (n=4691) and 11-13 y.o. (n=6386). The study confirmed the indications in the domestic and foreign literature that calcium intake was insufficient in children aged 4-13 years. Data showed age related particularities in consumption of products-sources of Calcium: percent of children consuming milk and milk-based beverages, milk porridges, cottage cheese declined rapidly in older age groups in comparison to preschoolers. A slight increase of cheese consumption was shown in older age groups. Breakfast is an important eating occasion that provides a significant proportion (23-28%) into calcium daily intake in children. Habit of skipping breakfast puts calcium daily intake at risk as it is not compensated throughout the day at other eating occasions. Our results indicate lower daily Calcium intake in breakfast skippers (11-14% of children) compared with kids of the same age who had breakfast at the day of survey. Sweetened tea and coffee consumption increased in older age groups and contrary, a milk and milk based beverages consumption droped in school age. We found lower Calcium intake and lower accessibility to variety of Calcium food sources in low socio-economic class of the children population, where milk seems to be the main product from milk and dairy food group. The findings can assist in developing food-based recommendations for optimal intake of calcium in children's daily diet. Consumption of dairy products is required to meet adequate intake and to low down prevalence of inadequate intake. There is room for improvement of dairy product consumption in terms of variety and number of serving a day especially, for children in older age groups. More attention to be dedicated to breakfast as it is an important eating occasion that contributes significantly to calcium daily intake. Study findings call for intervention programs aiming to correct the inadequacies of calcium intake in schoolchildren's diets, including nutrition education for families and support for accessibility of the products rich in calcium by low socio-economic population groups; for example, by inclusion of milk and dairy products into the school feeding programs.

Diet and exercise changes following bone densitometry in the Patient Activation After DXA Result Notification (PAADRN) study.

The Patient Activation After DXA Result Notification (PAADRN) study was designed to evaluate whether a letter with individualized fracture risk and an educational brochure mailed to patients soon after their DXA might improve bone health behaviors (daily calcium intake, vitamin D supplementation, and weekly exercise sessions) compared to slower, less individualized communication characterizing usual care. Participants ≥ 50years were recruited, at three sites, following their DXA and randomized with 1:1 allocation to intervention and control (usual care only) groups. Data were collected at enrollment interview and by phone survey at 12 and 52weeks thereafter. Intention-to-treat analyses were conducted on 7749 of the 20,397 eligible participants who enrolled. Changes in bone health behaviors were compared within and between study groups. Average treatment effects and heterogeneity of treatment effects were estimated with multivariable linear and logistic regression models. In unadjusted analyses, calcium intake, vitamin D supplementation, and weekly exercise sessions increased significantly over 52weeks within both the intervention and control groups (all p < 0.001). In unadjusted analyses and multivariable models, increases in each behavior did not significantly differ between the intervention and control groups. Intervention group participants with a > 20% 10-year fracture risk at enrollment did, however, have a significantly greater increase in calcium intake compared to other study participants (p = 0.031). Bone health behaviors improved, on average, over 52weeks among all participants following a DXA. Receipt of the PAADRN letter and educational brochure did not directly improve bone health behaviors compared to usual care. The Patient Activation after DXA Result Notification (PAADRN) Study is registered at ClinicalTrials.Gov: NCT01507662, https://clinicaltrials.gov/ct2/show/NCT01507662.

Dietary Calcium Intake in Sample of School Age Children in City of Rabat, Morocco.

Calcium is an important mineral playing a vital role to maintain bone health. Calcium intake is considered as one of the most important determinants to assess the calcium status and to evaluate the calcium deficiency in the human body. Our study aims at estimating calcium intake in a sample of children and adolescent to be used in the global strategy to reduce calcium deficiency disorders in Morocco. Thus, 131 children and adolescents were recruited from public schools at Rabat and its regions in the framework of a descriptive cross-sectional study. For each participant, anthropometric parameters were measured. Calcium status was assessed by 24 h dietary recall. Food frequency questionnaire was used to evaluate children's nutritional habits and to assess the consumption of calcium-rich food. Overall, the mean calcium intake was 522.0 ± 297.0 mg/day, and 85.5% of subjects highlighted calcium deficiency, with no significant difference between boys and girls. Calcium intake was significantly different according to age groups, and high consumption of calcium was found in subjects aged from 14 to 18 years (776.86 ±290.07 mg/day), giving evidence of the low calcium status of the studied population. Daily food intake and food frequency analysis showed that bread, vegetables, and fruits are the most consumed food and the main source of daily calcium intake. Consumption of dairy products, considered as the best source of calcium, is lower and represents only 14% of total calcium intake. Our study clearly showed that calcium status is very lower in Moroccan children and adolescents and a large proportion of this population have inadequate calcium intake. Hence, there's an urgent need of specific strategies, including children sensitisation and nutritional education, to increase calcium intake and therefore reduce calcium deficiency disorders impacting the whole body during childhood and in adult age.

Predisposing Risk Factors for Stress Fractures in Collegiate Cross-Country Runners.

