Supplemental Calcium Intake Research Articles

Calcium intake and genetic variants in the calcium sensing receptor in relation to colorectal cancer mortality: an international consortium study of 18,952 patients

BackgroundResearch on calcium intake as well as variants in the calcium sensor receptor (CaSR) gene and their interaction in relation to CRC survival is still limited.MethodsData from 18,952 CRC patients, were included. Associations between primarily pre-diagnostic dietary (n = 13.085), supplemental (n = 11,837), total calcium intake (n = 5970) as well as 325 single nucleotide polymorphisms (SNPs) of the CaSR gene (n = 15,734) in relation to CRC-specific and all-cause mortality were assessed using Cox proportional hazard models. Also interactions between calcium intake and variants in the CaSR gene were assessed.ResultsDuring a median follow-up of 4.8 years (IQR 2.4–8.4), 6801 deaths occurred, of which 4194 related to CRC. For all-cause mortality, no associations were observed for the highest compared to the lowest sex- and study-specific quartile of dietary (HR 1.00, 95%CI 0.92–1.09), supplemental (HR 0.97, 95%CI 0.89–1.06) and total calcium intake (HR 0.99, 95%CI 0.88–1.11). No associations with CRC-specific mortality were observed either. Interactions were observed between supplemental calcium intake and several SNPs of the CaSR gene.ConclusionCalcium intake was not associated with all-cause or CRC-specific mortality in CRC patients. The association between supplemental calcium intake and all-cause and CRC-specific mortality may be modified by genetic variants in the CaSR gene.

Comparative Analysis of Dietary and Supplemental Intake of Calcium and Vitamin D among Canadian Older Adults with Heart Disease and/or Osteoporosis in 2004 and 2015.

Despite the role of calcium and vitamin D in osteoporosis and heart disease, little research has examined changes in the intake of calcium and vitamin D among individuals with these conditions over time. Using data from the 2004 and 2015 Canadian Community Health Surveys, we investigated changes in dietary and supplemental intake of calcium and vitamin D among Canadian older adults aged ≥ 50 years, both with and without heart disease and/or osteoporosis, between 2004 and 2015. Notable declines in dietary calcium intake occurred, particularly among non-supplement users. Surprisingly, individuals with osteoporosis and heart disease, who are at higher nutritional risk, were less likely to use calcium supplements in 2015 compared to 2004. Among calcium supplement users, those with osteoporosis or both conditions experienced significant reductions in their usual calcium intake in 2015, with an increased proportion failing to meet recommended intake levels. Conversely, vitamin D supplement users experienced a substantial rise in vitamin D intake in 2015. In 2015, only a small proportion of supplement users did not meet the recommended vitamin D intake levels. These findings underscore the importance of public health initiatives to facilitate safe increases in calcium and vitamin D intake for older adults, particularly those with heart disease and osteoporosis.

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...

Factors related to bone mineral density in female patients receiving TSH-suppressive doses of levothyroxine for thyroid cancer

Background: Patients with thyroid cancer receive a high-dose thyroid hormone therapy after total thyroidectomy for suppression of thyroid stimulating hormone (TSH); this may affect bone mineral density (BMD). Identifying the common factors that affect BMD (including the duration of a high dose of thyroid hormone treatment) may, therefore, aid the delivery of appropriate and comprehensive care in such cases. Objective: To identify the factors related to BMD in female patients with thyroid cancer. Materials and Methods: This cross-sectional study evaluated data pertaining to the BMD and demographic characteristics of female patients with thyroid cancer. The patients were aged at least 40 years and received a high-dose thyroid hormone replacement therapy after total thyroidectomy at the Rajavithi Hospital between January 2004 and December 2019. The relationships between BMD and associated factors were analyzed using Pearson’s correlation and multiple linear regression. A p-value of less than 0.05 was considered statistically significant. Results: A total of 100 female patients with a mean age of 55.37 ± 11.36 (40-82) years and mean body mass index (BMI) of 24.8 ± 4.96 (15-40) were included; 60 and 56 of them were postmenopausal and coffee drinkers, respectively. High-dose thyroid hormone replacement therapy was received for a mean duration of 94.59±50.36 (3-210) months and 13 patients had a history of fractures; 60%, 30%, and 10% had normal BMD, osteopenia, and osteoporosis, respectively. The factors affecting BMD included the BMI (p-value <0.001) and postmenopausal status(p-value <0.001). Subgroup analyses showed the BMI to be the factor affecting BMD in the premenopausal group (p-value <0.001). Age, BMI, and calcium supplement intake were found to have an effect on the BMD in the postmenopausal group (p-value= 0.003, 0.002, and 0.020, respectively). The duration of high-dose thyroid hormone intake had no effect on the BMD in both the overall population (p-value= 0.558) and the subgroups based on the menopausal status (p-value = 0.437 and 0.380 in premenopausal and postmenopausal groups, respectively). Conclusion: In female patients who were treated for thyroid cancer, the factors affecting the BMD included the BMI in the premenopausal group and the age, BMI, and calcium supplementation in the postmenopausal group.

