Low Calcium Diet Research Articles

Calcium carbonate supplementation for the prevention of preeclampsia in high-risk pregnant women: a randomized clinical trial protocol

BackgroundPreeclampsia (PE) is a significant cause of maternal mortality worldwide, affecting 2% to 8% of pregnancies. The World Health Organization recommends the use of low-dose acetylsalicylic acid (100 mg of aspirin) and 1.5 to 2 g of calcium carbonate during pregnancy to prevent PE. However, robust evidence supporting the efficacy of calcium supplementation is still needed. This study aims to assess the efficacy of calcium carbonate in preventing preeclampsia in high-risk pregnant women.MethodsA triple-blind, randomized clinical trial will be conducted at an outpatient clinic in Brazil between May 2024 and March 2026. Pregnant women at high risk of developing preeclampsia and with low dietary calcium intake will be randomly assigned to one of three groups: one group will receive calcium carbonate capsules (commercially available in Brazil) along with 100 mg of aspirin; the second group will receive calcium carbonate derived from Crassostrea sp. along with 100 mg of aspirin; and the control group will receive a placebo alongside 100 mg of aspirin. The primary outcome is the diagnosis of preeclampsia during pregnancy, while secondary outcomes evaluate maternal and fetal health indicators.DiscussionThis trial seeks to generate evidence on the efficacy of calcium carbonate in preeclampsia prevention, with a focus on comparing industrial calcium carbonate with calcium carbonate sourced from Crassostrea sp., a more sustainable alternative.Trial registrationThe study was approved by the Research Ethics Committee of the Federal University of Sergipe and registered in the Brazilian Registry of Clinical Trials (ReBEC), under the ID RBR-7hqhj3y. Registered on November 16, 2023.

Experiences, acceptability and barriers to calcium supplementation during pregnancy in Dar es Salaam, Tanzania.

Calcium supplementation in pregnancy is recommended in contexts with low dietary calcium intake to reduce the risk of pre-eclampsia and its complications. The World Health Organisation suggested high-dose calcium supplementation (1500-2000 mg/day), divided into three doses and taken at different times from daily iron-folic supplements. We conducted a mixed methods evaluation study to assess experiences, acceptability and barriers to high-dose calcium supplementation from the perspectives of pregnant women and antenatal health care providers at two public health facilities in Dar es Salaam, Tanzania. Descriptive statistics and thematic analysis were used to characterise acceptability, barriers and overall experiences of using high-dose calcium supplementation. Pregnant women in the cohort were aged 19-41 years, with 32.4% being primiparous. The proportion of pregnant women who liked calcium supplements 'a lot' decreased from 50.2% at the first visit to 31.8% at the last antenatal follow-up visit. Adherence was 71.3% (interquartile range: 50.5%, 89.3%), with only 24.0% of the participants taking 90% or more of the required supplements. Although participants expressed positive attitudes towards using calcium supplements, they also voiced concerns about the large size, side effects, the potential to forget and the burden of taking calcium supplements three times per day. Antenatal health care providers also affirmed the high burden of taking calcium supplements in addition to iron-folic acid supplements. Participants expressed the acceptability of using calcium supplements during pregnancy, but adherence to three doses per day posed challenges to pregnant women. Reducing the number of calcium supplement doses per day may improve adherence.

Comparison analysis of the burden and attributable risk factors of early-onset and late-onset colorectal cancer in China from 1990 to 2019.

