Inadequate Calcium Intake Research Articles

The fraction of cancer attributable to modifiable risk factors in Turkey in 2018

AbstractCancer is the second leading cause of death in Turkey, with nearly one in six deaths attributed to the disease. In 2018, Turkey recorded 211,273 new cancer cases. Many cancers are linked to modifiable lifestyle risk factors, such as tobacco use, alcohol consumption, obesity, and inadequate diet and physical activity. Modifying these risk factors could potentially prevent 30%–50% of cancer cases and deaths. This study aims to estimate the population attributable fraction (PAF) of cancer cases and deaths due to various modifiable risk factors in Turkey. Modifiable cancer risk factors were identified as smoking, infections, obesity, physical inactivity, alcohol consumption, inadequate intake of fruits, vegetables, fiber, and calcium. Data on exposure prevalence and cancer incidence were sourced from national surveys and reports. Relative risks (RRs) were obtained from global studies. PAFs were calculated using Levin's equation, accounting for overlaps between risk factors. In 2018, 32% of the cancer cases were attributable to lifestyle risk factors. Smoking was the most significant factor, accounting for 28.4% of cases in men, while high BMI was the leading factor in women, contributing to 11.5% of cases. Lifestyle risk factors were responsible for 41.6% of cancer deaths, with smoking being the leading cause. Lifestyle risk factors contribute significantly to cancer incidence and mortality in Turkey. Prioritizing interventions to reduce tobacco use and obesity could substantially lower the cancer burden. These results are crucial for developing effective cancer prevention strategies and informing public health policies.

Developing an effective and simple digital screening tool to identify inadequate calcium intake in pregnant women: A prediction model in the Rotterdam periconception cohort

ObjectivesAn inadequate intake of calcium in pregnancy is associated with higher risks of maternal hypertensive pregnancy disorders, premature birth and intrauterine growth restriction. An evidence based and clinically applicable tool to efficiently estimate the adequacy of calcium intake in pregnant women currently does not exist. The aim of this study is to develop an effective and simple digital screening tool for calcium intake in pregnancy. Study DesignWe extracted all data from the Rotterdam Periconceptional cohort (PREDICT study) conducted at the Erasmus MC, University Medical Centre in Rotterdam, the Netherlands, between November 2014 and December 2020. Data was extracted from food frequency questionnaires. The estimated average requirement of 750 m/day was defined as the lower limit for an adequate calcium intake. We created a prediction model, using multivariable binary logistic regression with backward stepwise selection, predicting the probability of adequate calcium intake. We developed a simple screening tool based on the prediction model. Results694 participants are included, of which 201 (29 %) had an adequate calcium intake. Total daily or weekly intakes of cheese, milk, and yogurt or curd were selected as predictors for the prediction model. The model had excellent discrimination (AUC 0.858), a good fit (Brier score 0.136, HL statistic p = 0.499) and satisfactory calibration. The test accuracy measures were: sensitivity 80.9 %, specificity 77.1 %, PPV 89.7 %, NPV 62.2 %. A colour coded digital screening tool was developed for use in clinical practice. ConclusionsThis evidence-based and simple screening tool is a reliable and efficient instrument to predict inadequate calcium intakes in pregnancy, which can easily be incorporated in daily clinical practice and existing pregnancy coaching platforms.

Examining the role of industry lobbying on Canadian front-of-pack labelling regulations.

Health Canada recently issued a Marketing Authorization to expand the eligibility of the dairy-related exemption for Canadian front-of-pack labelling (FOPL) regulations. The 2024 Marketing Authorization exempts dairy-related products that are a 'source of calcium,' rather than only 'high in' calcium as previously regulated, from displaying a 'High in' front-of-pack nutrition symbol, regardless of their saturated fat and sodium levels. The Marketing Authorization, heavily influenced by the food industry, lacks strong scientific evidence to support its adoption. Although there is a high prevalence of inadequate calcium intakes among Canadians, the Marketing Authorization will exempt more dairy-related products that are significant contributors of saturated fat and sodium for Canadians. While providing very little calcium, many dairy-related products, particularly cheese products, are 'high in' saturated fat and/or sodium. Expanding the exemption criteria will allow dairy-related products with little health benefits to be reflected as 'healthy' (i.e., not display a 'High in' nutrition symbol), blunting the potential impact that FOPL regulations could have on improving the diets of Canadians. We strongly urge Health Canada to reconsider the expansion of the exemption and encourage others to conduct policy-relevant research and participate in the policy decision-making process to promote evidence-informed public health policies for the health of Canadians.