Opportunities and barriers for maternal nutrition behavior change: an in-depth qualitative analysis of pregnant women and their families in Uttar Pradesh, India.

Maternal undernutrition during pregnancy remains a critical public health issue in India. While evidence-based interventions exist, poor program implementation and limited uptake of behavior change interventions make addressing undernutrition complex. To address this challenge, Alive & Thrive implemented interventions to strengthen interpersonal counseling, micronutrient supplement provision, and community mobilization through the government antenatal care (ANC) platform in Uttar Pradesh, India. This qualitative study aimed to: (1) examine pregnant women's experiences of key nutrition-related behaviors (ANC attendance, consuming a diverse diet, supplement intake, weight gain monitoring, and breastfeeding intentions); (2) examine the influence of family members on these behaviors; and (3) identify key facilitators and barriers that affect behavioral adoption. We conducted a qualitative study with in-depth interviews with 24 pregnant women, 13 husbands, and 15 mothers-in-law (MIL). We analyzed data through a thematic approach using the Capability-Opportunity-Motivation-Behavior (COM-B) framework. For ANC checkups and maternal weight gain monitoring, key facilitators were frontline worker home visits, convenient transportation, and family support, while the primary barrier was low motivation and lack understanding of the importance of ANC checkups. For dietary diversity, there was high reported capability (knowledge related to the key behavior) and most family members were aware of key recommendations; however, structural opportunity barriers (financial strain, lack of food availability and accessibility) prevented behavioral change. Opportunity ranked high for iron and folic acid supplement (IFA) intake, but was not consistently consumed due to side effects. Conversely, lack of supply was the largest barrier for calcium supplement intake. For breastfeeding, there was low overall capability and several participants described receiving inaccurate counseling messages. Key drivers of maternal nutrition behavior adoption were indicator specific and varied across the capability-opportunity-motivation behavior change spectrum. Findings from this study can help to strengthen future program effectiveness by identifying specific areas of program improvement.

Vitamin D and Calcium Supplement Use and High-Risk Breast Cancer: A Case-Control Study among BRCA1 and BRCA2 Mutation Carriers.

The role of vitamin D and calcium use in the development of breast cancer among women in the general population is not clear. Furthermore, whether vitamin D and calcium supplement use are associated with breast cancer in high-risk populations has not been evaluated. Thus, we evaluated the association between vitamin D and/or calcium supplement use and breast cancer among women with a pathogenic variant (mutation) in BRCA1 or BRCA2. BRCA mutation carriers enrolled in a longitudinal study were invited to complete a supplemental questionnaire on lifetime supplement use. Cases included women with a prevalent diagnosis of invasive breast cancer, and controls had no history of breast cancer. Vitamin D and calcium use were categorized as never/ever use, and as tertiles of supplement intake (total average daily supplement use). Unconditional logistic regression was used to estimate the odds ratio (OR) and 95% confidence intervals (CIs) of breast cancer. This study included 134 breast cancer cases and 276 controls. Women who used vitamin D-containing supplements had 46% lower odds of having breast cancer compared to those who never used supplements (OR 0.54; 95% CI 0.31, 0.91; p = 0.02). Increasing vitamin D and calcium supplement intake was inversely associated with the odds of having breast cancer (p-trend = 0.04). Findings were suggestively stronger among BRCA1 mutation carriers; however, analyses were limited by small strata. These findings suggest a potential inverse association between vitamin D and calcium supplementation and BRCA breast cancer. Additional studies are warranted to confirm these findings and accurately inform clinical care guidelines.