The project intended to analyze the impact of burden and related risk factors of late-onset colorectal cancer (LOCRC) and early-onset colorectal cancer (EOCRC) in China, thus offering essential references for optimizing prevention and control strategies. Global Burden of Disease Study was employed to describe burden changes of EOCRC and LOCRC in China during 1990-2019, containing the numbers of incidence, deaths, prevalence, and disability-adjusted life years (DALYs), and to compare attributable deaths and DALYs risk factors in varying age and sex segments. The numbers and corresponding crude rates of incidence, deaths, prevalence, and DALYs of EOCRC and LOCRC in China during 1990-2019 demonstrated an upward trend across all age categories, with males being dramatically predominant. Overall, over time, the impact of a low-calcium diet and a low-fiber diet on mortality and DALY rates decreased, while the impact of other risk factors increased. In terms of gender, the risk factors affecting males changed greatly, with smoking, inadequate milk intake, and the low whole-grain diet being the main factors in 2019, while in 1990, the main factors were the low-calcium diet, smoking, and inadequate milk intake. The burden of colorectal cancer in China is concerning. Patients grouped by diagnostic age exhibit different characteristics, indicating the need for high-quality research in the future to achieve personalized medicine tailored to different population characteristics.

Sunflower seed and peanut peptide calcium-complex promote bone mass accumulation in growing female KM mice fed a low calcium diet by improving calcium bioavailability and bone type I collagen synthesis

Previous studies have indicated that Sunflower Seed Peptide (SSP)-Ca and peanut peptide (PP)-Ca improve Ca bioavailability and enhance bone mineral density in low-Ca diet-fed male mice. However, the mechanisms of SSP-Ca and PP-Ca act in bone metabolism, and whether their effect is affected by sex remain unclear. In this study, 5 week-old female KM mice were fed a low-Ca diet and gavaged with different doses of SSP-Ca, PP-Ca, or CaCO3 for 5 weeks. SSP-Ca and PP-Ca supplementation ameliorated femur binding toughness, BMD and microarchitecture. SSP-Ca and PP-Ca intake increased the bone type I collagen levels and Co1la1 mRNA expression. SSP-Ca and PP-Ca intake also significantly increased the serum P1NP levels. In conclusion, SSP-Ca and PP-Ca promote bone mass accumulation in growing female mice fed with a low-Ca diet by improving Ca bioavailability and bone type I collagen synthesis. The study provided novel insights for Ca supplementation in adolescence.

47. Effect of low calcium diet supplemented with microbial phytase in post-weaning piglets

47. Effect of low calcium diet supplemented with microbial phytase in post-weaning piglets

Bioequivalence and Food Effect Assessment of Eltrombopag Olamine Tablets in Healthy Chinese Subjects: An Open, Randomized, Single-Dose, and Two-Period Crossover Study.

Eltrombopag, a nonpeptide thrombopoietin receptor agonist, is primarily used for treating immune thrombocytopenic purpura. The aim of this study was to investigate the pharmacokinetic profile and food-drug interaction of test and reference eltrombopag olamine tablets among healthy Chinese volunteers. An open, randomized, single-dose, 2-period crossover design was employed, involving fasting and fed conditions with a 10-day washout period. Ninety-six healthy volunteers received a single oral dose of 25mg of the 2 eltrombopag formulations, with 48 participants in each group: fasting volunteers and those consuming a high-fat, low-calcium meal. Plasma eltrombopag concentrations were analyzed using liquid chromatography-tandem mass spectrometry, and pharmacokinetic parameters were derived from the concentration-time profiles. The geometric mean ratios, with 90% confidence intervals, for the maximum plasma concentration, area under the concentration-time curve from time 0 to the last measurable concentration, and area under the concentration-time curve from time 0 to infinity fell within the bioequivalence acceptance criteria (80%-125%) under both fasting and fed conditions, indicating bioequivalence between the test and reference formulations. Administration of eltrombopag with a high-fat, low-calcium diet reduced the net systemic exposure by approximately 40%. Adverse events were recorded, and no serious adverse events were observed in either fasting or fed conditions. In conclusion, eltrombopag is well tolerated and exhibits a favorable safety profile in the Chinese population. The achievement of bioequivalence under fasting and fed conditions supports the demonstration of biosimilarity between the test and reference formulations.

