Mg Of Calcium Research Articles

Development of a Pennywort (Centella asiatica) Ice Cream with Passion Fruit (Passiflora edulis)

Ice cream is a popular frozen dessert usually made of milk, cream, sugar, and flavoring. The goal of this study was to determine methods to enhance ice cream nutritionally through the addition of pennywort (Centella asiatica) and passion fruit (Passiflora edulis) extract. Pennywort is a nutritious leaf but not commonly utilized as food. The development of the product through laboratory experiments. The standardized ingredients and procedures were determined after five trial formulations. The pennywort leaf was dehydrated using the Multi-Commodity Heat Pump Dryer and ground using a food processor. Coconut milk was first chilled then mixed with soya milk from fresh soybeans. Sugar, vanilla, salt, pennywort and passion fruit extract were mixed using a blender. The mixture was poured into a plastic cup and frozen for 24 hours. The pennywort ice cream with passion fruit containeds 177 kcal per serving (125 ml). Each serving contained 33g of carbohydrates, 5g of protein, 2.8 g of fat, 88mg of calcium, 85mg of phosphorus, 1.1 mg of niacin, 0.9 mg of iron, 0.04 mg of thiamine, and 0.03 mg of riboflavin. The cost of one serving was ₱17. The product was evaluated by 30 individuals from both genders and was rated by the majority as like extremely in terms of odor, color, appearance, texture. Its taste was rated as like very much. This study showed that utilizing pennywort and passion fruit to enhance the taste and nutrient content of ice cream is possible.

Development and Evaluation of Instant Cookie Mix from Banana Peel and Malunggay

This study was conducted to utilize banana peel and malunggay in the development of an instant cookie mix. Using a multi-commodity heat pump dryer, the banana peel and malunggay were dehydrated for 15 and 5 hours, respectively. The ingredients were then powdered and mixed with other ingredients: flour, sugar, flaxseed, baking soda, and butter. Each tablespoon of batter was molded into a flat round shape then baked at 375ºF for 18 minutes. One pack of the instant cookie mix (262 grams) was found to have 288 kcal, 3.5 grams protein, 10.53 grams fat, 45.6 grams carbohydrates, 75 mg of calcium, 44 mg phosphorus, 1.5 mg iron, 86 µg vitamin A, 0.04 mg thiamine, 0.06 mg riboflavin, 1.8 mg niacin, and 8 mg vitamin C. The product was generally liked by all levels (elementary, high school, and college). The cookie mix is stored inside a grip seal bag stand-up pouch with aluminum foil, which will last approximately one month. The raw cost of one pack is PhP35.98 or PhP2.99 per cookie. The selling price of one pack is PhP57.57, cheaper compared to other cookie mixes. The utilization of banana peel and malunggay for vegan cookie mix exhibits innovation in food technology.

Development of Power Vegan Cupcake

The objective of this study was to develop a healthy eating on the go for busy people. The Power Vegan Cupcake is a plant-based, nutrient-dense product, and is made from local plant-based ingredients. Saluyot and soymilk were used as replacements for egg and milk. Brown rice flour, muscuvado, banana, raisins, and peanuts made the cupcake a complete food. The dry ingredients were sifted and mixed. Saluyot and pandan leaves were boiled for 15 minutes and then cooled, blended, and strained. The saluyot puree and pandan juice were then mixed with the dry ingredients, soy milk, and vanilla. The batter was mixed, and raisins and banana were added. The batter was baked in an oven for 25 minutes at 200°C. Each Power Vegan Cupcake (70g) contained 41.7g of carbohydrates, 4.7g of protein, and 3.12g of fat for a total calorie content of 198.4kcal. It also contained 28.75ug of Vitamin A, 2.4mg of Vitamin C, 50.6mg of calcium, 1.5mg of iron, 0.17mg of thiamin, 0.19mg of riboflavin, 2.93mg of niacin, and 98.7mg of phosphorus. The product was found to contain a higher amount of carbohydrates, protein, and micronutrients compared to regular cupcakes on the market. Thirty respondents, ages 18-29, evaluated the product. The results showed a rating of like very much from 63%, 53%, and 50% of the evaluators in terms of appearance, texture, and taste, respectively. Advance development of saluyot as egg substitute for strict vegetarian foods is recommended.