73 PREVALENCE OF SECONDARY HYPERPARATHYROIDISM BY VITAMIN D STATUS IN OLDER IRISH ADULTS

Abstract Background Secondary hyperparathyroidism commonly results from vitamin D deficiency and can lead to accelerated bone turnover and bone loss, especially at cortical sites like the hip. It can also attenuate the response to antiresorptive treatments used for osteoporosis. However, several factors may influence PTH response. We aimed to identify the prevalence of secondary hyperparathyroidism by categories of vitamin D status in older Irish adults attending a bone health clinic. Methods The study population consisted of older adults (aged over 60 years) attending a bone health clinic at a large hospital. Participants with a serum calcium >2.5 mmol/l and eGFR <30 ml/min were excluded to avoid cases of primary hyperparathyroidism or elevated serum PTH due to advanced renal disease. Hyperparathyroidism was defined as a serum PTH > 65 pg/ml. 25 hydroxyvitamin D (25(OH)D) was measured with liquid chromatography mass spectroscopy. Results There were 800 cases identified, mean age 72.9 +/- 7.9 years, and 85.3% were female. The prevalence of secondary hyperparathyroidism by 25(OH)D categories were 28.1% (<30nmol/l), 17.4% (30-49.9 nmol/l) and 8.0% (50-74 nmol/l). Older age (P < 0.03) and lower eGFR (P = 0.01) were associated with hyperparathyroidism independent of vitamin D status. Conclusion Nearly one-third of patients who were vitamin D deficient (<30 nmol/L) and one-sixth who were insufficient (30-49.9 nmol/l) had hyperparathyroidism, similar to the results of other studies. However, hyperparathyroidism was also observed in 8% of those with 25(OH)D levels between 50 -74 nmol/l, suggesting that higher levels i.e. ≥ 75 nmol/l may be preferable in older adults. Lower eGFR and older age were also independently associated with higher PTH, consistent with previous research. Higher dietary and supplemental calcium intake is also known to suppress PTH response, though we were not able to account for this in our study.

Risk Factors of Osteoporosis in a Tertiary Care Hospital of Rawalpindi

Purpose: Osteoporosis is a common health problem all over the world. Loss of bone mass with aging leads to osteoporosis. Different factors affect the bone mass loss and consequencltly osteoporosis prevalence. However, these factors are under-studied in the Pakistan.This study aims to identify the risk factors of osteoporosis among patients in Holy Family Hospital Rawalipindi.
 Methodology: This descriptive cross-sectional study was carried out in among 120 diagnosed patients of osteoporosis for six months from April 2021 to September 2021 in a tertiary care hospital of Rawalpindi. Patients were recruited in the study via a set of inclusion and exclusion criteria and non-probability convenient sampling technique. A self-strcutured questionnaire was used to collect data. Before data collection information consent was acquired from all participants. Data analysis was performed on SPSS version 25. Descriptive statistics were applied.
 Findings: Osteoporosis was more prevalent among the patients who had, age group with more than 45years (79.16%), female gender (72.50%), low education level (64.16%), lower socioeconomic status (68.33%), family history of osteoporosis (61.67%), sedentary lifestyle (57.50%), history of corticosteroids therapy (53.33%), no milk use (69.20%), no fresh vegetables and fruits use (80.00%), no inatke of calcium supplements (78.33%), no sunshine exposure (77.50%), and overweight (48.33%). In short, age group with age above 45years, female gender, low education level, lower socioeconomic status, family history of osteoporosis, sedentary lifestyle, overweight, history of use of corticosteroids, no milk use, no intake of fresh vegetables and fruits, no intake of calcium supplements, and no sunshine exposure, all raise the incidence of osteoporosis.
 Recommendations: People should take milk, fresh fruits and vegetables, calcium supplements, and sun bath. Furthermore, people should spend active life with proper weight.

Effect of a Screening and Education Programme on Knowledge, Beliefs, and Practices Regarding Osteoporosis among Malaysians.