Calcium deficiency and its implications for cardiovascular disease and cancer: Strategies for resolution via agronomic fortification.

Calcium (Ca) is a vital nutrient essential for structural development and signal transmission in both plants and animals. In humans, inadequate calcium intake has been correlated with various diseases, including osteoporosis, cardiovascular and cerebrovascular diseases, and cancer. In areas where plants serve as a main dietary source, calcium intake is significantly lower than the recommended adequate intake, notably in low- and middle-income countries (LMICs). Exploring the connections between calcium consumption and cardiovascular disease (CVD) and cancer has significant implications for public health, given that these two conditions are the primary contributors to global mortality. This study conducted a systematic review of existing literature to assess the evidence regarding calcium intake and its effect on blood pressure control, stroke prevention, and the controversial association with myocardial infarction. Furthermore, the preventive effect of calcium intake on tumor development, particularly in cancer prevention, was discussed. The study explores the potential of agronomic biofortification as a key strategy to enhance plant-based dietary calcium density and improve human health. By advocating for the incorporation of calcium-rich plants and plant-derived products, alongside appropriate calcium supplementation, the study emphasizes the economic and practical benefits of plants as a calcium source. This approach is aligned with global dietary patterns and socioeconomic disparities. The review also highlights the need for further research to better understand the mechanisms through which agronomic biofortification can increase dietary calcium intake and reduce the risks of CVD and cancer associated with calcium deficiency. Ultimately, this study aims to deepen our understanding of the complex relationship between calcium intake and health.

Eating Egg-Rich Diets and Modeling the Addition of One Daily Egg Reduced Risk of Nutrient Inadequacy among United States Adolescents with and without Food Insecurity

BackgroundAdolescents have the poorest dietary intake throughout their lifespan. Food insecurity worsens these nutritional risks. Eggs are a nutrient-dense strategy to increase nutrient quality. Objectives1) compare usual nutrient intakes, Dietary Reference Intake and protein compliance with recommendations and scores of micronutrient quality; and 2) analyze how adding 1 egg affects adolescents’ nutrient profiles, by food security status and egg-rich diets. MethodsDietary data of United States adolescents in the 2007–2018 National Health and Nutrition Examination Survey were analyzed (14–17 y; n = 3633). Egg-rich diet levels were categorized as 1) no eggs, 2) eggs as ingredients in dishes, or 3) primarily egg dishes. Food security status was classified using the United States Household Food Security Survey Module. The National Cancer Institute method was used to estimate usual nutrient intake and nutrient exposure scores [i.e., Food Nutrient Index (FNI) and Total Nutrient Index (TNI)]. Nutrient amounts from 1 medium egg were modeled on existing intakes. Pairwise t-tests determined significant differences. ResultsOver 60% of adolescents risked inadequate intake of calcium, choline, magnesium, vitamin D, and vitamin E regardless of food security status. Food-secure adolescents consuming primarily egg dishes had higher mean usual intakes of lutein + zeaxanthin (1544.1 μg), choline (408.4 mg), vitamin B2 (2.3 mg), selenium (128.6 μg), vitamin D (6 μg), docosahexaenoic acid (70 mg), and protein (89.1 g) than other groups (P < 0.0002). Those who were food secure and consuming eggs as ingredients in dishes demonstrated higher nutrient adequacy for magnesium (scored ∼66 out of 100), potassium (scored 81), and total scores (scored 72 and 69, respectively) for the TNI and FNI; and folate only (scored 92) for the TNI, than those who were food insecure and not consuming eggs (P < 0.0002). Adding 1 egg increased choline and vitamin D usual intakes for some groups and nutrient index scores for all groups (P < 0.0005). ConclusionsAdolescents are at substantial nutritional risk that was exacerbated by food insecurity and less egg consumption.