A maternal brain hormone that builds bone

In lactating mothers, the high calcium (Ca2+) demand for milk production triggers significant bone loss1. Although oestrogen normally counteracts excessive bone resorption by promoting bone formation, this sex steroid drops precipitously during this postpartum period. Here we report that brain-derived cellular communication network factor 3 (CCN3) secreted from KISS1 neurons of the arcuate nucleus (ARCKISS1) fills this void and functions as a potent osteoanabolic factor to build bone in lactating females. We began by showing that our previously reported female-specific, dense bone phenotype2 originates from a humoral factor that promotes bone mass and acts on skeletal stem cells to increase their frequency and osteochondrogenic potential. This circulatory factor was then identified as CCN3, a brain-derived hormone from ARCKISS1 neurons that is able to stimulate mouse and human skeletal stem cell activity, increase bone remodelling and accelerate fracture repair in young and old mice of both sexes. The role of CCN3 in normal female physiology was revealed after detecting a burst of CCN3 expression in ARCKISS1 neurons coincident with lactation. After reducing CCN3 in ARCKISS1 neurons, lactating mothers lost bone and failed to sustain their progeny when challenged with a low-calcium diet. Our findings establish CCN3 as a potentially new therapeutic osteoanabolic hormone for both sexes and define a new maternal brain hormone for ensuring species survival in mammals.

Effects of low dietary calcium and lipopolysaccharide challenges on production performance, eggshell quality, and bone metabolism of laying hens.

Dietary calcium supply is essential for bone development and egg production in laying hens. This study investigated the effects of low dietary calcium and lipopolysaccharide (LPS) induced immune challenge in aged laying hens. A total of thirty-two Hy-Line Brown laying hens at 80 weeks old with an average laying rate of 62% were randomly divided into two groups and fed a normal calcium diet (3.57% Ca, NCA) or low calcium diet (2.08% Ca, LCA). At 88 weeks, the experiment was designed using a 2 × 2 factorial arrangement, and hens were intraperitoneally injected with saline (SAL) or LPS (0.5mg/kg, 0.5mg/kg, or 1.5mg/kg body weight) once every 48h intervals over 5 days. Production performance, egg quality, and bone physiology were evaluated. Results showed that LPS challenge decreased the hen-day egg production, egg mass, and eggshell traits (p < 0.05), but increased (p < 0.05) the calcium content of the tibia compared to SAL-injected hens. LCA diet decreased (p < 0.05) the hen-day egg production, and eggshell traits such as weight, percentage, strength, and thickness compared to the NCA diet. LCA diet increased the serum alkaline phosphatase (ALP) activity (p < 0.01) and tibial expression of ALP (p < 0.05) compared to NCA diet. LPS injection suppressed both the serum ALP activity (p < 0.05) and tibial expression of ALP (p < 0.001) compared to SAL injection. Furthermore, LPS injection increased (p < 0.05) the expression of both pro and anti-inflammatory cytokines in the spleen and tibia. The expression of cathepsin K ( Cts K ) and matrix metalloproteinase 9 ( MMP-9 ) were downregulated by LPS injection (p < 0.001). Broken and shell-less egg production and calcium content of eggshell, as well as tibial mRNA expression of osteocalcin ( Ocn ), tumor necrosis factor-alpha ( TNF-α ) and tartrate-resistant acid phosphatase ( TRAP ) were affected by the interaction (p < 0.05) of diet and injection. Therefore, this study demonstrated that to certain extents, low dietary calcium and LPS challenge dysregulated bone homeostasis and metabolism, with detrimental effects on the performance and eggshell quality of aged laying hens.