Background: Osteoporosis is an emerging geriatric condition with high morbidity and healthcare cost in developing nations experiencing rapid population ageing. Thus, identifying strategies to prevent osteoporosis is critical in safeguarding skeletal health. This study aimed to evaluate the effects of a bone health screening and education programme on knowledge, beliefs, and practice regarding osteoporosis among Malaysians aged 40 years and above. Methods: A longitudinal study was conducted from April 2018 to August 2019. During the first phase of the study, 400 Malaysians (190 men, 210 women) aged ≥ 40 years were recruited in Klang Valley, Malaysia. Information on subjects’ demography, medical history, knowledge, and beliefs regarding osteoporosis, physical activity status, and dietary and lifestyle practices were obtained. Subjects also underwent body anthropometry measurement and bone mineral density scan (hip and lumbar spine) using a dual-energy X-ray absorptiometry device. Six months after the first screening, similar investigations were carried out on the subjects. Results: During the follow-up session, 72 subjects were lost to follow up. Most of them were younger subjects with a lower awareness of healthy practices. A significant increase in knowledge, beliefs (p < 0.05), calcium supplement intake (p < 0.001), and dietary calcium intake (p = 0.036) and a reduction in coffee intake (p < 0.001) were found among subjects who attended the follow-up. In this study, the percentage of successful referrals was 41.86%. Subjects with osteoporosis were mostly prescribed alendronate plus vitamin D3 by medical doctors, and they followed the prescribed treatment accordingly. Conclusions: The bone health screening and education programmes in this study are effective in changing knowledge, beliefs, and practice regarding osteoporosis. The information is pertinent to policymakers in planning strategies to prevent osteoporosis and its associated problems among the middle-aged and elderly population in Malaysia. Nevertheless, a more comprehensive bone health education program that includes long-term monitoring and consultation is needed to halt the progression of bone loss.

Association of newborn blood lead concentration with neurodevelopment outcome in early infancy

BackgroundIn utero exposure to toxic metal substances can cause severe neurodevelopmental deficits in developing fetus and infant. MethodsWe evaluated the association of newborn umbilical cord blood lead concentration with early neurodevelopmental performance (cognitive, receptive language, expressive language, fine motor, gross motor and social-emotional development). The Bayley Scale of Infants Developments-III (BSID-III) was used to perform neurodevelopment outcomes at an average age of 6.5 months. In this prospective study, total of 167 mother-child pairs were enrolled from Western Rajasthan, India. Association between risk factors of lead contamination and newborn umbilical cord blood lead levels was observed. Multivariate regression was performed to see the association of cord blood lead level with infant neurodevelopment outcome. ResultsThe obtained newborn umbilical cord blood lead concentration 5.0–10.5 μg/dL was negatively associated with the sub-scale score of gross motor development (β-coefficient with 95 % CI; −0.29 (−5.0–0.11), p = 0.04). However, no associations were found with the score of cognitive, language, gross motor, and social-emotional development. The umbilical cord blood lead concentration <5.0 μg/dL was also not associated with the BSID-III scores. The mother's regular intake of calcium supplements during the antenatal period was significantly associated with a lower umbilical cord blood lead level (p-value 0.031). ConclusionThe data suggest that newborn umbilical cord blood lead concentration 0.5–10.5 μg/dL has a negative association with early gross motor development during infancy.

Effects of Adolescents' Lifestyle Habits and Body Composition on Bone Mineral Density.

The incidence of osteoporosis is increasing as the population ages, as is the need to manage and prevent it. Adolescence is the period when the fastest development of bone mass takes place. Increasing adolescents’ maximum bone mass and avoiding the risk factors for its loss are effective for preventing osteoporosis. This study investigated the factors influencing adolescents’ bone mineral density (BMD). The participants were 126 middle- and high-school students from Gangwon-do; 47.6% (n = 60) were male, with an average age of 15 (range 12–18) years of age. It was found that age, carbonated beverages, snacks, and calcium supplements were variables that showed significant differences in adolescents’ BMD. Additionally, through correlation analysis, it was found that height, weight, body mass index (BMI), body water, protein, minerals, body fat mass, and skeletal muscle mass were correlated with BMD. Multiple regression analysis identified age, calcium supplements, BMI, body fat mass, and skeletal muscle mass as BMD-associated factors. These results show that adolescents’ BMD is higher with lower body fat mass, higher BMI and skeletal muscle mass, and a higher intake of calcium supplements.