Knowledge, attitude regarding osteoporosis, dietary calcium intake and food sources of calcium among Chinese young adults in Klang Valley, Malaysia

BackgroundOsteoporosis is a major public health issue with huge socioeconomic implications. Adequate knowledge and a positive attitude regarding osteoporosis with sufficient dietary calcium intake are important to prevent osteoporosis, especially in young adults. Nonetheless, data on the knowledge and attitude regarding osteoporosis, dietary calcium intake and its food sources among the high-risk population, including Malaysian Chinese are limited.ObjectiveThe study aimed to determine the knowledge and attitude regarding osteoporosis, dietary calcium intake, and food sources of calcium among young Malaysian Chinese.MethodsA total of 130 Malaysian Chinese aged 18 to 26 years living in Klang Valley were recruited. Knowledge and attitude regarding osteoporosis were assessed using the Osteoporosis Prevention and Awareness Tool (OPAAT) and Osteoporosis Health Belief Scale (OHBS). Dietary calcium intake and food sources were obtained from a 7-day diet history.ResultsParticipants had low knowledge regarding osteoporosis (48.8% ± 16.6), but moderate knowledge (53.2% ± 17.9) regarding preventive measures of osteoporosis. The median dietary calcium intake was 546 mg/day and only 6.2% of the participants achieved the Recommended Nutrients Intake (RNI). There was a discernible weak positive correlation between knowledge and dietary calcium intake (r = 0.192, p = 0.029).ConclusionYoung Malaysian Chinese adults exhibited low knowledge about osteoporosis and reported inadequate dietary calcium intake. Thus, there is a need for community-based health education programs focusing on osteoporosis awareness among Malaysian young adults.

Deficiency of Energy and Nutrient and Gender Differences among Chinese Adults: China Nutrition and Health Survey (2015-2017).

Half of Chinese adults face the double burden of overweight/obesity and micronutrient deficiencies, and nearly 40% of them are severely overweight/obese or have micronutrient deficiencies. This study used the data from China Nutrition and Health Survey (CNHS) from 2015 to 2017 to estimate the prevalence of inadequate dietary micronutrient intake (including vitamin A, vitamin B1, vitamin B2, vitamin C, cCalcium, iron and sodium) in Chinese adults and further determine the differences in micronutrient intake by gender, age and BMI. A total of 61,768 subjects were included in this study, of which 33,262 (54%) were female. The intake of energy and all macronutrients decreased with age, and the intake was higher in men than in women. Inadequate energy intake occurs in adults of all ages. In terms of nutrient intake, women had a higher rate of insufficient carbohydrate intake than men in all age groups. Inadequate protein intake was more common in women aged 18-49 years (60.9%) than in men. Compared with women, men had a higher rate of vitamin B2 intake. Insufficient vitamin B3 intake was more common in women aged 18-49 years (35.6%), men aged 65-79 years (39.7%) and men aged 80 years and above (47.9%). In all age groups, insufficient vitamin C intake is higher in women than in men-up to 85.8 percent in women aged 80 years old and above. Compared with men in the same age group, insufficient intake of calcium and iron is more obvious in women. Women have significantly higher rates of inadequate intake of calcium, iron and sodium than men. In the analysis of correlations between BMI or demographic data and micronutrient intakes, the likelihood of micronutrient intakes being insufficient was higher in the central and western regions in all age groups compared to the eastern regions. The risk of insufficient micronutrient intake was higher in obese men and women aged 18-49 years and 50-64 years. Underweight and overweight women in the 65-79 age group were more likely to have inadequate micronutrient intake. Obese women over 80 years of age were less likely to have inadequate micronutrient intake. No significant difference was found between urban and rural areas for each age group.

Vitamin D Supplementation and the Incidence of Fractures in the Elderly Healthy Population: A Meta-analysis of Randomized Controlled Trials.

Although a well-established component of bone metabolism, the efficacy and safety of vitamin D supplementation for the prevention of fractures in elderly healthy individuals is still unclear. To perform a meta-analysis comparing vitamin D supplementation with placebo and its contributions on fracture incidence. This meta-analysis was registered in the International Prospective Register of Systematic Reviews (PROSPERO), under protocol CRD42023484979. We systematically searched PubMed, Embase, and Cochrane Central databases from inception to November 2023 for randomized controlled trials (RCTs) comparing vitamin D supplementation versus placebo in individuals with 60years of age or more and without bone related medical conditions such as cancer and osteoporosis. Seven RCTs with 71,899 patients were included, of whom 36,822 (51.2%) were women. There was no significant difference in total fracture incidence (RR 1.03; 95% CI 0.93-1.14; p = 0.56; I2 = 58%) between groups or subgroups. However, women had an increased risk for hip fractures (164 vs. 121 events; RR 1.34; 95% CI 1.06-1.70; p = 0.01; I2 = 0%). There was no significant difference in non-vertebral fractures, osteoporotic fractures development, or falls (RR 1.02; 95% CI 0.94-1.12; p = 0.6; I2 = 47%; RR 0.97; 95% CI 0.87-1.08; p = 0.63; I2 = 0%; RR 1.01; 95% CI 0.97-1.04; p = 0.66; I2 = 55%, respectively). Vitamin D supplementation does not reduce the total fracture development rate in the elderly healthy population, and it may increase the incidence of hip fractures among elderly healthy women. This finding suggests refraining from prescribing high intermittent doses of vitamin D, without calcium, to individuals aged 60 or older with unknown vitamin D serum concentration or osteoporosis status and inadequate calcium intake.

