Ingesta de calcio y densidad mineral ósea en adolescentes chilenos con desarrollo puberal completo

Introducción: La cantidad diaria recomendada (RDA) de calcio en adolescentes es de 1.300 mg/día. La última Encuesta Nacional de Consumo Alimentario de Chile, mostró que la mediana de ingesta total de calcio fue menos de la mitad de la RDA. Una ingesta insuficiente de calcio puede impactar negativamente la mineralización ósea. Objetivo: Determinar el efecto de la ingesta de calcio y estado nutricional sobre la densidad mineral ósea (DMO) de adolescentes con desarrollo puberal completo. Métodos: Estudio de corte transversal. Participaron n= 79 adolescentes de ambos sexos de entre 17 y 18 años elegidos al azar, aparentemente sanos, estadio Tanner 5 e IMC-1 DE). Según estado nutricional, no hubo diferencias significativas en la ingesta de nutrientes, pero sí en la DMO. En media, la DMO estandarizada (puntaje Z) fue normal para ambos sexos (>-1 DE); los adolescentes con obesidad presentaron una DMO estandarizada significativamente mayor que los adolescentes de peso normal (1,05±0,85 vs 0.33±0,86; P= 0,04). La ingesta de calcio no se relacionó con la masa ósea total ni con la DMO estandarizada. Conclusión: En adolescentes con desarrollo puberal completo no hubo relación entre la ingesta de calcio y los niveles de mineralización ósea. Sí hubo relación entre mineralización ósea y estado nutricional, siendo mayor la DMO en los individuos con obesidad.

Background: In adolescents, the recommended daily intake (RDI) of calcium is 1,300 mg. In Chile, the latest National Survey of Food Consumption showed that the median total calcium intake was less than half of the RDI. An adequate intake of calcium in adolescence negatively affects BMD. Aim: To determine the association of calcium intake and nutritional status with bone mineral density (BMD) in male and female adolescents with completed pubertal development (Tanner 5). Methods: Cross-sectional study in a random sample of 79 male and female adolescents, ages 17-18. Participants were healthy, Tanner stage 5, and BMI −1 SD. BMD was higher in obese participants compared to normal-weight adolescents (1.05±0.85 vs 0.33±0.86; P= 0.04), although no differences in nutrients and food intake. Calcium intake was unrelated to total bone mass and unstandardized BMD. Conclusions: In our sample of adolescents with complete pubertal development, there was no relationship between calcium intake and bone mineralization levels. There was a significant relationship between bone mineralization and nutritional status, with BMD being higher in adolescents with obesity.

Ingesta de calcio por la dieta en una población de mujeres embarazadas ecuatorianas que viven a 2800 metros sobre el nivel del mar / Calcium Intake from Diet in a Population Group of Ecuatorian Pregnant Women Living 2800 Above Sea Level / Ingestão de cálcio na dieta de gestantes equatorianas que vivem a 2800 metros acima do nível do mar

Resumen: El objetivo del presente artículo es determinar los valores de ingesta de calcio dietario en mujeres embarazadas. Para el efecto se realizó un estudio descriptivo, observacional-transversal, en el Hospital Privado Básico Provida de Latacunga, Ecuador. Se aplicó una encuesta nutricional, previamente validada, a mujeres gestantes desde el segundo trimestre de gestación, que acudieron a los controles prenatales en la consulta del hospital, en el período de septiembre de 2017 a julio de 2018. El análisis estadístico se realizó con el software spss v.23; se aplicó estadística descriptiva en las variables edad, índice de masa corporal (IMC) y edad gestacional; se obtuvieron media y desviación estándar, mínima y máxima. Se realizó el cálculo de frecuencia para los resultados de ingesta de calcio en la dieta y su distribución según grupos de edad. Como se verá en la sección de los resultados, con la participación de 210 mujeres embarazadas, la media de edad fue de 30,3 ± 4,8 años, la media de la edad gestacional fue de 31,2 semanas, 61,4 % fueron multíparas. La ingesta de calcio media fue de 562,11 ± 257,52 mg/día, el aporte máximo de calcio proveniente de lácteos fue de 1.536,90 mg/día y el aporte mínimo de calcio proveniente de alimentos complementarios fue de 18,93 mg/día. El 90,48 % tuvieron una ingesta de calcio inferior a 900 mg/día con mayor porcentaje en edades entre 26 y 35 años; solo el 9,52 % tuvieron una ingesta mayor a 900 mg/día. Con base en los resultados se ha concluido que la ingesta dietética de calcio en las mujeres embarazadas es de alrededor de 562,11 ± 257,52 mg/día, dato que varía según el país o región de la población estudiada. Se puede afirmar que la ingesta dietética de calcio no llega a los niveles recomendados por la Organización Mundial de la Salud (OMS) para las mujeres gestantes. La población de estudio tiene acceso a servicios de salud privada.