#1096 Improving the diagnostic accuracy of absorptive hypercalciuria: a comparative analysis of calcium load tests at 2-hour and 4-hour intervals

Abstract Background and Aims A calcium load test (CLT) has been developed by Pak et al in 1974 to better discriminate absorptive, resorptive and renal hypercalciuria, leading to a tailored treatment approaches for patients. Originally, Calcium load was a 4-hours (4 h) test with a timepoint at 2-hours (2 h) defining an absorptive hypercalciuria (AH) by an increase of the difference between urinary calcium on creatininuria ratio (ΔUCa/Cr) of more than 0.5 mmol/mmol. In clinical practice and in more recent studies, CLT is only a 2 h test using this 0.5 or sometime 0.6 mmol/mmol cut-off. We hypothesized that a 2-hours timepoint is not sufficient to diagnose all AH and that the 4-hours timepoint as initially described is more efficient to improve accuracy of AH diagnosis. Method We report a single-centre, retrospective study including all patients who underwent CLT between January 2015 and September 2020. These tests were carried out in patients with hypercalciuria or in patients with elevated parathyroid hormone (PTH, standard 15-65 ng/L, Elecsys PTH) with normocalcemia, with or without kidney stones history. After a low-calcium diet for 3 days and a 12-hours fast, 24-hours urine were collected and blood and urinary samples were done at arrival. Two hours and 4 h after ingestion of one gram of calcium per os, blood and urinary samples were collected. AH was diagnosed by a ΔUCa/Cr at baseline and 2 h or 4 h timepoints of more than 0.5 mmol/mmol. We compared the number of AH diagnosed after 2 h and 4 h of testing using a 0.5 mmol/mmol delta at each timepoint. We also analysed clinical and biological profile of early and late AH. Results A total of 328 patients were included, 48 ± 14.8 years old, mean glomerular filtration rate of 92.8 ± 22.1 mL/min/1.73 m², 52.8% of women. At baseline, ionized calcemia (iCa2+) was 1.2 ± 0.1 mmol/L with a significant increase at 2 h (1.3 ± 0.1 mmol/L, p &amp;lt; 0.001) and a stabilisation at 4 h (1.3 ± 0.1 mmol/L, p = ns). Simultaneously, PTH showed a significant drop between baseline and 2-hours (60 ± 26.1 ng/L versus 35.3 ± 19.7 ng/L, p &amp;lt; 0.001) follows by a significant increase between 2 and 4 h (35.3 ± 19.7 ng/L versus 39.5 ± 21.4 ng/L, p &amp;lt; 0.01). Mean 25-Hydroxyvitamin D and 1,25-Dihydroxyvitamin D3 were respectively 67.4 ± 24.7 ng/mL and 154.6 ± 54pg/mL. Baseline UCa/Cr ratio was 0.3 ± 0.2 mmol/mmol and increased significantly after 2 h (0.6 ± 0.3 mmol/mmol, p &amp;lt; 0.001) and 4 h (0.8 ± 0.4 mmol/mmol, p &amp;lt; 0.001) (Fig. 1a). ΔUCa/Cr was significantly different between baseline and 2 h and between baseline and 4 h (0.2 ± 0.2 versus 0.5 ± 0.4, p &amp;lt; 0.001) (Fig. 1b). AH was diagnosed in 35 (10.7%) patients after 2 h, 84 (25.6%) more were diagnosed at 4 h (p &amp;lt; 0.001) for a total of 119 (36.3%) AH diagnosed. Between early and late AH, we found no significant differences in 1,25-Dihydroxyvitamin D3, phosphatemia or phosphaturia, but 25-Hydroxyvitamin D which (67.3 ± 21 ng/mL in late AH versus 59.2 ± 18.3 ng/mL, p = 0.039). In comparison to the rest of the cohort, AH have a higher 1,25-Dihydroxyvitamin D3 level, a lower PTH at 2 h and 4 h, a lower phosphaturia at 2 h and 4 h and a higher magnesiuria at 4 h. Conclusion This study shows that performing the 4 h CLT improves the diagnosis of AH with more than fifty percent of AH diagnosed within 4 h of calcium ingestion. It seems that there are AH of later diagnosis with a similar clinical and biological profile depending of enteral absorption.