Bone Health in Premenopausal Women with Coeliac Disease: An Observational Study.

Low bone mineral density (BMD) is common in adults with coeliac disease (CD), even in individuals adhering to a gluten-free diet (GFD). Women are more likely to have low BMD and have an increased risk of osteoporosis, so women with pre-existing low BMD related to CD are at an even higher risk. BMD assessed by dual X-ray absorptiometry (DXA) and bone quality assessed through quantitative ultrasound (QUS) were investigated in 31 premenopausal women with CD consuming a GFD, and 39 matched healthy controls from the Lower North Island, New Zealand. In addition, bone metabolism and nutrient status were assessed, and four-day diet diaries were used to estimate nutrient intake. No statistically significant differences were found in BMD assessed by DXA between the two groups at the hip, lumbar spine or forearm. However, the parameters measured by the QUS were significantly lower in CD participants. Dietary data indicated significantly lower intakes of energy, dietary fibre, magnesium and phosphorus in women with CD, likely as a result of a reduced intake of wholegrain foods, and suggested that both groups had inadequate intake of calcium. No significant differences were demonstrated in biochemical parameters. BMD and bone biomarkers indicated no differences between coeliac and healthy women in New Zealand. However, these findings suggest that QUS may be more sensitive for the coeliac population, due to the disease's affect on the trabecular bone, and warrant further research.

Prevalence of osteoporosis and associated factors among people aged 50 years and older in the Madhesh province of Nepal: a community-based cross-sectional study

BackgroundThe high prevalence of osteoporosis has increased the economic burden on the health system globally. The burden of osteoporosis and its associated factors have not been adequately assessed in community settings in the Nepalese context thus far. Therefore, this study aimed to assess the prevalence of osteoporosis and its associated factors, lifestyle behaviors, and dietary calcium intake.MethodsA community-based cross-sectional study was conducted among 395 people aged 50 years and older in the Madhesh Province of Nepal between July 2022 and August 2023. The Osteoporosis Self-assessment Tools for Asians (OSTA) index was used to measure osteoporosis. A structured questionnaire was used to collect sociodemographic information, anthropometric data, lifestyle behavior, daily dietary calcium intake, and frequency of calcium-rich food consumption. A food frequency questionnaire and 24-hour recall methods were used to assess dietary intake. The chi-square test, binary logistic regression and Mann‒Whitney U test were applied to measure the association between predictors and the outcome of interest.ResultsThe prevalence of no risk, moderate risk and high risk of osteoporosis were 38.7%, 39%, and 22.3% respectively. The risk of osteoporosis was higher in females (aOR = 5.18, CI: 2.10-12.75, p < 0.001) and increased risk with advancing age (aOR = 32.49, CI: 14.02–75.28, p < 0.001). Similarly, underweight was associated with increased odds of having osteoporosis (aOR = 13.42, CI = 4.58–39.30, p < 0.001). The incidence of osteoporosis was strongly associated with daily calcium intake of 225 mg (100, 386).ConclusionThis study revealed a high prevalence of osteoporosis among people aged 50 years and older due to the combined effect of being underweight and having inadequate calcium intake. Nutritional counselling services encourage people to consume sufficient calcium-rich food and adopt an appropriate lifestyle behaviours to maintain healthy body weight so that osteoporosis and osteoporotic fractures could be prevented. Further research can explore the impact of socioeconomic status and medical comorbidities on a large scale.