Abstract: The objective of this article is to determine dietary calcium intake values in pregnant women. For this purpose, a descriptive, observational-cross-sectional study was carried out at the Provida Basic Private Hospital in Latacunga, Ecuador. A nutritional survey, previously validated, was performed with women in the third quarter of their pregnancy, who attended prenatal checkups at the hospital consultation, between September 2017 and July 2018. Statistical analysis was performed using the SPSS v.23 software; descriptive statistics were applied in the age, body mass index (BMI) and gestational age variables; and the mean, minimum and maximum standard deviations, were obtained. The frequency calculation was carried out for the dietary calcium intake and its distribution according to the age groups. As seen in the result section, with the participation of 210 pregnant women, the mean age was 30.3 ± 4.8 years, the mean gestational age was 31.2 weeks, 61.4% they were multiparous. Mean calcium intake was 562.11 ± 257.52 mg/day, the contribution of calcium coming from dairy was 1.536,90 mg/day and the minimum calcium contribution coming from complementary food was 18.93 mg/day. 90.48 % had a calcium intake lower than 900 mg/day with higher percentage in ages between 26 and 35 years old; only 9.52 % had an intake higher than 900 mg/day. Based on the results, it has been concluded that the dietary intake of calcium in pregnant women is around 562.11 ± 257.52 mg/day, data that varies according to the country or region of the population studied. It can be stated that dietary calcium intake does not reach the levels recommended by the World Health Organization (WHO) for pregnant women. The population under study has access to private health services.

Resumo: Este artigo tem o objetivo de determinar os valores de ingestão de cálcio dietário em gestantes. Para isso, foi realizado um estudo descritivo, observacional-transversal, no Hospital Privado Básico Provida de Latacunga, Equador. Foi aplicado um questionário nutricional, previamente validado, a gestantes a partir do segundo trimestre de gestação, que participaram dos pré-natais no referido hospital, entre setembro de 2017 e julho de 2018. A análise estatística foi realizada com o software SPSS versão 23; foi aplicada estatística descritiva nas variáveis idade, índice de massa corporal (IMC) e idade gesta-cional; foram obtidos média e desvio-padrão, mínima e máxima. Foi realizado o cálculo de frequência para os resultados de ingestão de cálcio na dieta e sua distribuição segundo grupos de idade. Na seção dos resultados, vê-se que, com a participação de 210 mulheres grávidas, a média de idade foi de 30,3 ± 4,8 anos, a média da idade gestacional foi de 31,2 semanas, 61,4 % foram multíparas. A ingestão de cálcio média foi de 562,11 ± 257,52 mg/dia, a contribuição máxima de cálcio proveniente de lácteos foi de 1.536,90 mg/dia e a mínima proveniente de alimentos complementares foi de 18,93 mg/dia. 90,48 % tiveram uma ingestão de cálcio inferior a 900 mg/dia com maior porcentagem na faixa etária de 26 a 35 anos; somente 9,52 % tiveram uma ingestão maior a 900 mg/dia. Com base nos resultados, conclui-se que a ingestão dietética de cálcio em gestantes é ao redor de 562,11 ± 257,52 mg/dia, dado que varia segundo o país ou a região da população estudada. Pode-se afirmar que a ingestão de cálcio dietário não chega aos níveis recomendados pela Organização Mundial da Saúde para as gestantes. A população de estudo tem acesso a serviços de saúde particulares.

Consumo de calcio y otros predictores de la densidad mineral ósea en adolescentes venezolanos / Calcium consumption and other predictors of bone mineral density in Venezuelan adolescents

La acumulación adecuada de masa ósea durante la adolescencia es un factor protector para osteoporosis y otras afecciones óseas, por tanto, resulta relevante la evaluación del consumo de calcio y de otros determinantes de la densidad mineral ósea (DMO), en adolescentes. Se evaluó el consumo de calcio, otros factores biológicos y de estilo de vida, como predictores de la DMO en adolescentes venezolanos. Se realizó un estudio transversal, correlacional en 60 adolescentes (15 a 18 años), de la cohorte 2011-2012 del Programa Igualdad de Oportunidades de la Universidad Simón Bolívar (USB). La DMO, y el consumo de calcio y bebidas antagonistas del metabolismo del calcio, se determinaron mediante un cuestionario semicuantitativo de frecuencia de alimentos; También se evaluó el estado nutricional (por índice de masa corporal) y el nivel de actividad física. En promedio, la ingesta de calcio fue adecuada (1183 mujeres y 1315 mg/d hombres) y las principales fuente de calcio fueron la leche y sus derivados. Sin embargo, el 42% de los individuos presentó un consumo de calcio por debajo de lo recomendado. Los niveles de actividad física fueron entre bajos y moderados. El 95% de los adolescentes presentaron una DMO adecuada para su edad, siendo el sexo y el consumo de calcio los principales predictores. El consumo de calcio es un determinante importante de la DMO, siendo necesario para garantizar una contribución dietética adecuada durante la adolescencia, con el fin de prevenir un riesgo de deficiencia nutricional que pueda afectar la salud ósea(AU)