Effect of storage of hot dried cape gooseberry added with physiologically active components by vacuum impregantion

The aim of the research was to evaluate the effect of temperature (4, 20 and 30°C), time (0, 1, 2, 3, 4, 5 and 6 months) and the packaging conditions (with and without vacuum), during the storage of gooseberries added with calcium and vitamins B9, C, D3, E by means of vacuum impregnation and then dehydrated by air at 60°C and 2 m/s. The effect of the packing was not a critical factor in the stability of the physiologically active components (PAC). The calcium was stable at the storage conditions evaluated. Vitamins B9, C and D3 decreased with increasing storage time and temperature; whereas, vitamin E showed degradation. The best storage conditions during the 6 months were 4oC and atmospheric packing, reaching values of 434,0 ± 45,0mg; 179,1 ± 89,2mg; 28,3 ± 5,4mg; 3,5 ± 1,1g y 8,7 ± 1,2mg for calcium and vitamins B9, C, D3 y E respectively, complying with the descriptor “Excellent source” in all evaluated nutrients in a portion of 100g according to the Colombian regulations. The technique of vacuum impregnation is an effective pre-treatment for the incorporation of PAC, contributing to the generation of value of the cape gooseberry agro-chain.

Complex method for calculating total serum calcium concentration.

Abstract Background Calcium drugs are analogs of endogenous substances. The baseline concentration of endogenous substances in the body and homeostasis mechanisms of regulation make the bioavailability and bioequivalence (BE) evaluation of these drugs very difficult. The aim of the study was to assess the pharmacokinetic parameters of calcium in the studies of comparative bioavailability combined with the assessment of homeostatic regulation mechanisms. Methods The study included 42 healthy male volunteers. We studied the composition of 1000 and 1200 mg of calcium, and 800 and 1000 IU of cholecalciferol. Blood sampling was carried out at 8 a.m. and 0.5, 1, 2, 3, 4, 6, 8 h after administering the drugs. Calcium pharmacokinetic parameters were measured: the area under the curve (AUC) “concentration-time”, and maximum concentration (Cmax) in volunteers. The excretion of calcium in urine in terms of creatinine clearance and parathyroid hormone (PTH) levels was assessed. The maximum excretion of calcium was converted to creatinine (calcium/creatinine). Enzyme-linked immunosorbent assay (ELISA) was used to determine the PTH and the o-cresolphthalein method to quantitatively measure the total calcium serum and urine. Results Results indicated that both the AUC and the excretion of calcium are comparable, and the differences are not statistically significant, p>0.05 (the ratio of calcium and creatinine in the urine maintained within physiological levels). The comparable dynamics of PTH concentration is an indirect measure of the amount of absorbed calcium. Conclusions The study demonstrates that, along with the standard way of calculating the area under the curve “concentration-time” (total calcium in serum), it is important to assess the calcium excretion in urine in terms of creatinine excretion, as well as focusing on the changes in the PTH levels in volunteers, which could be considered as a marker of the calcium level in the blood.

Rationale to reduce calcium intake in adult patients with chronic kidney disease.

Calcium is an essential ion for the maintenance of normal bone health and physiologic functions. The extracellular and intracellular levels of calcium are maintained through hormonal regulation called homeostasis. Balance, the net intake minus excretion of calcium, is maintained by hormonal regulation of intestinal absorption and fecal/urinary excretion. Homeostasis and balance are disconnected in patients with chronic kidney disease (CKD). The purpose of this review is to understand how calcium homeostasis and balance are impaired in CKD. Two formal calcium balance studies have found that an oral intake of 800-1000 mg of calcium in adults with CKD leads to neutral calcium balance, whereas amounts greater than that lead to positive calcium balance. In patients with CKD, the main determinant of positive calcium balance is the intake and the lack of urinary calcium excretion. Calcium balance is different in patients with advanced CKD compared with patients without CKD. Thus, the oral intake of calcium in the form of diet and binders should not exceed 800-1000 mg/day to achieve neutral calcium balance in adult patients with CKD stages 3b/4.