Undernutrition levels in Scottish older-adult population: a secondary data analysis of the Scottish Health Survey 2021

The proportion of the UK population over 65 years old is predicted to increase from 18.7% to 26% by 2066(1). However, healthy life expectancy (HLE) and disability free life expectancy (DLE) are decreasing(2, 3), which is particularly concerning in Scotland which also has the lowest overall life expectancy(4). Diet is a major modifiable factor in healthy aging(5) and should be a target to address declining HLE and DLE, but nutrient deficiencies in over 65s in Scotland are poorly understood. This study aimed to understand the presence and extent of inadequate intake of protein, fibre, vitamins, and minerals within over 60 year olds in Scotland.Secondary data analysis of the Scottish Health Survey 2021(6) was performed. Dietary data of older adults (≥ 60 years old, n = 1344) were analysed for protein, fibre, and micronutrient (from food sources) inadequacies, defined as percentage below estimated average requirement, reference nutrient intake or adequate intake(7, 8). Wald Z-test was used to analyse inadequacy between males and females, and urban and rural populations. Differences between Scottish index of multiple deprivation (SIMD) levels (1 [most deprived] to 5 [least deprived]) were analysed using χ2 test and cellwise sub-analysis(9) with Bonferroni corrections.The percentage of over 60s that had inadequate nutrient intake was highest for vitamin D (97%), fibre (93%), selenium (90%), potassium (79%) and Zinc (65%). Compared to males, females were at a greater risk of undernutrition in 18 of the 25 nutrients analysed, of which 11 were significant (p&lt;0.05). Compared to rural populations, urban populations were at a greater risk of undernutrition in 22 of 25 nutrients analysed, of which 10 were significant. People in SIMD 1 were at a greater risk of undernutrition in 20 of 25 nutrients analysed, of which 14 were significant. 40% of over 60s had inadequate protein intake. Risk of inadequate protein intake was greatest for people in SIMD 1 (56%, p&lt;0.001). 24% of over 60s had inadequate folate intake which was significantly higher in females than males (28% and 18%, respectively; p&lt;.001), urban than rural (26% and 19%, respectively; p&lt;.01), and in SIMD1 (36%; p&lt;.001). Inadequate fibre intake was significantly higher in females than males (95% and 91% respectively, p&lt;.01), and urban than rural (95% and 89%, respectively, p&lt;.001). 26% of over 60s had inadequate calcium intake. Inadequate calcium intake was significantly higher in females than males (25% and 17%, respectively; p&lt;.001).These data highlight a considerable undernutrition risk, both overall and within specific nutrients important for healthy aging, in Scotland’s older adult population. Those in SIMD 1, females, and urban dwelling demographics being particularly vulnerable. Although the extent of potential health implications, are dependent on key aspects such as nutrient absorption and utilisation.

Association between dietary calcium and pregnancy induced hypertension

Background: Pregnancy induced hypertension (PIH) is one of the major complications of pregnancy. Inadequate calcium (Ca) intake is considered a public health problem in some vulnerable groups, especially pregnant women. A balanced diet during pregnancy with adequate Ca should be the ideal solution, and to proceed in this direction, evidence is required on the nature and extent of Ca deficiency in the diet of PIH mothers. Objectives: To assess the dietary intake of Ca in PIH (compared to non-PIH) mothers and to explore the factors affecting the intake of those nutrients. Methods: Under an observational case-control design, we recruited 300 Bangladeshi pregnant women in two groups (150 with and 150 without PIH), aged between 20-40 years (from 3 hospitals in Dhaka) at the 3rd trimester of pregnancy. A pre-tested questionnaire was used to collect the data. The first part of the questionnaire was allocated to general socio-demographic and clinical characteristics. Secondly, a food frequency questionnaire was used to estimate individual dietary Ca intake. Results: The dietary Calcium intake [(mg/day), median (range)] was significantly lower [265(111-487)] (p&lt;0.001) in the PIH compared to the non-PIH [350(201-984) ;(p&lt;0.001)] group. On bivariate analysis, the dietary Calcium intakes had a significantly negative correlation with mean blood pressure which was considered an indicator of the severity of PIH (r=-0.276; p&lt;0.001) for Ca. On regression analysis, PIH was found to be significantly associated with a lower intake of Ca (b=-0.009; p&lt;0.001) when the effects of age, family history of HTN and family income were adjusted. Conclusion: Dietary consumption of Calcium during pregnancy is much lower than those recommended in our population, PIH seems to have an association with dietary deficiency of Calcium in pregnant women. Bioresearch Commu. 10(2): 1612-1618, 2024 (July)

Osteosarcopenia in women with rheumatoid arthritis: association with nutritional status and physical condition