The adequate accumulation of bone mass during adolescence is a protective factor against the development of osteoporosis and other bone conditions. Therefore, evaluation of the consumption of calcium and other determinants of bone mineral density (BMD) in adolescents is relevant. The consumption of calcium and other biological and lifestyle factors were evaluated as predictors of BMD in Venezuelan adolescents. A correlational cross-sectional study was conducted in a group of 60 adolescents (15-18 years old), of the 2011-2012 cohort of the Equal Opportunities Program of the Simón Bolívar University (USB). BMD, and the consumption of calcium and drinks antagonistic to calcium metabolism, were determined through a semi-quantitative food frequency questionnaire; the nutritional status (by body mass index) and the level of physical activity were also evaluated. On average, calcium intake was adequate (1183 women and 1315 mg/d men) and the main sources of calcium were milk and its derivatives. However, 42% of individuals had a calcium intake below recommended. The majority of adolescents presented BMI within normal values (78.4% women and 69.6% men). Physical activity levels were between low and moderate. 95% of adolescents presented an adequate BMD for their age, being sex and calcium consumption the main predictors. The calcium consumption is an important determinant of BMD, being necessary to ensure an adequate dietary contribution during adolescence, with the purpose of preventing a risk of nutritional deficiency that may affects bone health(AU)

A systemic review on global dietary calcium intake in adults / 中华内分泌代谢杂志

Low calcium intake may impose adverse impacts on bone health. The current paper is the Chinese translation for a systemic review article published in December, 2017 in Osteoporosis International with open access [ Balk EM, Adam GP, Langberg VN, et al. Global dietary calcium intake among adults: a systematic review. Osteoporos Int. 2017;28 ( 12 ):3315-332 ] . Through searching 13 electronic databases and requesting data from domain experts, an interactive global calcium map was developed. Average national dietary calcium intake ranges from 175 to 1233 mg/day. Many Asia countries have average dietary calcium intake less than 500 mg/day. Countries in Africa and South America mostly have low calcium intake between about 400 and 700 mg/day. Only Northern European countries have national calcium intake greater than 1000 mg/day. This review draws attention to regions where measures to increase calcium intake are likely to have skeletal benefits.

Association between Nutritional Status, Food Insecurity and Frailty among Elderly with Low Income / Jurnal Sains Kesihatan Malaysia

Aging is associated with increased risk of frailty and malnutrition. However, food insecurity has rarely been highlighted in the elderly population, especially among the low income group. Thus, a cross-sectional study was conducted to determine the association between nutritional status, food insecurity and frailty among elderly in low income residences in Klang Valley. A total of 72 elderly individuals aged 60 years and above was selected (mean age 66 ± 6 years) through convenient sampling. Participants were interviewed to obtain information on socio-demographic, health status, food insecurity and cognitive status. Anthropometrics parameters and frailty assessments was measured using standard criteria. Results showed that 75.0% of the participants had abdominal obesity. Nearly half of the participants were overweight (41.7%), followed by normal (43.0%) and underweight (15.3%). With respect to food insecurity, most of them reported that they had enough food (93.1%). There were significant correlation (p < 0.05) between food insecurity with height (r = -0.263, p = 0.026). Most of the participants were pre-frail (58.3%), frail (27.8%) and followed by non-frail (13.9%). Calcium intake is inversely associated with frailty (t = -2.62, p = 0.011). In conclusion, food insecurity was not a problem, however, half of the subjects were overweight and pre-frail. Three out four subjects had abdominal obesity. There is a need to investigate further the pathogenesis of fat frail in this low income elderly population and formulate effective intervention strategies.

Effects of vitamin D deficiency and daily calcium intake on bone mineral density and osteoporosis in Korean postmenopausal woman

OBJECTIVE: We evaluated the combined effects of vitamin D and daily calcium intake on bone mineral density (BMD) and osteoporosis in Korean postmenopausal women. METHODS: This study is a cross-sectional study consisting of 1,921 Korean postmenopausal women aged 45 to 70 years without thyroid dysfunction, from the 2008–2011 Korean National Health and Nutrition Examination Survey. Participants were classified into six groups according to serum 25-hydroxyvitamin D (25(OH)D) levels and daily calcium intake. BMD was measured using dual-energy X-ray absorptiometry at femur and at lumbar spine, and the serum vitamin D levels were measured by radioimmunoassay. RESULTS: The BMD divided according to serum 25(OH)D and daily calcium intakes were not statistically different among the groups. However, when both daily calcium intake and serum 25(OH)D were not sufficient, risk of osteopenia and osteoporosis showed significant increase in both femur neck and lumbar spine (odds ratio [OR] 2.242, P=0.006; OR 3.044, P=0.001; respectively). Although daily calcium intake was sufficient, risks of osteopenia and osteoporosis significantly increased in lumbar spine group if serum 25(OH)D is <20 ng/mL (OR 2.993, P=0.006). CONCLUSION: The combined effects of insufficient daily calcium intake and vitamin D deficiency may cause low BMD and increase in prevalence of osteopenia and osteoporosis in Korean postmenopausal women aged 45 to 70 years.