Diagnostic Accuracy of Different Screening Tools for Identifying Osteoporosis Risk Among Post-Menopausal Filipino Women Aged 45–65 Years

Abstract Early screening of osteoporosis decreases fracture risk. Several identified clinical risk factors led to the development of screening tools to estimate osteoporosis risk. Bone Mineral Densitometry (BMD) as a diagnostic tool for screening is not practical because of high cost and poor availability. The extensively studied osteoporosis screening tools are: Simple Calculated Osteoporosis Risk Estimation (SCORE), the Osteoporosis Risk Assessment Instrument (ORAI), the Age Bulk One or Never Estrogen (ABONE), body weight (WEIGHT), and the Osteoporosis Risk Index (OSIRIS). These tools were developed and validated in Caucasians. Validation of these tools for specific populations is necessary because of the observed variations in BMD across geographic and ethnic groups. To date, the utility of these screening tools in the Philippines is unknown. We conducted a cross-sectional analysis of all patients who underwent BMD screening for osteoporosis in a tertiary hospital from January 2015 to September 2020. The study participants were postmenopausal Filipino women aged 45 to 65 years. The subjects had no history of osteopenia, osteoporosis, hip or spine fractures, use of osteoporosis medications, renal insufficiency, bilateral oophorectomy, hysterectomy, or early menopause. We identified demographic and clinical risk factors. These risk factors were used to calculate the risk score of five osteoporosis risk assessment tools: ORAI, ABONE, WEIGHT, OSTA, and ORISIS. Using the DEXA T-score as an external criterion, the sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and diagnostic accuracy for each tool were calculated. Included were 1869 subjects with a mean age of 57.9 + 4.3 years old. Osteoporosis, with a T-score of &amp;lt;-2.5 at the lumbar or femoral neck area, was seen in 665 (35.58%). Risk factors such as weight, height, BMI, menopausal years, history of previous fractures, and intake of oral calcium supplements correlated significantly with a higher risk (OR=1.025, 95%CI: 0.974–1.079; OR=1.059, 95%CI: 0.84–1.338; OR=1.063, 95%CI: 0.817–1.383; OR=1.74, 95%CI: 1.198–2.528; and OR=1.088, 95%CI: 0.869–1.319), of having osteoporosis in the said population. ORAI and WEIGHT have the highest probability of identifying patients with a sensitivity of 88.42% and 91.28%, and accuracy of 85.71% and 87.98%. Both performed equally in screening for osteoporosis in this setting. However, ABONE, OSTA, and ORISIS underestimated the number of high-risk osteoporosis patients, because of their low sensitivity and diagnostic accuracy. Both ORAI and WEIGHT are simple and easy to calculate and can serve as an initial screening tool to identify Filipino postmenopausal women who are at high risk for osteoporosis. A prospective study with a correlation of fracture occurrences may provide evidence for the value of these tools as a screening test.