The Effect of Bacillus Coagulans and Galactomannans on the Quality of Life of Patients Undergoing Laparoscopic Sleeve Gastrectomy: A Randomized Controlled Clinical Trial

The purpose of this study was to examine the effect of probiotics and prebiotics (LactoWise®) on the quality of life (QOL) of morbidly obese patients undergoing laparoscopic sleeve gastrectomy (LSG) using the Gastrointestinal Quality of Index (GIQLI). Study was made of 60 consecutive patients undergoing LSG, who were randomized into two groups, one of which took LactoWise® and the other a placebo. The LactoWise® group received 4.5 billion live cells of Bacillus coagulans and galactomannans (300 mg) in capsule form, and the placebo group received 600 mg of calcium citrate yielding 126 mg of elemental calcium, in identical capsules, daily for 3 months post-surgery. The participants completed the GIQLI prior to surgery at their pre-operation consultation and 3 times post-surgery, at 2 and 6 weeks and at 3 months. A total of 40 patients, with a mean age of 48.0±12.7 years and body mass index (BMI) of 46.2 ±8.0 kg/m2 completed the study. In both the group taking LactoWise® and the placebo group, following surgery a significant improvement in QOL, according to the median scores on GIQLI was recorded over time (p<0.001). Pairwise comparison showed a significant difference between the baseline and each time point (weeks 2 and 6 and month 3). No difference in GIQLI score was detected between the two groups. Bariatric surgery has a positive impact on the QOL of morbidly obese patients, as assessed by their scores on the GIQLI. No difference in GIQLI scores was demonstrated with the use of probiotics and prebiotics.

NUTRITIONAL COMPOSITIONS OF SIX EDIBLE INSECTS IN JAVA

Nutritional deficiency is still a problem faced by many families in Indonesia. One of the important issues is the level of protein consumption that is still below the minimum required standard. Edible insects could be one alternative of protein sources since their availability in the nature is quite abundant. This paper analyses six edible species of both cultivated and wild insects for its proximate compositions to measure their nutritional value. The cultivated insects consist of cricket (Gryllus sp.), giant mealworm (Zophobas morio F.), yellow mealworm (Tenebrio molitor L.), and silkworm (Bombyx mori L.), and the wild insects consist of javanese grasshopper (Valanga nigricornis Burm.) and paddy locust (Nomadacris succincta L.). Results shows that the nutritional composition of insects varies widely. Each 100g of dry weight contains of 32.59-76.69% of protein, 6.9-29.47% of fat, 0.92-30.76% of carbohydrate, 2.80-5.79% of ash, 407.34- 517.50 kcal of energy, and minerals about 24.82-31.22 mg of calcium (Ca) and 3.15-4.1 mg of iron (Fe). Some species such as grasshoppers, silkworm pupae and crickets have high protein content which potentially can be utilized as an alternate protein sources to fight against malnutrition and to increase nutritious food consumption. Efforts should be made to encourage the consumption of edible insects as an alternative source of protein. It is especially important to those who live in and around the forest, since the forest area is an excellent habitat for various species of insects.

NUTRITIONAL COMPOSITIONS OF SIX EDIBLE INSECTS IN JAVA

Nutritional deficiency is still a problem faced by many families in Indonesia. One of the important issues is the level of protein consumption that is still below the minimum required standard. Edible insects could be one alternative of protein sources since their availability in the nature is quite abundant. This paper analyses six edible species of both cultivated and wild insects for its proximate compositions to measure their nutritional value. The cultivated insects consist of cricket (Gryllus sp.), giant mealworm (Zophobas morio F.), yellow mealworm (Tenebrio molitor L.), and silkworm (Bombyx mori L.), and the wild insects consist of javanese grasshopper (Valanga nigricornis Burm.) and paddy locust (Nomadacris succincta L.). Results shows that the nutritional composition of insects varies widely. Each 100g of dry weight contains of 32.59-76.69% of protein, 6.9-29.47% of fat, 0.92-30.76% of carbohydrate, 2.80-5.79% of ash, 407.34- 517.50 kcal of energy, and minerals about 24.82-31.22 mg of calcium (Ca) and 3.15-4.1 mg of iron (Fe). Some species such as grasshoppers, silkworm pupae and crickets have high protein content which potentially can be utilized as an alternate protein sources to fight against malnutrition and to increase nutritious food consumption. Efforts should be made to encourage the consumption of edible insects as an alternative source of protein. It is especially important to those who live in and around the forest, since the forest area is an excellent habitat for various species of insects.