Nutrientes y parámetros bioquímicos relacionados con la salud ósea en mujeres mayores de 65 años / Dietary intake and biochemical parameters related to bone health in women older than 65 years old / Nutrientes e parâmetros bioquimicos relacionados com a saúde óssea em mulheres maior do que 65 anos

Ingestas (I) bajas de energía (E), proteínas (Pr), calcio (Ca), y vitamina D (VD) afectan la salud ósea del adulto mayor. El objetivo del trabajo consistió en evaluar la I de E, Pr, Ca y VD en mujeres mayores de 65 años y su relación con parámetros bioquímicos (PB) del metabolismo óseo. La población estudiada estuvo formada por: Grupo total (GT): 151 mujeres ambulatorias de la Ciudad de Buenos Aires y alrededores, de (X±DE) 72±6 años [102 en verano (G V) y 49 en otoño-invierno (G O-I)]. Se realizaron cuestionarios de frecuencia de consumo de alimentos y de exposición solar. Se midió en suero 25-hidroxi vitamina D (25OHD), crosslaps (CTX), fosfatasa alcalina ósea (FAO), calcio (Ca) y fósforo (P), y en orina de 24 h: índice calciuria y creatininuria (cau/cru). Como resultado se evidenció una adecuada I.E, elevada de Pr, sin superar límites máximos; I bajas de VD (100%), y Ca (50%). Los niveles de 25OHD fueron deficientes (<20 ng/mL) en el 93% del G O-I y 37,2% del G V. Se observaron correlaciones positivas débiles entre 25OHD y Ca (r=0,212; p<0,013), P (r=0,267; p<0,003), Cau/Cru (r=0,227; p<0,02), exposición solar (r=0,267; p<0,014); I. Ca (r=0,26; p<0,003) en el GT y entre 25OHD e I. de VD sólo en G-OI (r=0,367, p<0,012). Se evidenció una I. insuficiente de Ca y de VD con elevada prevalencia de deficiencia de VD. Se requieren programas de suplementación de VD y promoción de ingesta de lácteos en adultos mayores.

An inadequate intake (I) of energy (E), protein (Pr), calcium (Ca) and vitamin D (VD) might affect elderly bone health. The objectives of the present work were to assess energy (E), protein (Pr), calcium (Ca), and VD I in women older than 65 years old(y) and to evaluate bone biochemical parameters (BP) and the relationship with dietary I The population under sudy was constituted by a total group (TG):151 [102 in summer (SG) and 49 in autumm-winter (A-WG)] ambulatory healthy women with 72±6 (X±SD). Food consumption frequency and sunlight exposure questionnaires were carried out. Serum 25 hydroxy vitamin D (25OHD), crosslaps (CTX), calcium (sCa), phosphate (sP), bone alkaline phosphatase and uCa/uCr ratio were measured in 24-hour urine samples. As a result, the TG showed an adequate EI, lower CaI (in 50%) and VD (in 100%) and higher PrI than dietary reference intake but not higher than the upper I level. A total of 93% of A-WG and 37.2% of SG had vitamin D deficiency (25OHD < 20 ng/mL). There were significative but weak correlations between 25OHD and sCa (r=0.212; p<0.013), sP (r=0.267; p<0.003), uCa/uCr (r=0.227; p<0.02), sunlight exposure (r=0.267; p<0.014), CaI (r=0.26; p<0.003) in TG; and between 25OHD and VD I only in the A-WG (r=0.367, p<0.012). An inadequate intake of Ca and VD and high prevalence of VD deficiency were evident. VD supplementation and promotion of a higher intake of dairy products in the elderly are suggested.

Ingestões (I) baixas de energia (E), proteínas (Pr), cálcio (Ca), e vitamina D (VD) afetam a saúde óssea do adulto maior. O objetivo do trabalho consistiu em avaliar a I de E, Pr, Ca e VD em mulheres mais do que 65 anos e sua relação com parâmetros bioquímicos (PB) do metabolismo ósseo. A população estudada esteve constituída por: Grupo total (GT): 151 mulheres ambulatórias da cidade de Buenos Aires e seus arredores, de (X±DE) 72±6 anos [102 no verão (G V) e 49 no outono-inverno (G O-I)]. Foram realizados questionários de frequência de consumo de alimentos e de exposição solar. Mensurou-se em soro 25-hidroxi vitamina D (25OHD), crosslaps (CTX), fosfatase alcalina óssea (FAO), cálcio (Ca) e fósforo (P), e em urina 24 h: índice calciúria e creatininúria (cau/cru). Como resultado, foi evidenciada uma adequada I E, elevada de Pr, sem superar limites máximos; I baixas de VD (100%), e Ca (50%). Os níveis de 25OHD foram deficientes (<20 ng/mL) em 93% do G O-I e 37.2% do G V. Observaram-se correlações positivas fracas entre 25OHD e Ca (r=0.212; p<0.013), P (r=0.267; p<0.003), Cau/Cru (r=0.227; p<0.02), exposição solar, (r=0.267; p<0.014,i. Ca (r=0.26; p<0.003) no GT e entre 25OHD e IVD só em GO-I (r=0.367, p<0.012). Foi evidenciada uma i insuficiente de Ca e VD com elevada prevalència de deficiência de VD. Requerem-se programas de suplementação VD e promoção de ingestão de lacticínios em adultos maiores.