POS-094 A CASE OF HYPOPARATHYROIDISM: WHEN A NEPHROLOGIST TURNS INTO AN ENDOCRINOLOGIST

Hypoparathyroidism is a rare endocrine disorder infrequently seen in everyday practice. It may be primary due to a genetic cause or secondary which is by far the most common form and due to a variety of etiologies for instance during radiation, auto-immune diseases or acquired after neck surgery with the latter being the most common cause accounting for 75 % of cases. Herein we report the case of a patient who presented to our department as a potential kidney donor to her husband. The pre-transplant workup has shown features of hypoparathyroidism that were subsequently confirmed. The patient is a 36-year-old female with no past medical history of auto-immune disease and no history of neck surgery. She denies any over the counter consumption of dietary or supplemental intake of calcium or vitamin D. She also denied any family history of hypoparathyroidism or consanguinity thus ruling out a genetic cause and no history of autoimmune disease or other endocrine disorders. She had dry scaly skin, thin hair, and fragile nails. No mucocutaneous candidiasis. No scars of previous trauma or surgery in the neck. No malar rash. A carpal spasm was observed during the inflation of the blood pressure cuff on the arm classically know as The Trousseau sign. An ophthalmology exam has shown a cataract at an early onset. An electrocardiogram has shown a slightly prolonged QT interval. A laboratory exam was performed. Her creatinine was normal at 62 uoml/l. She had hypocalcemia of 1.35 mmol/l, a phosphatemia of 1.7 mmol/l, a normal magnesium level of 0.8mmol/l, a PTH level of 12 pg/ml, vitamin D was 18.1 ng/ml. Additional workup was performed seeking other endocrine disorders that may be associated. For instance, her thyroid-stimulating hormone was normal at 2.98 UI/ml with a normal level of free thyroxin at 13.3 ng/ml. Her cortisol level was slightly low at 84 ug/l compared to the laboratory inferior normal limit of 100 but she did not exhibit any signs of adrenal insufficiency. Ultrasonography did not show any kidney stones or abnormalities. A cerebral scan was also performed looking for basal ganglia calcifications and luckily came back normal. An immunologic assessment was performed including antinuclear antibodies, anti-thyroid peroxidase antibodies, anti-thyroglobulin antibodies and came back negative The patient was treated with IV supplementation of calcium in the acute phase in order to alleviate the cardiovascular signs seen in the electrocardiogram. She was then supplemented with oral calcium and vitamin D. Her calcium levels were at 1.9 mmol/l. Her symptoms improved at discharge. Hypoparathyroidism is a rare endocrine disorder. A thorough work-up should be done to look for a cause. It may be due to a variety of etiologies but so far neck surgery represents 75 % of cases.

Calcium Supplements and Risk of Cardiovascular Disease: A Meta-Analysis of Clinical Trials.

Background: Recent systematic reviews and meta-analyses of randomized, double-blind, placebo-controlled trials (double-blind, placebo-controlled RCTs) have reported controversial findings regarding the associations between calcium supplements on the risk of cardiovascular disease (CVD). This meta-analysis aimed to investigate the association between them. Methods: We searched PubMed, EMBASE, the Cochrane Library, and the bibliographies of relevant articles for double-blind, placebo-controlled RCTs in November, 2020. Relative risks (RRs) with 95% confidence intervals (CIs) for the risk of cardiovascular disease were calculated using a random effects model. The main outcomes were CVD, coronary heart disease (CHD), and cerebrovascular disease. Results: A total of 13 double-blind, placebo-controlled RCTs (n = 28,935 participants in an intervention group and 14,243 in a control group)) were included in the final analysis. Calcium supplements significantly increased the risk of CVD (RR 1.15, 95% CI 1.06–1.25], I2 = 0.0%, n = 14) and CHD (RR 1.16, 95% CI 1.05–1.28], I2 = 0.0%, n = 9) in double-blind, placebo-controlled RCTs, specifically in healthy postmenopausal women. In the subgroup meta-analysis, dietary calcium intake of 700–1000 mg per day or supplementary calcium intake of 1000 mg per day significantly increased the risk of CVD and CHD. Conclusions: The current meta-analysis found that calcium supplements increased a risk of CVD by about 15% in healthy postmenopausal women.

Prevalence and factors associated with morbidity among postmenopausal women in a rural area in Kozhikode District

Introduction: The focus of women's health researchers and health policy planners has also shifted toward postmenopausal women since recent trends suggest an increase in their number and life expectancy. In general, women have more complex and stressful aging process as men do, as a consequence of hormonal changes that occur during menopausal transition. Objectives: The objective of this study is to estimate the prevalence of postmenopausal symptoms among women in a rural area of Kozhikode and study factors associated with it. Material and Methodology: A cross-sectional study was conducted among postmenopausal women aged 40–55 years in Nanminda panchayat, a rural area in Kozhikode district. This 1-year study was conducted from June 2015 to June 2016, had 245 participants with informed consent. There are 17 wards (17 clusters) in Nanminda panchayat area from which 6 wards were selected. The prevalence of postmenopausal symptoms and associated factors such as sociodemographic profile, morbidity details, diet supplements, anthropometric, clinical, and reproductive components was assessed using the pretested semistructured questionnaire. Results: A total of 245 postmenopausal women were studied. The prevalence of postmenopausal symptoms was found to be 64%. The mean age of the study population was 50.87 years. Age, education, marital status, menopausal age, and duration of menopause were found to be significantly associated with the presence of postmenopausal symptoms. Intake of Calcium supplements was found to be having protective effect against menopausal symptoms. Binary logistic regression revealed that age, educational status, marital status, and dietary intake of calcium supplements are significantly associated with postmenopausal symptoms. Conclusion: Women with early age of menopause and less duration since menopause had more risk of having postmenopausal symptoms. The prevalence of symptoms was found to be less if calcium supplements were taken.