Giffin, KL, Knight, KB, Bass, MA, and Valliant, MW. Predisposing risk factors and stress fractures in collegiate cross-country runners. J Strength Cond Res 35(1): 227-232, 2021-The purpose of this study was to explore factors associated with increased stress fractures in collegiate cross-country runners. Subjects in this study were 42 male and female cross-country runners at a Division I university. Each athlete completed a questionnaire regarding smoking status, vitamin/mineral intake, previous stress fracture history, birth control usage, menstrual status, and demographic information. Nutritional assessment using a 3-day food record and measurements of whole body, lumbar spine, and hip bone mineral densities (BMDs) were also conducted on each athlete. Results indicated that 40% of the female and 35% of the male runners reported a history of stress fracture, and that all of them did not meet the recommended daily energy intake or adequate intakes for calcium or vitamin D required for their amount of training. Two-tailed t-test found statistically higher incidences of lumbar spine BMD in male and female runners whose daily calcium and vitamin D intakes were below minimum requirements as well as for women whose caloric intake was below the required level. When data on the lumbar spine was evaluated, 31% of subjects (31.8% of the male and 30% of the female runners) were identified as having osteopenia and 4.8% with osteoporosis. Results warrant a need for future longitudinal studies.

Effect of suboptimal levels of non-phytate phosphorus and exogenous phytase on precaecal digestibility of phosphorus and calcium in laying hens

The precaecal digestibility of phosphorus and calcium in laying hens was evaluated at two dietary levels of non-phytate phosphorus (NPP; 1.58 and 2.03 g/kg) and two levels of exogenous 3-phytase (F; 0 and 300 phytase units (FTU)/kg). A total of 192 ISA Brown hens were used for the study, and were housed in enriched cages (8 per cage). At the end of the experiment, which was the peak of the egg production, the content of the posterior half of the ileum from each hen was collected. The lower level of NPP significantly (P &amp;lt; 0.05) improved the precaecal phosphorus digestibility coefficient. There was no significant difference in the amount of absorbed phosphorus between the lower and the higher level of NPP. The level of NPP with supplementation of exo-genous phytase had a significant effect (P &amp;lt; 0.001) on the concentration of phosphorus in ileum, while the higher level of NPP increased phosphorus concentration in the ileum and phytase decreased phosphorus content in the ileal digesta. The phytase had no significant effect on phosphorus precaecal digestibility. There was no significant effect of the both factors, level of NPP, and exogenous phytase on the daily calcium intake, the amount of absorbed calcium, the content of calcium in ileal digesta, and on the precaecal digestibility of calcium. However a significant effect (P &amp;lt; 0.05) of the interaction between NPP and phytase was observed on the amount of absorbed calcium and on the precaecal digestibility coefficient. It can be concluded that the estimation of phosphorus ileal digestibility depends on the level of dietary phosphorus.

Micronutrient Intake Changes With the Low FODMAP and mNICE Diets

Introduction: The role of the low FODMAP (fermentable oligo-, di-, mono-saccharides and polyols) diet has gained increasing acceptance for the treatment of irritable bowel syndrome (IBS) but potential safety concerns have been raised regarding nutritional adequacy. Changes in micronutrient intake with a low FODMAP diet have not been previously investigated. Daily micronutrient intake after 4 weeks of a low FODMAP diet or a modified NICE (mNICE) diet was compared to baseline. Methods: A post-hoc analysis of a single-center, randomized-controlled trial of adult patients with IBS-Diarrhea (IBS-D) was utilized which compared the efficacy of a low FODMAP and the mNICE diets on IBS symptoms over a 4-week period. The Nutrition Data System for Research (NDSR) computer program was used to analyze 3-day food diaries at baseline and at 4 weeks. Results: Data from 78 patients who completed the study were included. 41 patients were randomized to the low FODMAP diet and 37 patients were randomized to the mNICE diet. The average BMI in the low FODMAP group was 27.7 ± 6.5 compared to an average BMI of 31.4 ± 7.9 in the mNICE group (p=0.003). Both diets resulted in fewer daily kilocalories and number of daily meals consumed (Table 1). Among the patients on the low FODMAP diet, a statistically significant decrease from baseline in the daily intake retinol, thiamin, riboflavin, calcium, and trans-fatty acids was observed. There was a statistically significant increase from baseline in the intake of vitamin B6. In the mNICE group, there was a statistically significant decrease in the daily intake of polyunsaturated fatty acids only. The remaining micronutrient differences compared to baseline were not statistically significant.Table: No Caption availableConclusion: During a 4-week dietary intervention, the average daily intake of most micronutrients remained stable and within recommended dietary allowances. A low FODMAP diet was associated with a significantly lower daily intake of retinol, thiamin, riboflavin, calcium, trans-fatty acids, while the daily intake of vitamin B6 was increased. The mNICE diet was associated only with lower daily intake of polyunsaturated fatty acids. While statistically significant, the clinical significance of these findings are unclear and suggest that for a short-term elimination diet, the low FODMAP diet is not associated with major micronutrient inadequacies. These findings reinforce the importance of diversifying a patient's diet through reintroduction of foods containing FODMAPs.

The Daily Calcium Intake and Food Sources among Chinese Adults Aged 18-49 Years Old from 15 Provinces in 2015

The Daily Calcium Intake and Food Sources among Chinese Adults Aged 18-49 Years Old from 15 Provinces in 2015