The Association between Coffee Consumption and Bone Status in Young Adult Males according to Calcium Intake Level

The purpose of this study was to investigate the association between coffee consumption and bone status (bone mineral density and bone metabolism-related markers) according to calcium intake level in Korean young adult males. Healthy and nonsmoking males (19-26 years, n = 330) participated in this study. Anthropometric measurements, dietary habits, and nutrient intakes were surveyed. Bone status of the calcaneus was measured by using quantitative ultrasound (QUS). Bone metabolism-related markers including serum total alkaline phosphatase activity (TALP), N-mid osteocalcin (OC), and type 1 collagen C-terminal telopeptide (1CTP) were analyzed. The subjects were divided into two groups based on daily calcium intake level: a calcium-sufficient group (calcium intake ≥ 75% RI, n = 171) and a calcium-deficient group (calcium intake < 75% RI, n = 159). Each group was then further divided into three subgroups based on daily average coffee consumption: no-coffee, less than one serving of coffee per day, and one or more servings of coffee per day. There were no significant differences in height, body weight, body mass index, energy intake, or calcium intake among the three coffee consumption subgroups. QUS parameters and serum 1CTP, TALP, and OC were not significantly different among either the two calcium-intake groups or the three coffee consumption subgroups. Our results may show that current coffee consumption level in Korean young men is not significantly associated with their bone status and metabolism according to the calcium intake level.

The cross-sectional relationship between dietary calcium intake and metabolic syndrome among men and women aged 40 or older in rural areas of Korea

BACKGROUND/OBJECTIVES: Studies conducted in Western populations have suggested that dietary calcium may protect against metabolic abnormalities, but there is little evidence of this effect in Asians, who have relatively low calcium intake. We evaluated the cross-sectional relationship between dietary calcium and metabolic syndrome among Korean men and women aged 40 years and over. SUBJECTS/METHODS: A total of 6,375 subjects aged 40 years and over and were recruited between January 2005 and February 2010 from the baseline study of the Multi-Rural Communities Cohort Study in Rural Communities (MRCohort). A food frequency questionnaire was used to collect dietary information. Metabolic syndrome was defined using the modified criteria published in the Third Report of the National Cholesterol Education Program Adult Treatment Panel. RESULTS: Calcium intake was related inversely to metabolic syndrome in women (P-value = 0.0091), but not in men (P = 0.1842). Among metabolic components, high waist circumference (WC) (P = 0.0426) and high blood glucose (P = 0.0027) in women and hypertriglyceridemia (P = 0.0017) in men were inversely correlated with calcium intake. Excluding those who used calcium or multinutrient supplements did not attenuate the relationship between dietary calcium and metabolic abnormalities. CONCLUSION: Dietary calcium intake from foods may be inversely related to metabolic syndrome, WC, and blood glucose among women in rural areas of Korea.

The Role of Calcium in Human Aging

Calcium is an essential nutrient that is necessary for many functions in human health. Calcium is the most abundant mineral in the body with 99% found in teeth and bone. Only 1% is found in serum. The serum calcium level is tightly monitored to remain within normal range by a complex metabolic process. Calcium metabolism involves other nutrients including protein, vitamin D, and phosphorus. Bone formation and maintenance is a lifelong process. Early attention to strong bones in childhood and adulthood will provide more stable bone mass during the aging years. Research has shown that adequate calcium intake can reduce the risk of fractures, osteoporosis, and diabetes in some populations. The dietary requirements of calcium and other collaborative nutrients vary slightly around the world. Lactose intolerance due to lactase deficiency is a common cause of low calcium intake. Strategies will be discussed for addressing this potential barrier to adequate intake. The purpose of this narrative review is a) to examine the role of calcium in human health, b) to compare nutrient requirements for calcium across lifecycle groups and global populations, c) to review relationships between calcium intake, chronic disease risk, and fractures, and d) to discuss strategies to address diet deficiencies and lactose intolerance.

Nutrition knowledge, outcome expectations, self-efficacy, and eating behaviors by calcium intake level in Korean female college students

BACKGROUND/OBJECTIVES: Calcium is important but deficient in diets of young adult women. This study aimed to examine if cognitive factors and eating behaviors differ according to calcium intake based on the Social Cognitive Theory. SUBJECTS/METHODS: Subjects were female college students in Seoul, Korea. Three hundred students completed the questionnaire regarding calcium intake, nutrition knowledge, outcome expectations, self-efficacy and eating behaviors. Data on 240 students were analyzed using t-test or chi2-test. Subjects were categorized into two groups, high calcium intake (HC, > or = 650 mg/day) and low calcium intake (LC, < 650 mg/day), according to recommended intakes of calcium for women aged 19-29 years. RESULTS: The LC group constituted 77.9% of total subjects. Nutrition knowledge was not different according to calcium intake. Three out of 12 outcome expectations items were significantly different between the HC and LC groups. Subjects in the HC group agreed more strongly with the practical benefits of consuming calcium-rich foods, including 'taste' (P < 0.01) and 'going well with other snacks' (P < 0.05), compared to those in the LC group. Negative expectations of 'indigestion' were stronger in the LC group than HC group (P < 0.001). Among self-efficacy items, perceived ability of 'eating dairy foods for snacks' (P < 0.001), 'eating dairy foods every day' (P < 0.01), and 'eating calcium-rich side dishes at meals' (P < 0.05) differed significantly between the HC and LC groups. Eating behaviors including more frequent consumption of dairy foods, fruits or fruit juice (P < 0.001), anchovy, seaweeds, green vegetables, protein-rich foods (P < 0.05), and less frequent consumption of sweets or soft drinks (P < 0.01) were significantly related to calcium intake. CONCLUSIONS: This study found that outcome expectations, self-efficacy in consuming calcium-rich foods, and eating behaviors are important in explaining calcium intake. Nutrition education needs to address practical benefits, reduce negative expectations of calcium-rich foods, increase self-efficacy, and modify eating behaviors contributing to calcium intake.