Objective: to evaluate nutritional status, muscle strength, functional status of skeletal muscles and physical activity (PHA) and their relationship with the osteopenic body composition phenotype in women in post menopause with rheumatoid arthritis (RA). Material and methods. The case-control study included 134 women in post menopause with RA, 52 of them had osteosarcopenia (OSP) according to densitometry and 82 had no decrease in bone mineral density (BMD) and muscle mass (mean age 62.0 ± 7.2 and 59.6 ± 7.5 years, respectively; p &gt; 0.05). A clinical and laboratory examination as well as tests to assess muscle strength and functional status were performed. The MNA-SF and IPAQ questionnaires were used to determine nutritional status and physical activity. Results and discussion. Malnutrition was found in 51.9 % of patients, and low and average levels of PHA were found in 5.8 and 50.0 % of patients with OSP, respectively. Factors associated with OSP were identified: nutritional status according to MNA-SF &lt; 12 points (odds ratio, OR 2.52; 95 % confidence interval, CI 1.10–5.77; p = 0.029), dietary calcium intake &lt; 500 mg/day (OR 3.23; 95 % CI 1.49–7.01; p = 0.003), 25(OH)D level &lt; 30 ng/ml (OR 4.55; 95 % CI 1.86–11.16; p = 0.001), moderate PHA &lt; 1 hour per day (OR 2.67; 95 % CI 1.06–6.75; p = 0.037), walking &lt; 1 hour per day and &lt; 4 hours per week (OR 3.25; 95 % CI 1.26–8.38; p = 0.015 and OR 3.17; 95 % CI 1.19–8.46; p = 0.021, respectively). Conclusion. Reduced nutritional status was found in 51.9 % and average or low levels of PHA in 55.8 % of patients with OSP. The risk of OSP development was increased by low nutritional status, inadequate dietary calcium intake, low vitamin D levels, short duration of daily moderate exercise, and inadequate daily and weekly walking time.

Triple burden of malnutrition among Vietnamese 0·5-11-year-old children in 2020-2021: results of SEANUTS II Vietnam.

SEANUTS II Vietnam aims to obtain an in-depth understanding of the nutritional status and nutrient intake of children between 0.5-11.9 years old. Cross-sectional survey. A multistage cluster systematic random sampling method was implemented in different regions in Vietnam: North Mountainous, Central Highlands, Red River Delta, North Central and Coastal Area, Southeast and Mekong River Delta. 4001 children between 6 months and 11.9 years of age. Prevalence of stunting and underweight was higher in rural than in urban children, whereas overweight and obese rates were higher in urban areas. 12.0% of the children had anemia and especially children 0.5-1-year-old were affected (38.6%). Low serum retinol was found in 6.2% of children ≥ 4 years old. Prevalence of vitamin D insufficiency was 31.1% while 60.8% had low serum zinc. For nutrient intake, overall, 80.1% of the children did not meet the estimated energy requirements. For calcium intake, ∼60% of the younger children did not meet the RNI while it was 92.6% in children >7 years old. For vitamin D intake, 95.0% of the children did not meet RNI. SEANUTS II Vietnam indicated that overnutrition was more prevalent than undernutrition in urban areas, while undernutrition was found more in rural areas. The high prevalence of low serum zinc, vitamin D insufficiency and the inadequate intakes of calcium and vitamin D are of concern. Nutrition strategies for Vietnamese children should consider three sides of malnutrition and focus on approaches for the prevention malnutrition.

The Frequency and Associated Factors of Restless Leg Syndrome among Pregnant Women in 3rd Trimester

Background: Restless leg syndrome (RLS), also known as Willis-Ekbom disease, is characterized by an uncomfortable sensation in the legs, often occurring at the onset of sleep, which triggers an irrepressible urge to move the legs. This condition is particularly prevalent among pregnant women, with symptoms typically worsening during the third trimester. Despite its impact, many pregnant women are unaware of RLS, attributing their discomfort to normal pregnancy symptoms. Objective: To assess the frequency and associated factors of RLS in pregnant females during the third trimester and to evaluate its impact on their quality of life. Methods: A cross-sectional study was conducted involving 250 pregnant females in their third trimester, recruited from Shalimar Hospital, Nawaz Sharif Hospital, Zahida Welfare Trust, Alshad Clinic, Ali Hospital, Ahsan Hospital, Nargis Clinic, Manawa Government Hospital, and Sultan Medical Center. Participants aged 15-45 years were included, while those with rheumatoid arthritis, diabetes mellitus, neurological disorders, preeclampsia, and gestational diabetes mellitus were excluded. Data were collected using structured questionnaires incorporating the International Restless Legs Syndrome Study Group (IRLSSG) criteria and the Pittsburgh Sleep Quality Index (PSQI). Ethical approval was obtained, and the study adhered to the Declaration of Helsinki principles. Statistical analysis was performed using SPSS version 25, with descriptive statistics, frequencies, and graphical representations employed to summarize and analyze the data. Results: The mean age of participants was 26.32 years (SD = 5.08). The prevalence of RLS in the third trimester was found to be 89.2%. The age group most affected was 18-23 years. Factors associated with RLS included inadequate calcium intake (40.4%), insufficient daily water intake (40.4%), poor food intake (48%), mood disturbances (89.2%), lack of movement or light exercise (78%), caffeine consumption (16%), disturbances in sexual activities (48%), and disruption in daily activities (45.2%). Conclusion: RLS is highly prevalent among pregnant women, particularly in the third trimester, significantly impacting their quality of life. Despite its prevalence, many women remain unaware of RLS, mistaking it for typical pregnancy discomfort. Raising awareness and implementing screening and management strategies during prenatal care could improve the quality of life for affected women.