Sensory and nutritional evaluation of beverages developed using malted ragi (Eleusine coracana)

Five milk based beverages were developed by supplementing malted ragi and were organoleptically evaluated for sensory attributes by semi-trained panel of 10 judges. Control samples were developed by using milk, fruits (banana, kiwi, strawberry, papaya and mango) and honey and in test samples malted ragi was added at different levels ranging from 5-15 percent. Results revealed that banana based malted ragi beverage supplemented with 5 percent malted ragi was overall highly acceptable in terms of all sensory attributes. The most accepted level was chemically analysed for proximate composition, amino acids, vitamins, minerals, available carbohydrates and antinutritional components by using standard methods. The most acceptable malted ragi beverage was estimated to have 11.78±0.06 g crude protein, 6.81±0.51 g of crude fat, 1.21±0.07 g of crude fibre, 27.44±1.03 g of carbohydrates, 594.3±4.5 mg of tryptophan, 517.6±23.2 mg of methionine, 372.3±8.5 mg of lysine, 172.6 mg of calcium, 3.73 mg of iron, 102.2 mg of phosphorus and 0.596 mg of zinc per 100 ml. The anti-nutritional components were 155.8±11.3 mg of phytates, 15.4±2.3 mg of total phenols and 0.32±0.01 mg of trypsin inhibitor activity. Total sugars were found to be 5.44±0.21 g, 3.16±0.15 g of reducing sugars, 2.28±0.14 g of non-reducing sugars and 1.06±0.05 g of starch. It may be concluded that malted ragi can be utilized successfully up to 5 percent level to prepare beverages with high nutritional value without imposing negative impact on sensory attributes which may prove a boon to osteoporotic patients.

Milk, Daily products and Bone health.Characteristics of calcium in milk.

Milk contains approximately 110mg of calcium per 100mL of milk, a good source of dietary calcium. The calcium in milk comprises of calcium caseinate, micellar calcium phosphate and soluble calcium. It is also reported that the calcium in milk has an excellent bioavailability. Intervention studies of Japanese women have shown that the absorption rate of calcium in milk was greater than that found in small fish and vegetables. Factors taken into account as contributing to higher absorption rates of calcium in milk were:1)the types of calcium present(caseinate, micellar, soluble), 2)the presence of lactose which promotes calcium absorption, and 3)the presence of casein-phosphopeptide which increases soluble calcium fraction. Higher solubility was also observed in the small intestine of rats fed a micellar calcium phosphate casein-phosphopeptide(MCP-CPP)complex prepared from milk compared to that in rats fed insoluble whey calcium.

Effect of ascorbic acid rich, micro-nutrient fortified supplement on the iron bioavailability of ferric pyrophosphate from a milk based beverage in Indian school children.

Nutritional anemia is a significant public health issue with 50-80% prevalence in Indian children. Fortification of food, specifically milk, with iron is a potential approach to increase dietary iron intake. Ferric pyrophosphate [Fe4(P2O7)3] is organoleptically neutral and is less soluble in acid medium and, further, has low bioavailability in milk. However, since ascorbic acid is a potent enhancer of iron absorption, the coadministration of ascorbic acid with Fe4(P2O7)3 might enhance the absorption of iron. We evaluated the effect of ascorbic acid on iron absorption from a Fe4(P2O7)3 and an ascorbic acid fortified milk beverage with respect to milk fortified with Fe4(P2O7)3 alone. A double-blind, two-way crossover, randomized study was conducted in 25 mildly anemic children. The test group received milk fortified with beverage powder containing 7 mg isotopically labeled iron (57Fe/58Fe) as Fe4(P2O7)3, equimolar proportions of ascorbic acid and 200 mg of calcium whereas control group received milk fortified with energy, calcium and iron equivalent beverage powder. Fractional iron absorption was measured by erythrocyte incorporation of stable isotopes of iron (57Fe/58Fe) in both the groups. The fractional iron absorption from the control drink was 0.80% (95% CI: 0.57, 1.12). Fortifying the milk with an equimolar amount of ascorbic acid increased the fractional iron absorption almost 2-fold to 1.58% (95% CI: 1.13, 2.22). The presence of ascorbic acid in an equimolar ratio with that of iron from Fe4(P2O7)3 salt in milk as a fortificant enhanced iron absorption when compared to milk fortified with only Fe4(P2O7)3.