Hypercalcaemic Crisis Associated with Hyperthyroidism: A Rare and Challenging Presentation

A 51-year-old female with a history of multinodular goitre presented with vomiting, abdominal discomfort, and generalized tiredness. Investigations revealed hypercalcemia (ionized calcium 1.41 mmol/L), hypokalaemia, suppressed parathyroid hormone, and significantly elevated free thyroxine (&gt; 7.77 ng/dL) with a suppressed thyroid-stimulating hormone level consistent with hyperthyroidism. Further, the workup confirmed Graves’ disease as the underlying aetiology. Hyperthyroidism is occasionally associated with mild to moderate hypercalcemia, but severe hypercalcemia or hypercalcaemic crisis is an extremely rare complication. Prompt recognition and treatment are crucial to prevent life-threatening complications. The patient was treated with intravenous fluids, a low-calcium diet, zoledronic acid, carbimazole, and a beta-blocker, leading to improvement in her condition. This case highlights a rare occurrence of hypercalcaemic crisis in a patient with thyrotoxicosis due to Graves’ disease. Hyperthyroidism-induced hypercalcemia requires prompt recognition and multidisciplinary management involving endocrinologists, internists, and critical care specialists to prevent potentially life-threatening complications. Healthcare providers should consider the hypercalcaemic crisis in the differential diagnosis of hypercalcemia in the context of hyperthyroidism.

259 Effect of very low calcium diet supplemented with microbial phytase in post-weaning piglets

Abstract Young piglets have an immature intestine that provides limited gastric acidity to digest nutrients compared with later stages of growth. Food has the intrinsic capacity to modify gastric acidity, particularly in relation to their concentrations of limestone, the ingredient with the greatest capacity to bind to acid. An experiment was conducted to evaluate the impacts of reducing dietary calcium (Ca) by reducing calcium supplementation immediately after weaning; compared with the recommendations of the NRC (2012), in association with phytase supplementation. The treatments were distributed during 3 phases [Phase 1 (P1, d 0-9), 2 (P2, d 10-16) and 3 (P3, d 17-35)]. Treatments were: 1) a diet low Ca that did not contained limestone during phase 1 (LowCa), P1 to P3 respectively, 0.51-0.60-0.65 % Ca and 0.48-0.43-0.38 % standardized ileal digestible P (STTD P), 2), diet 1 with microbial phytase (LowCa+PhytM); P1 to P3 respectively, 0.51-0.60-0.65 % Ca and 0.48-0.43-0.38% STTD P with 750 FTU phytase, and 3) a diet fulfilling requirement (NormalCa+PhytM) P1 to P3 respectively, 0.85-0.80-0.70 % Ca and 0.48-0.43-0.38 % STTD P with 750 FTU phytase. Piglets (n = 120) were allocated to 6 pens of 5 piglets per treatment in function of initial body weight (BW; 6.12 ± 0.028 kg). On d 0, 15 and 36, dual X-ray (DXA) bone densitometry was used to measure body fat, lean and mineral content (BMC) compositions using 8 piglets per treatment. At the end of phase 1 (d 9) a blood sample was collected. Data were analyzed using the SAS MIXED procedure with Tukey’s test to compare means. No differences were observed in growth performance or DXA measurements during the first phase. On d 9, LowCa piglets showed signs of hypocalcaemia with reduced plasma Ca (P = 0.03), increased plasma P (P = 0.02) and a lower Ca:P ratio in plasma (P = 0.04). From d 9-15, piglets that had received LowCa+PhytM showed greater average daily gain (ADG; P = 0.002) while other criteria did not differ between treatments. On d 15, the body composition evaluated by DXA showed no difference among dietary treatments. During phase 3, final BW and average daily feed intake were not modified by dietary treatments, while average daily gain and feed efficiency were greater in LowCa than in NormalCa+PhytM (+7.3 and 6.7%, respectively), and LowCa+PhytM was intermediate. Body composition on d 35 showed no difference among treatments while a tendency (P = 0.095) for greater BMC deposition (g/d) in LowCa in comparison with NormalCa+PhytM (+1.3 %). The implemented LowCa strategy resulted in momentary hypocalcemia which probably activated homeostatic mechanisms allowing piglets to be more efficient in using minerals and possibly other nutrients leading to better growth performance, without impact on bone mineralization.