Dietary intake of polish organic and conventional fruit growers and their life partners - a pilot study.

Diet is one of the elements that contribute to health and quality of life. There are significant discrepancies between the diets of people living in different regions, with different beliefs, or with different approaches to sustainability and ecology. There is a lack of research on dietary intake among organic and conventional fruit growers. The aim of our study was to examine the diets of orchardists and their immediate life partners in terms of meeting energy requirements, nutrient intake and fulfillment of dietary recommendations in this group. Fifty-three participants (28 in the organic group and 25 in the conventional group) took part in the study. Dietary data were obtained using the 3-day dietary record. Body mass and height were measured and BMI was calculated. Physical activity was estimated using a questionnaire method. The study group was aged 44 ± 8 years, with a body weight of 84 ± 16 kg and a height of 172 ± 9 cm. The mean BMI was 28 ± 4 kg/m2. Mean energy intake with diet was 2170 ± 606 kcal/day with needs of 3002 (1991-5144) kcal/day. A significant proportion of the study group did not fulfill their calcium and vitamin D requirements. In addition, a significant proportion of the conventional fruit growers did not cover their needs for potassium, magnesium and vitamins: E, C, and folate. Both groups had too high an intake of cholesterol and saturated fatty acids, and too low an intake of polyunsaturated fatty acids. In conclusion, the orchardists' diets mostly provided adequate amounts of nutrients, with inadequate intakes of calcium, vitamin D, cholesterol, and fatty acids. The diets of organic fruit growers were significantly richer in selected nutrients.

Reducing hip and non-vertebral fractures in institutionalised older adults by restoring inadequate intakes of protein and calcium is cost-saving

Older adults in aged care homes account for 30% of the population burden of hip fractures(1). Nutritional interventions to correct protein and calcium inadequacies reduce these and other debilitating fractures, perhaps partly by reducing falls and slowing deterioration in bone morphology. We aimed to determine whether a nutritional approach to fracture risk reduction in aged care homes is cost-effective. Costing was estimated based on results of a prospective two-year cluster-randomised controlled trial involving 3313 residents in 27 aged care homes (intervention using high dairy menus), 3911 residents in 29 aged care homes (controls consuming from normal menus) and cost of ambulance, hospital, rehabilitation, and residential care incurred after fracture. The incremental cost-effectiveness ratios per fracture averted within a 2-year time horizon were estimated from the Australian healthcare perspective applying a 5% discount rate on costs after the first year. Intervention resulted in a total of 3.5 servings of milk, yoghurt and/or cheese daily, achieving 1,142mg calcium and 69g protein versus usual daily intakes of 700mg calcium and 58g protein consumed by controls. This intervention reduced all fractures by 33% at a daily cost of AU$0.66 per resident. The base-case results showed that intervention was cost-saving per fracture averted, with robust results in a variety of sensitivity and scenario analyses. Scaling the benefits of intervention to the Australian community equated to a saving of AU$66,780,000 annually in Australia and remained cost saving up to a daily food expenditure of AU$1.07 per aged care resident. Averting hip and other non-vertebral fractures in older adults in aged care homes by restoring nutritional inadequacies of protein and calcium is cost saving and supports the wide-spread implementation of this type of nutritional intervention in similar settings.