Nutrition Education Based on Health Belief Model Improves Dietary Calcium Intake among Female Students of Junior High Schools.

This study examined the effects of a nutrition education programme based on the Health Belief Model (HBM) on knowledge, attitude, and practice (KAP) of dietary calcium in female students. In this interventional study, 188 students were placed into intervention (95) and control (93) groups. The intervention group participated in a nutrition education programme. Students in both the groups completed KAP and food frequency questionnaire (FFQ) at baseline and after two and three months of follow-up respectively. The data were analyzed by independent and paired t-tests. Those who received the intervention were found to have better attitude (p=0.049) and practice (p=0.005) scores compared to the controls. The HBM constructs, including perceived susceptibility (p=0.006), perceived severity (p=0.001), perceived benefits (p=0.002), perceived barriers (p=0.001), and taking health action (p=0.02) scores, were also significantly higher. The findings support the effectiveness of nutrition education based on the HBM in improving the knowledge, attitude, and practice relating to calcium intake among adolescent students.

Calcium and Milk Intake of Elementary School Students from School Foodservices: Focus on the Gyeongsangbukdo Province

The calcium intake of elementary school students residing in Gyeongsangbukdo province from their school foodservice and milk program was evaluated. A total of 252 subjects (50.4% boys and 49.6% girls) were examined. A significant percentage of the total subjects (32.9%) reported skipping breakfast once or more per week, with the major reasons for skipping breakfast being a lack of time and appetite. A majority of the total subjects (78.2%) participated in the school milk program. The type of milk consumed by the subjects was mainly white milk, with a milk intake mostly between one and two cups. Participants in the school milk program consumed over the recommended nutrient intake (RNI) of calcium, but non-participants consumed only 48.1% of the RNI (P<0.001). The calcium intake rate according to food cooking methods, from highest to lowest was in the order bap, twigim, jeon, jjim, and gui. Although the food intake rate of guk was low, the calcium intake rate by RNI was the highest for guk. On the other hand, the food intake rate of bap and kimchi was high, but their calcium intake rate by RNI was relatively low. These results show that non-participants in the school milk program are significantly deficient in calcium. Therefore, to improve the calcium nutrition for children, school lunch menus containing high calcium need to be developed and children should be encouraged to enter a school milk program.

Ingestión de calcio y adiposidad en adolescentes de 12 a 16 años en Guadalajara, México / Calcium intake and adiposity in adolescents aged 12- 16 years in Guadalajara, Mexico

El objetivo del trabajo fue evaluar la asociación entre el consumo de calcio (Ca) y adiposidad en un grupo de adolescentes. Se realizó un estudio transversal en 125 adolescentes de 12 a 16 años. El consumo de Ca se evaluó por encuestas alimentarias de recordatorio de 24 horas y frecuencia de consumo de alimentos. Se midió la adiposidad por métodos antropométricos e impedancia bioeléctrica (IBE). Se identificó la relación entre el consumo de Ca y adiposidad mediante correlación simple; se realizaron modelos multivariados ajustados al consumo de energía, edad, sexo y menarquía. El promedio de edad fue de 13.5 ± 0.8 años. Se identificó correlación negativa entre el consumo de Ca y los indicadores antropométricos peso, pliegues cutáneos, índice de masa corporal, masa grasa y porcentaje de grasa (los dos últimos por IBE y solamente en mujeres). El análisis multivariado, que incluyó el consumo de energía, no demostró asociación entre el consumo de Ca y adiposidad. En conclusión, el consumo de Ca no se asocia a adiposidad en adolescentes; los modelos multivariados mostraron que el consumo total de energía y la menarquía son las variables que muestran mayor asociación con adiposidad en esta etapa de la vida.

The purpose was to evaluate the association between calcium (Ca) intake and adiposity in adolescents. A cross-sectional study of 125 adolescents 12 to 16 years. Ca intake was evaluated by 24-hour recall dietary surveys and food frequency consumption. Adiposity was measured by anthropometric methods and bioelectrical impedance (BIA). The association between Ca intake and adiposity was identified by simple correlation and multivariate models adjusted to energy consumption, age, sex and menarche. Mean age of adolescents was 13.5 ± 0.8 years. A negative correlation was identified between Ca intake and anthropometric indicators weight, skinfolds, body mass index, fat mass and percentage of fat (the latter two by BIA and only in women). Multivariate analysis, including energy consumption showed no association between Ca intake and adiposity. In conclusion, Ca consumption does not associate with adiposity in adolescents; multivariate models showed that energy intake and menarche are the variables that show a higher association with adiposity at this stage of life.