Effects of alendronate and alfacalcidol on bone in patients with myasthenia gravis initiating glucocorticoids treatment.

Glucocorticoids (GCs) are the first-line treatment for myasthenia gravis (MG) and act as long-term immunosuppressants. However, GCs can induce osteoporosis and bone fractures. In this study, we evaluate the effects of oral alendronate and alfacalcidol, or alfacalcidol alone on the bone of Chinese patients with MG who will initiate treatment with GCs. A total of 75 patients were included in this 12-month prospective, open-label, single-centre study. Patients with bone mineral density (BMD) T-score less than -1.0 at baseline were treated with 70mg of alendronate per week. Patients with BMD T-score greater than -1.0 at baseline were included in the alfacalcidol-alone group. Patients in two groups were treated with 0.25μg of alfacalcidol every other day and 600mg of calcium daily. After 12months of treatment, the mean BMD of lumbar spine, femoral neck and total hip increased by 3.4% (P=.002), 1.8% (P=.21) and 2.6% (P=.02), respectively, in alendronate group. In alfacalcidol-alone group, the mean BMD of lumbar spine, femoral neck and total hip decreased by 6.1%, 3.2% and 3.3%, respectively (all P<.001 vs baseline). We demonstrated for the first time that treatment with alendronate combined with alfacalcidol significantly increased BMD, decreased bone turnover biomarker levels and reduced the occurrence of hypercalciuria in a large cohort of Chinese patients with MG who initiated treatment with glucocorticoids. However, treatment with alfacalcidol alone failed to prevent bone loss in patients with MG receiving glucocorticoid therapy.

Complementary and Integrative Therapies in Psychiatry

Complementary and Integrative Therapies in Psychiatry

Response of serum 25(OH)D to Vitamin D and calcium supplementation in school-children from a semi-rural setting in India

The objectives of this study were to: 1) Determine the impact of varying baseline serum 25OHD on increase in vitamin D concentrations after daily supplementation with vitamin D and calcium (1000 IU + 500 mg respectively) for six months in school-children from a semi-rural setting 2) Test the efficacy of daily vitamin D-calcium supplementation on improvement in serum vitamin D concentrations to ≥75 nmol/L. Data collected from 106 subjects (58 boys, 48 girls), aged 6–12 years, included anthropometric measures like height and weight, body composition analysis, three one-day dietary recalls and sunlight exposure (by questionnaire). Blood was collected at baseline and endline and estimated for serum vitamin D by ELISA technique using standard kits. Classification of Vitamin D status was performed according to the 2011 Endocrine Society Practice Guidelines: vitamin D deficiency – <50 nmol/L; insufficiency – 50.0–74.9 nmol/L; sufficiency – ≥75 nmol/L. Statistical analysis was performed using SPSS software. Mean baseline serum vitamin D concentration was 59.7 ± 11.2 nmol/L; this rose to 79.8 ± 23.3 nmol/L with no significant differences between genders at the two time-points. Inverse relationship was obtained between baseline serum 25(OH)D concentrations and change in serum concentrations after supplementation, implying that with increasing baseline serum concentrations of 25(OH)D, increase in vitamin D levels post supplementation were significantly lower (r = − 0.96, p < 0.0001). Greatest benefit of change in serum vitamin D concentrations after supplementation was experienced by children with basal concentrations of <45 nmol/L. Daily vitamin D supplementation was effective in improving serum 25(OH)D to ≥75 nmol/L in 44% of children. Significantly higher percentage of children who were deficient at baseline (64%) were able to attain serum concentrations of ≥75 nmol/L as compared to children who were vitamin D insufficient (43%) (p < 0.001). Thus, daily supplementation with 1000 IU of vitamin D along with 500 mg of calcium helped in improving serum vitamin D concentrations to ≥75 nmol/L. Children who were vitamin D deficient particularly experienced these benefits.