Deletion of FNDC5/irisin modifies murine osteocyte function in a sex-specific manner

Irisin, released from exercised muscle, has been shown to have beneficial effects on numerous tissues but its effects on bone are unclear. We found significant sex and genotype differences in bone from wildtype (WT) mice compared to mice lacking Fndc5 (knockout [KO]), with and without calcium deficiency. Despite their bone being indistinguishable from WT females, KO female mice were partially protected from osteocytic osteolysis and osteoclastic bone resorption when allowed to lactate or when placed on a low-calcium diet. Male KO mice have more but weaker bone compared to WT males, and when challenged with a low-calcium diet lost more bone than WT males. To begin to understand responsible molecular mechanisms, osteocyte transcriptomics was performed. Osteocytes from WT females had greater expression of genes associated with osteocytic osteolysis and osteoclastic bone resorption compared to WT males which had greater expression of genes associated with steroid and fatty acid metabolism. Few differences were observed between female KO and WT osteocytes, but with a low-calcium diet, the KO females had lower expression of genes responsible for osteocytic osteolysis and osteoclastic resorption than the WT females. Male KO osteocytes had lower expression of genes associated with steroid and fatty acid metabolism, but higher expression of genes associated with bone resorption compared to male WT. In conclusion, irisin plays a critical role in the development of the male but not the female skeleton and protects male but not female bone from calcium deficiency. We propose irisin ensures the survival of offspring by targeting the osteocyte to provide calcium in lactating females, a novel function for this myokine.

Deletion of FNDC5/irisin modifies murine osteocyte function in a sex-specific manner.

Irisin, released from exercised muscle, has been shown to have beneficial effects on numerous tissues but its effects on bone are unclear. We found significant sex and genotype differences in bone from wildtype (WT) mice compared to mice lacking Fndc5 (knockout [KO]), with and without calcium deficiency. Despite their bone being indistinguishable from WT females, KO female mice were partially protected from osteocytic osteolysis and osteoclastic bone resorption when allowed to lactate or when placed on a low-calcium diet. Male KO mice have more but weaker bone compared to WT males, and when challenged with a low-calcium diet lost more bone than WT males. To begin to understand responsible molecular mechanisms, osteocyte transcriptomics was performed. Osteocytes from WT females had greater expression of genes associated with osteocytic osteolysis and osteoclastic bone resorption compared to WT males which had greater expression of genes associated with steroid and fatty acid metabolism. Few differences were observed between female KO and WT osteocytes, but with a low-calcium diet, the KO females had lower expression of genes responsible for osteocytic osteolysis and osteoclastic resorption than the WT females. Male KO osteocytes had lower expression of genes associated with steroid and fatty acid metabolism, but higher expression of genes associated with bone resorption compared to male WT. In conclusion, irisin plays a critical role in the development of the male but not the female skeleton and protects male but not female bone from calcium deficiency. We propose irisin ensures the survival of offspring by targeting the osteocyte to provide calcium in lactating females, a novel function for this myokine.