Enzymatic hydrolysates from sea cucumber body wall prevent low calcium-induced osteoporosis by regulating calcium absorption and gut microbiota

Inadequate calcium intake or intestinal malabsorption is closely related to osteoporosis. The aim of this study was to investigate the effects of sea cucumber enzymatic hydrolysates (SCEH) prepared from body wall on calcium absorption in calcium-deficient rats. Fifty-six female Sprague-Dawley rats on a low calcium diet that induced osteoporosis were fed SCEH and calcium carbonate for 3 months. The results showed that oral administration of SCEH and calcium carbonate both increased the body weight (bw) and bone mineral density (BMD) in calcium-deficient rats to varying degrees, thereby alleviating the adverse effects of osteoporosis. In addition, oral administration of a combination of SCEH (2000 mg/kg bw/day) and calcium (333 mg/kg bw/day) upregulated the expression of calcium transporter genes (TRPV6 and Calbindin-D9k) in the intestines, increased serum 1,25(OH)2D3 levels and BMD, decreased trabecular bone separation, and inhibited parathyroid hormone (PTH) release in calcium-deficient rats compared to calcium carbonate groups. Thus, this combination promoted calcium absorption and improved the efficiency of calcium utilization. These results might be associated with a higher short chain fatty acid (SCFA) level in the gut and an increased abundance of butyrate and acetate producing bacteria, such as Christensenellaceae R7 group, UCG-005 and Clostridium UCG-014. Therefore, a diet containing SCEH and calcium combinations might be recommended to increase bone mass and inhibit osteoporosis.

Trends in Calcium Intake among the US Population: Results from the NHANES (1999-2018).

Inadequate calcium intake is common in the US. Trends in calcium intake among the US population have been less studied, especially in more recent years. We used data from the National Health and Nutrition Examination Survey (NHANES) 1999-2000 to 2017-2018 to study trends in calcium derived from diet and dietary supplements among the US population aged 2 years, stratified by sex, age group, race, and ethnicity. Among the 80,880 participants included in our study, a substantial portion consistently lacked sufficient calcium intake, even when considering calcium from supplements. Concerning trends were observed over the more recent ten years (2009-2018), with decreased dietary calcium intake and no significant improvement in the prevalence of dietary calcium intake < Estimated Average Requirement (EAR) or the prevalence of taking calcium-containing dietary supplements among them. Decreasing trends in dietary calcium intake were more concerning among men, children, and non-Hispanic Whites. Attention should be given to subgroups with higher calcium intake requirements (e.g., 9-18 years and 60+ years), and subgroups with low levels of dietary calcium and a low prevalence of obtaining calcium from dietary supplements (e.g., the non-Hispanic Black subgroup). Concerning trends of calcium intake were observed among the US population from 2009 to 2018. Tailored guidance on dietary choices and dietary supplement use is required to change consumers' behaviors.

Male Lrp5A214V mice maintain high bone mass during dietary calcium restriction by altering the vitamin D endocrine system.

Environmental factors and genetic variation individually impact bone. However, it is not clear how these factors interact to influence peak bone mass accrual. Here we tested whether genetically programmed high bone formation driven by missense mutations in the Lrp5 gene (Lrp5A214V) altered the sensitivity of mice to an environment of inadequate dietary calcium (Ca) intake. Weanling male Lrp5A214V mice and wildtype littermates (control) were fed AIN-93G diets with 0.125%, 0.25%, 0.5% (reference, basal), or 1% Ca from weaning until 12 weeks of age (ie, during bone growth). Urinary Ca, serum Ca, Ca regulatory hormones (PTH, 1,25 dihydroxyvitamin D3 (1,25(OH)2D3)), bone parameters (μCT, ash), and renal/intestinal gene expression were analyzed. As expected, low dietary Ca intake negatively impacted bones and Lrp5A214V mice had higher bone mass and ash content. Although bones of Lrp5A214V mice have more matrix to mineralize, their bones were not more susceptible to low dietary Ca intake. In control mice, low dietary Ca intake exerted expected effects on serum Ca (decreased), PTH (increased), and 1,25(OH)2D3 (increased) as well as their downstream actions (ie, reducing urinary Ca, increasing markers of intestinal Ca absorption). In contrast, Lrp5A214V mice had elevated serum Ca with a normal PTH response but a blunted 1,25(OH)2D3 response to low dietary Ca that was reflected in the renal 1,25(OH)2D3 producing/degrading enzymes, Cyp27b1 and Cyp24a1. Despite elevated serum Ca in Lrp5A214V mice, urinary Ca was not elevated. Despite an abnormal serum 1,25(OH)2D3 response to low dietary Ca, intestinal markers of Ca absorption (Trpv6, S100g mRNA) were elevated in Lrp5A214V mice and responded to low Ca intake. Collectively, our data indicate that the Lrp5A214V mutation induces changes in Ca homeostasis that permit mice to retain more Ca and support their high bone mass phenotype.