Consumo de matéria seca e desempenho de novilhas Nelore alimentadas com dietas contendo cana-de-açúcar hidrolisada / Dry matter intake and performance of Nellore heifers fed with hydrolyzed sugarcane

Objetivou-se avaliar o consumo de nutrientes e o desempenho de novilhas Nelore alimentadas com dietas contendo cana-de-açúcar in natura (CN) ou hidrolisada (CH) com 0,5% de Ca(OH)2 armazenada por 24, 48 e 72 horas. Foram utilizadas 24 novilhas com nove meses de idade e 119,6±8,1kg de peso corporal inicial. O delineamento experimental utilizado foi o inteiramente casualisado com quatro tratamentos e seis repetições. O consumo de matéria seca foi reduzido em 29% pela adição de Ca(OH)2, não sendo alterado pelo período de armazenamento da CH. O consumo de cálcio foi incrementado (P<0,05) pela utilização de CH nas dietas, mantendo níveis de ingestão aceitáveis. Novilhas alimentadas com CH armazenada por 24, 48 e 72 horas apresentaram, respectivamente, ganhos de peso 41, 30 e 35% inferior (P<0,05) àquelas alimentadas com CN. O tratamento da cana-de-açúcar com Ca(OH)2 não é recomendado para alimentação de novilhas Nelore, em virtude de limitar a ingestão e reduzir o ganho de peso.

The study aimed to evaluate the nutrients intake and performance of Nellore heifers fed with chopped sugarcane, fresh (FS) or treated (HS) with 0.5% of Ca(OH)2 and stored during 24, 48 or 72 hours. It was used twenty-four heifers with nine months age and 119.6±8.1kg of initial body weight. The experimental design was completely randomized with four treatments and six replications. The dry matter intake showed an average reduction of 29% by adding Ca(OH)2, and didn't change with the storage period. Calcium intake was increased by the use of HS in the diet, while maintaining acceptable levels of intake. Heifers fed with HS stored during 24, 48 and 72 hours had, respectively, average daily weight gain of 41, 30 and 35% lower than those fed with FS. The treatment of sugarcane with Ca(OH)2 is not recommended for feeding Nellore heifers, due to limited intake and lower weight gain.

Asociación entre la ingesta de calcio dietético y el índice de masa corporal elevado en adultos mexicanos de 20 a 59 años de edad: estudio de corte transversal / Dietary calcium intake and higher body mass index in Mexican adults aged 20 to 59 years old: cross-sectional study

Antecedentes: Aunque, el balance energético es el principal factor que regula el peso corporal, estudios recientes sugieren que el metabolismo del calcio puede modificar el balance energético y actuar en la regulación del mismo. Objetivo: Evaluar la asociación entre la ingesta de calcio dietético y el índice de masa corporal elevado en adultos mexicanos de 20 a 59 años. Material y métodos: Estudio secundario de tipo analítico, derivado de la Encuesta Nacional de Salud y Nutrición 2006. Se analizó la información del cuestionario de frecuencia de alimentos a 16.494 adultos. Después de eliminar valores biológicamente inadmisibles o casos con información incompleta, la muestra final fue de 15.662 adultos que se agruparon según su índice de masa corporal. Se utilizó regresión lineal para estimar la asociación entre ingesta de calcio dietético y el índice de masa corporal. Resultados: Hubo asociación inversa entre el consumo de calcio dietético e índice de masa corporal. Los sujetos con índice de masa corporal normal consumieron 903,9 mg/d versus 832,0 mg/d de calcio en obesos (p < 0,0001). Conclusión: Este estudio corrobora la evidencia existente de asociación inversa entre la ingesta de calcio dietético y el índice de masa corporal elevado.

Background. Although energy balance is the main factor that regulates body weight, recent studies suggest that calcium metabolism can modify the energy balance and help regulate body weight. Objective. To evaluate the association between the calcium intake in the diet and high body mass index in Mexican adults in the 20-59 age group. Material and methods. A cross-sectional secondary analytical study was conducted based on the 2006 Mexican National Health and Nutritional Survey (ENSANUT 2006). Food intake questionnaires applied to 16,494 adults were analyzed. After removing biologically implausible values or incomplete information, we arrived at a final sample of 15,662 adults grouped according to their body mass index. Linear regression was used to assess association between daily dietary calcium intake and body mass index. Results. There was an inverse association between dietary calcium consumption and a high body mass index. The mean calcium intake in subjects with normal body mass index was 903.9 mg/day versus 832.0 mg/day in obese subjects (p < 0.0001). Conclusion. The study corroborates existing evidence of an inverse association between the dietary calcium intake and a high body mass index.