Effects of Sheep Bone Peptide-Chelated Calcium on Calcium Absorption and Bone Deposition in Rats Fed a Low-Calcium Diet

Sheep bones, as the main byproduct after sheep slaughter, are rich in proteins, but their utilization in deep processing is relatively low. Currently, calcium deficiency is a common health issue that can lead to metabolic bone diseases. Peptide calcium chelate is considered a superior substance, having a significant effect on improving the absorption and utilization efficiency of calcium in the human body. This study used sheep bone byproducts as the raw material to prepare sheep bone peptide-chelated calcium (SBP-Ca) and its structure was characterized and analyzed in depth. SBP-Ca was supplemented in a low-calcium diet to assess its effects on calcium absorption and bone formation in a rat model experiencing calcium deficiency. The results showed that under optimal preparation conditions for SBP-Ca (peptide-calcium ratio set at 1 : 1, pH maintained at 7, temperature set to 45°C, and duration of 60 min), calcium could chelate with sheep bone peptide (SBP) at the sites C=O, -NH2, and -COOH sites, forming a structurally dense SBP-Ca with a chelation rate of up to 89.24%. In rats fed a low-calcium diet, SBP-Ca significantly improved the rat femoral diameter, dry weight, trabecular bone structure, bone density, and bone volume fraction (P&lt;0.05). A decline in serum alkaline phosphatase levels (P&lt;0.05), elevation in bone calcium content, and a rise in serum osteocalcin levels (P&lt;0.05) were observed. Furthermore, morphological studies on bone tissue suggest that SBP-Ca has the ability to restore trabecular bone structure. In conclusion, SBP-Ca has been successfully prepared as a novel calcium absorption promoter. By improving the bioavailability of calcium, bone formation was facilitated, demonstrating a significant application value in the prevention of calcium deficiency disorders.

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.

The Most Important Metabolic Diseases in Dairy Cattle during the Transition Period.

This review paper provides an in-depth analysis of three critical metabolic diseases affecting dairy cattle such as subacute ruminal acidosis (SARA), ketosis, and hypocalcemia. SARA represents a disorder of ruminal fermentation that is characterized by extended periods of depressed ruminal pH below 5.5-5.6. In the long term, dairy herds experiencing SARA usually exhibit secondary signs of the disease, such as episodes of laminitis, weight loss and poor body condition despite adequate energy intake, and unexplained abscesses usually 3-6 months after an episode of SARA. Depressed milk-fat content is commonly used as a diagnostic tool for SARA. A normal milk-fat test in Holstein dairy cows is >4%, so a milk-fat test of <3% can indicate SARA. However, bulk tank testing of milk fat is inappropriate to diagnose SARA at the herd level, so when >4 cows out of 12 and <60 days in milk are suspected to have SARA it can be considered that the herd has a problem. The rapid or abrupt introduction of fresh cows to high-concentrate diets is the most common cause of SARA. Changes in ruminal bacterial populations when exposed to higher concentrate rations require at least about 3 weeks, and it is recommended that concentrate levels increase by no more than 400 g/day during this period to avoid SARA. Ketosis, a prevalent metabolic disorder in dairy cattle, is scrutinized with a focus on its etiological factors and the physiological changes leading to elevated ketone bodies. In total mix ration-fed herds, an increased risk of mastitis and reduced fertility are usually the first clinical signs of ketosis. All dairy cows in early lactation are at risk of ketosis, with most cases occurring in the first 2-4 weeks of lactation. Cows with a body condition score ≥3.75 on a 5-point scale at calving are at a greater risk of ketosis than those with lower body condition scores. The determination of serum or whole blood acetone, acetoacetate, beta-hydroxybutyrate (BHB) concentration, non-esterified fatty acids (NEFA), and liver biopsies is considered the best way to detect and monitor subclinical ketosis, while urine or milk cowside tests can also be used in on-farm monitoring programs. Concentrations >1.0 mmol/L or 1.4 mmol/L blood or serum BHB are considered diagnostic of subclinical ketosis. The standard threshold used for blood is 1.2 mmol/L, which corresponds to thresholds of 100 mcmol/L for milk and 15 mg/dL for urine. Oral administration of propylene glycol (250-400 g, every 24 h for 3-5 days) is the standard and most efficacious treatment, as well as additional therapy with bolus glucose treatment. Hypocalcemia is a disease of adult dairy cows in which acute hypocalcemia causes acute to peracute, afebrile, flaccid paralysis that occurs most commonly at or soon after parturition. Dairy cows are at considerable risk for hypocalcemia at the onset of lactation, when daily calcium excretion suddenly increases from about 10 g to 30 g per day. Cows with hypocalcemia have a more profound decrease in blood calcium concentration-typically below 5.5 mg/dL. The prevention of parturient paresis has been historically approached by feeding cows low-calcium diets during the dry period. Negative calcium balance triggers calcium mobilization before calving and better equips the cow to respond to the massive calcium needs at the onset of lactation. Calcium intake must be limited to <20 g per day for calcium restriction to be effective. The most practical and proven method for monitoring hypocalcemia is by feeding cows an acidogenic diet for ~3 weeks before calving. Throughout the review, emphasis is placed on the importance of early diagnosis and proactive management strategies to mitigate the impact of these metabolic diseases on dairy cattle health and productivity. The comprehensive nature of this paper aims to serve as a valuable resource for veterinarians, researchers, and dairy farmers seeking a deeper understanding of these prevalent metabolic disorders in dairy cattle.