Effects of Vitamin D Supplementation on Semen Quality, Reproductive Hormones, and Live Birth Rate: A Randomized Clinical Trial.

Results of animal models and cross-sectional cohort studies have suggested a beneficial role for vitamin D in male reproduction. Determine the effect of vitamin D and calcium supplementation on semen quality in infertile men with serum 25-hydroxyvitamin-D (25OHD) levels ≤50 nmol/L. A single-center, triple-blinded, randomized clinical trial. A total of 1427 infertile men were screened to include 330; 1002 men did not meet inclusion criteria and 95 did not wish to participate. The active group received cholecalciferol 300,000 IU initially, then 1400 IU cholecalciferol and 500 mg of calcium daily for 150 days; the other group received placebo. Serum concentrations of 25OHD and 1,25-dihydroxyvitamin D3 were significantly higher in men in the treatment group compared with the placebo group. Vitamin D supplementation was not associated with changes in semen parameters, although spontaneous pregnancies tended to be higher in couples in which the man was in the treatment group [7.3% vs 2.4%, Δ5.0% (-0.6%; 10.5%)]. Vitamin D treatment in a subgroup of oligozoospermic men increased the chance for a live birth compared with placebo [35.6% vs 18.3%, Δ17.3% (1.6%; 32.9%)]. Moreover, serum inhibin B levels were higher in men deficient in vitamin D who were randomly assigned to receive high-dose vitamin D [193 pg/mL vs 143 pg/mL, Δ49 pg/mL (8; 91 pg/mL)]; however, the increase in sperm concentration was not significantly higher than in the placebo group (P = 0.07). High-dose vitamin D supplementation did not improve semen quality in vitamin D-insufficient infertile men. The positive impact of vitamin D supplementation on live birth rate and serum inhibin B in oligozoospermic and vitamin D-deficient men may be of clinical importance and warrant verification by others.

The influence of drying on the physiological quality of cape gooseberry (Physalis peruviana L.) fruits added with active components

Dehydrated products added with active components (AC) represent a healthy alternative for modern consumer. The aim of this research was to evaluate the influence of drying process conditions on the physiological quality attributes of cape gooseberry ( Physalis peruviana L.) impregnated under vacuum with AC and dehydrated. A factorial design was performed with two independent variables, 2 levels per variable (temperature: 50 and 60oC, air velocity: 2.0 and 3.0 m.s-1) and three replicates per drying condition. In fact, cape gooseberry fruits were previously impregnated under vacuum with an emulsion containing calcium and vitamins B9, C, D3 and E, which were subjected to dehydration until a water activity of approximately 0.6. In addition, drying rate curves presented in all cases two periods of decreasing speed. An increase of drying temperature decreases the processing time, presenting a greater AC degradation, while the air velocity offers a non-significant effect. The treatment which have allowed an AC better retention and low processing times was 60° C and 2 m.s-1, reaching levels of 204.8 ± 10.5 mg, 137.0 ± 34.7 μg, 13.6 ± 0.9 mg, 2.2± 0.6 μg, 7.0±1.2 mg for calcium and vitamins B9, C, D3 and E, respectively per 50 g serving of dehydrated cape gooseberry. An integration of the vacuum impregnation process with conventional air-drying, represents an effective technological alternative, which confers a higher added value to cape gooseberry fruit.

Treatment of Vitamin and Mineral Deficiencies After Biliopancreatic Diversion With or Without Duodenal Switch: a Major Challenge.