On the question of the application of calcium preparations for the purpose of optimizing the diets of the population, including and for different diseases

In recent years, there has been a particular interest in the use of calcium in order to optimize the diet of the population. It is known that calcium, indirectly affecting nervous excitability, muscle contractility, hormone secretion and blood clotting, plays an important role in the human body. However, there is an opinion about the risks of calcium supplement intake, and concerns about possible adverse consequences are becoming more pronounced. In this regard, the aim of this study was to review the scientific literature on calcium supplement intake from the standpoint of the effectiveness of fortification of food rations and the occurrence of concomitant risks. Results. The results of the analysis of numerous literature data allow us to conclude that due to the threat of calcium overdose and an increased risk of cardiovascular complications as a result of transient hypercalcemia, calcium intake from dietary sources is a priority, and calcium supplements should be prescribed only to patients with a serious risk of osteoporotic fractures and those individuals who, due to social reasons, cannot meet their daily nutritional needs. With equal effects, calcium consumption precisely from foods containing a sufficient amount of this micronutrient, in comparison with calcium supplements, provides the organism with other nutrients (proteins, amino acids, etc.), without causing risks of side effects. It can be assumed that the results of risk-benefit assessments of calcium supplements in connection with the descriptions of risks to the cardiovascular, gastrointestinal, and urinary-excretory systems cannot be considered final. In view of the above, cautious use of calcium supplements is recommended, especially considering their possible interaction with various medications, including antihypertensive drugs, calcium channel blockers, synthetic thyroid hormones, bisphosphonates and antibiotics, etc. Conclusion. Given the growing concern of the medical community about the role of calcium intake and the conflicting results of individual studies, it is clear that largescale prospective cohort studies are needed to clarify the balance of benefits and risks of calcium supplementation in different populations, especially in the elderly.

Oral Calcium Supplements Associate With Serial Coronary Calcification: Insights From Intravascular Ultrasound

ObjectivesThis study sought to evaluate and assess the extent of serial coronary artery calcification in response to oral calcium supplementation. BackgroundOral calcium supplements are frequently used despite their cardiovascular safety remaining controversial. Their effects on serial coronary calcification are not well established. MethodsIn a post hoc patient-level analysis of 9 prospective randomized trials using serial coronary intravascular ultrasound, changes in serial percentage of atheroma volume (PAV) and calcium indices (CaI) were compared in matched segments of patients coronary artery disease who were receiving concomitant calcium supplements (n = 447) and in those who did not receive supplements (n = 4,700) during an 18- to 24-month trial period. ResultsPatients (mean age 58 ± 9 years; 73% were men; 43% received concomitant high-intensity statins) demonstrated overall annualized changes in PAV and CaI with a mean of −0.02 ± 1.9% (p = 0.44) and a median of 0.02 (interquartile range: 0.00 to 0.06) (p < 0.001) from baseline, respectively. Following propensity-weighted mixed modeling adjusting for treatment and a range of demographic, clinical, ultrasonic, and laboratory parameters (including but not limited to sex, race, baseline, and annualized change in PAV, baseline CaI, concomitant high-intensity statins, diabetes mellitus, renal function), there were no significant between-group differences in annualized changes in PAV (least-squares mean: 0.09; 95% confidence interval [CI]: −0.20 to 0.37 vs. 0.01; 95% CI: −0.27 to 0.29; p = 0.092) according to calcium supplement intake. Per a multivariable logistic regression model accounting for the range of covariates described, calcium supplementation independently associated with an increase in annualized CaI (odds ratio: 1.15; 95% CI: 1.05 to 1.26; p = 0.004). ConclusionsOral calcium supplementation may increase calcium deposition in the coronary vasculature independent of changes in atheroma volume. The impact of these changes on plaque stability and cardiovascular outcomes requires further investigation.