Ileal Phosphorus Digestibility in Broiler Chickens Fed Low Calcium and Phosphorus Diets Supplemented with Phytase and Cholecalciferol

Ileal Phosphorus Digestibility in Broiler Chickens Fed Low Calcium and Phosphorus Diets Supplemented with Phytase and Cholecalciferol

Disease Burden of Colorectal Cancer in China from 1990 to 2019: Age- and Sex-Specific Time Trends and 10-Year Forecast

Introduction: Colorectal cancer (CRC) is the third most prevalent malignant tumor worldwide and the second leading cause of cancer-related death. This study aimed at reporting the disease burden of CRC in China from 1990 to 2019 and predicting the trend of mortality burden over the next 10 years. Methods: The age-period-cohort model was implemented to analyze the trends of mortality from CRC in China from 1990 to 2019, and the autoregressive integrated moving average (ARIMA) model was used to predict the trends of CRC incidence and mortality from 2020 to 2029. Results: From 1990 to 2019, the incidence of CRC in China increased from 105,911 cases (95% uncertainty interval [UI]: 93,808–119,021) to 607,900 cases (95% UI: 521,805–708,420). The age-standardized incidence rate increased from 12.52 per 100,000 (95% UI: 11.15–14.03) to 30.55 per 100,000 (95% UI: 26.37–35.5), with an estimated annual percentage change (EAPC) of 3.66 (95% confidence interval [CI]: 3.37–3.95), showing an upward trend. The age-standardized mortality rate increased from 10.18 per 100,000 (95% UI: 9.03–11.37) to 13.86 per 100,000 (95% UI: 11.92–16.01), with an EAPC of 1.39 (95% CI: 1.14–1.63), also showing an upward trend. The age group with the highest incidence and mortality in 2019 was 65–69 years old for both sexes, and the age group with the highest mortality was 70–74 years old. Males had higher relative risks of incidence and mortality than females. Low-calcium diet was the risk factor for both sexes and females alone in 1990, while low-milk diet was the risk factor in 2019; however, smoking remained the risk factor for males. The ARIMA model predicted an increase in both disease and mortality burden of CRC over the next 10 years. Conclusion: The disease and mortality burden of CRC in China showed an overall upward trend from 1990 to 2019, with higher burden in males than females, and the situation remains extremely severe in the next decade.

Factors affecting the implementation of calcium supplementation strategies during pregnancy to prevent pre-eclampsia: a mixed-methods systematic review

ObjectivesDaily calcium supplements are recommended for pregnant women from 20 weeks’ gestation to prevent pre-eclampsia in populations with low dietary calcium intake. We aimed to improve understanding of barriers and...

A Pharmacovigilance Study on Steroid Induced Osteoporosis

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