Vitamin and mineral deficiencies are a major concern after biliopancreatic diversion (BPD) and BPD with duodenal switch (BPD/DS). Evidence-based guidelines how to prevent or how to treat deficiencies in these patients are currently lacking. The aim of the current study is to give an overview of postsurgical deficiencies and how to prevent and treat these deficiencies. Retrospective evaluation of a 1-year structured monitoring and treatment schedule for various deficiencies in 34 patients after BPD or BPD/DS. Patients were introduced into the program 12-90months after surgery. Vitamin B1, B6, B9, and B12 deficiencies could be prevented by mean daily doses of 2.75mg, 980μg, 600μg, and 350μg, respectively. However, many patients continued to develop deficiencies of vitamin A, D, iron, calcium, and zinc despite major dose adjustments. Current observations suggest that at least total daily doses of 200mg Fe in premenopausal women and 100mg in men, 100mg of Zinc, 3000mg of calcium, and weekly doses of at least 50,000IU solubilized vitamin A and vitamin D are needed to prevent the occurrence of major deficiencies. Exceptionally high supplementation doses are needed to prevent and treat vitamin and mineral deficiencies in patients after BPD or BPD/DS. Further refinement and simplification of treatment schedules is needed. Focus on improvement of compliance to treatment is recommended.

Prevention and Treatment of Vitamin D and Calcium Deficiency in Children and Adolescents: Indian Academy of Pediatrics (IAP) Guidelines.

Vitamin D deficiency (VDD) is being increasingly reported from India from all age-groups. Reports suggest that VDD affects all age groups, from neonates to adolescents. Further, habitually low calcium intakes are also reported in Indian children. Given the multiple guidelines, peculiarities of Indian circumstances, changing lifestyles, and lack of fortification, the Indian Academy of Pediatrics (IAP) felt the need for a Practice Guideline for Pediatricians for the prevention and treatment of vitamin D and calcium deficiency in children and adolescents. The 'Guideline for Vitamin D and Calcium in Children' committee was formed by the IAP in September 2016. A consultative committee meeting was held in November 2016 in Mumbai. Evidence from Indian and international studies and other previous published recommendations, which were pertinent to the Indian circumstances, were collated for the preparation of these guidelines. To present a practice guideline for pediatricians for the prevention and treatment of deficiency of vitamin D and calcium in the Indian context. For the prevention of rickets in premature infants, 400 IU of vitamin D and 150-220 mg/kg of calcium, and in neonates, 400 IU of vitamin D and 200 mg of calcium are recommended daily. For prevention of rickets and hypocalcemia in infants (after neonatal period) upto 1 year of age, and from 1-18 years, 400 IU and 600 IU vitamin D/day and 250-500 mg/day and 600-800 mg/day of calcium, respectively, are recommended. For treatment of rickets in premature neonates, infants upto 1 year and from 1-18 years, 1000 IU, 2000 IU and 3000-6000 IU of vitamin D daily, respectively, and elemental calcium of 70-80 mg/kg/day in premature neonates and 500-800 mg daily for all children over that age are recommended. Larger doses of vitamin D may be given from 3 months to 18 years of age as 60,000 IU/week for 6 weeks.

Calcium Bioavailability from Mineral Waters with Different Mineralization in Comparison to Milk and a Supplement

ABSTRACTObjective: The aim of the present study was to compare the bioavailability of calcium from 3 mineral waters with different concentrations of minerals with that of milk and a calcium supplement.Methods: A single-center, randomized controlled trial with a crossover design with 21 healthy men and women was conducted at the Institute of Food Science and Human Nutrition, Leibniz University Hannover. The participants consumed the 5 test products providing 300 mg of calcium each on 5 examination days with 1-week wash-out phases in between. Primary outcome variables were the area under the curve of serum calcium levels for 10-hour (AUC0–10h) and 24-hour urinary calcium excretion.Results: In all groups, no significant differences in the AUC0-10h of serum calcium levels as well as in the 24-hour urinary calcium excretion were observed. Likewise, mean changes in serum phosphate and urinary phosphate, as well as serum parathormone, showed no differences between the groups.Conclusion: Given an equivalent bioavailability of calcium in all test products, neither a high concentration of SO42− or of HCO3 influenced the bioavailability of calcium. Accordingly, the use of mineral water with high concentrations of calcium constitutes a calorie-free calcium source that can improve calcium supply.