Vitamin D evaluation based on demographics and calcium supplement intake in children suffering from acute febrile illness admitted in as tertiary care center

Background: Vitamin D or sunshine vitamin is a vital steroid group of vitamins with its deficiency being common, especially among children. The literature establishing the correlation of dietary habits with Vitamin D levels in Indian population is scarce. Objective: This study aims to evaluate serum 25-hydroxyvitamin D (25(OH)D) level in the hospitalized children suffering from acute febrile illness (AFI) and find its correlation with calcium intake and demographic characters. Materials and Methods: The study was conducted at the pediatric department of a tertiary hospital of Maharashtra, over a period of 6 months in the children between the age groups of 1 month and 12 years, admitted with AFI and with or without clinical or biochemical evidence of rickets. After detailed history, evaluation of Vitamin D status was done in all children within 48 h of admission to the hospital using early morning sample of 2 ml of serum using chemiluminescent immunoassay method. We correlated Vitamin D levels with socioeconomic status (SES) along with various other parameters like serum calcium (S. calcium). Results: It was observed that with the improvement of SES, the Vitamin D deficiency (VDD) did not improve. The biochemical parameters such as S. calcium and alkaline phosphatase revealed a significant correlation with Vitamin D status. S. calcium level was significantly low in children with VDD. Radiological evidence of rickets was seen only in 40.5% of cases of VDD and 14.3% of cases of Vitamin D insufficiency and thus was not a diagnostic hallmark for rickets. Conclusion: The data suggested that VDD is very common among children aged 1 month–12 years and it is not correlated with SES and calcium intake. Efforts need to be made to improve the Vitamin D status by creating awareness among people.

Prevalence of vitamin D deficiency and associated risk factors among adults in Chandigarh

Background: Vitamin D deficiency is a global health concern affecting individuals across all the age groups in both the genders. Aims and Objectives: The present study intends to assess the prevalence of Vitamin D deficiency and associated risk factors in adult males and females of Chandigarh. Materials and Methods: The sample included 332 males and 295 females of the age ranging between 30 and 70 years. Vitamin D level of all the participants was estimated by employing chemiluminescence immunoassay method. All the subjects were divided into three categories of Vitamin D level, i.e., normal range (>30–100 ng/ml), insufficiency (21–29 ng/ml), and deficiency (0–20 ng/ml) as per the Endocrine Society Guidelines (2011). Results: The overall prevalence of Vitamin D deficiency was found to be 28.5% in males and 63.4% in females of Chandigarh. The prevalence of Vitamin D deficiency exhibited an age-associated increment in both the males and females. Conclusion: Lesser physical activity and no intake of calcium, Vitamin D, and multivitamin supplements were possible determinants of Vitamin D deficiency.

Association of supplemental calcium and dairy milk intake with all-cause and cause-specific mortality in the UK Biobank: a prospective cohort study.

Excessive Ca intakes have been proposed to associate with vascular calcification and a higher risk of prostate cancer. We investigated the associations of supplemental and dietary Ca intake with mortality using data from 497828 UK Biobank participants. The average follow-up was 4·2 years and 14255 participants died, 8297 from cancer, 2959 from CVD and 572 from respiratory disease. The use of Ca supplements and milk consumption were associated with differences in mortality in younger (≤65 years) but not in older participants (>65 years, Pinteraction ≤ 0·04 for all comparisons). Among participants <65 years, there was an inverse association between Ca supplementation (OR 0·91, 95 % CI 0·83, 0·99) and milk consumption (OR 0·93, 95 % CI 0·86, 1·00) with respect to all-cause mortality. In the same age group, milk drinkers had lower odds of cancer mortality (OR 0·89, 95 % CI 0·80, 0·98) but Ca supplement use was associated with increased odds of respiratory mortality (OR 1·69, 95 % CI 1·16, 2·74). All associations in participants aged ≥65 years were null after full adjustment. In sensitivity analyses stratified by hormone replacement therapy, Ca supplement use was associated with decreased odds of cancer mortality in users but increased risk in other women (OR 0·81, 95 % CI 0·69, 0·94 v. OR 1·17, 95 % CI 1·01, 1·35, respectively). To conclude, we saw little evidence for harm with dietary or supplemental Ca. Further studies are required to confirm the proposed interaction with hormone replacement therapy and to exclude reverse causation as a determinant in the association between Ca supplements and increased risk of respiratory diseases.