Calcium Intakes in Korean and American Populations

Calcium intake has been insufficient in all age groups in previous Korean national surveys. This study was conducted to investigate calcium intake in Korean and American populations at different ages. We analyzed two national survey data: the 2007~2009 Korean National Health and Nutrition Examination Survey (KNHANES) and the 2007~2008 National Health and Nutrition Examination Survey (NHANES). Statistically, survey procedures were applied using the weight, cluster, and strata variables. The mean calcium intake of Koreans at ages of 1~2 y, 3~5 y, 6~11 y, 12~18 y, 19~64 y, and 65+y was lower than American populations at those ages. The sufficient proportions based on Korean Estimated Average Requirement (EAR) of 1~2 y, 3~5 y, 6~11 y, 12~18 y, 19~64 y, and 65+y in Koreans were 45.5%, 33.1%, 24.3%, 16.6%, 32.7%, and 19.0%. While the sufficient rates based on American EAR of 1~3 y, 4~8 y, 9~13 y, 14~18 y, 19~30 y, 31~50 y, 51~70 y, and 71+y in US population were 88.5%, 54.4%, 35.2%, 35.8%, 55.3%, 55.2%, 40.6%, and 24.5%. Overall, the major foods contributing to calcium intakes in Koreans were milk, baechukimchi, and anchovies, whereas, milk products, pasta, or bread were major contributions to calcium in American populations. The calcium supplement intakes in the American population were 5.5 mg (1~2 y), 15.5 mg (3~5 y), 13.9 mg (6~11 y), 35.7 mg (12~18 y), 150.3 mg (19~64 y) and 334.4 mg (> or =65 y). These results suggest that Korean adolescents and older adults are the most insufficient in dietary calcium intakes among Koreans. In order to accurately estimate calcium intakes in Korean populations, calcium supplements and calcium-fortified foods should be considered.

Análisis de la variación de los niveles de calcio durante el embarazo en una población hospitalaria / Analysis of the variations in calcium levels during pregnancy in a hospital population

La mujer embarazada constituye un reservorio de minerales para la formación de su hijo. El aporte inadecuado de diversos nutrientes durante la gesta, puede afectar tanto al bebé como a la madre. El embarazo y la lactancia son etapas del ciclo reproductivo donde se registran cambios significativos en el metabolismo del calcio. Los niveles de calcio detectables en madre e hijo pueden mostrar variaciones notables según la cultura alimentaria y las costumbres imperantes en la población que se estudie en el momento que se efectúe la observación. El objetivo de esta presentación es observar el nivel de calcio sérico determinado en un grupo de mujeres embarazadas de nivel socioeconómico medio y medio bajo de nuestro país y también de recién nacidos del mismo nivel y compararlo con los valores ideales aconsejados para una concepción y desarrollo neonatal saludables. Los niveles maternos tienden a disminuir con la edad, siendo los recién nacidos posiblemente afectados por dicha disminución. Cierta proporción de los casos estudiados, que algunos meses supera el 30%, mostró niveles menores a los niveles para un recién nacido. Se interpreta que en la población estudiada, representativo de un sector del populoso Conurbano Bonaerense de nivel socioeconómico medio-bajo o bajo, es recomendable la instrumentación de medidas educativas y profilácticas para mejorar los patrones nutricionales y la consiguiente tarea de prevención de la salud de la madre y el niño

Pregnancy and lactation are stages of the breeding cycle that present significant changes in the metabolism of the calcium. The pregnant woman constitutes a reservoir of minerals for the formation of his son. For diverse motives, many women do not consume during the pregnancy the necessary nutrients, which concern both the baby and his own body. Information of calcium levels in mother and son depends on the food culture and other characteristics of the studied population of study, being able to present notable variations. This project tries to know the values of calcium of pregnant moms of a population of socioeconomic low level and determine his relation with the necessary values for a healthy conception. In a hospital population of 600 pregnant women and the correspondents 600 children is observed that the levels of the mothers diminish with the age, newborn children seem to be affected by the mentioned decrease. A certain proportion of the studied cases (some months >30%) are below the normal levels for a newborn child. The studied population is representative of a sector of the populous Gran Buenos Aires city of socioeconomic low level, so there is advisable the instrumentation of educational and prophylactic measures to improve the nutritional customs and the consequent task of prevention of the health of mothers and children

Trend in dietary calcium intake among Chinese elderly aged 50 years and over in nine provinces, from 1991 to 2009 / 中华流行病学杂志

Objective To understand the daily calcium intake and the dietary sources,as well as its trends from 1991 to 2009 in Chinese elderly aged 50 years and over.Methods Consecutive 3 d-24 hr Dietary Recall Data from the seven waves of the China Health and Nutrition Survey (CHNS) was used to describe the status and trends of daily calcium intake and its food sources.Results Between 1991 and 2009,the daily intake of calcium in the Chinese elderly showed an increasing trend.In 2009,the average intakes of calcium in Chinese elderly men and women were 400.2 mg/day and 352.7 mg/day,respectively.72.0％-82.2％ of males and 78.8％-88.0％ of females had their calcium intake less than half of the recommended amount of adequate intakes,but only 0.4％-3.9％ of males and 0.4％-3.0％ of females had their calcium intake equal or higher than the recommended amount of intakes.The sources of dietary calcium were mainly from vegetables,legumes,and cereals for the Chinese elderly,accounting for more than 70％ of the average daily intakes.Conclusion During the past twenty years,the average daily calcium intake of the Chinese elderly still remained at low level while the optimal calcium sources as milk and legumes,were under-consumed.

Daily calcium intake and its relation to blood pressure, blood lipids, and oxidative stress biomarkers in hypertensive and normotensive subjects

Several studies revealed that low calcium intake is related to high prevalence of cardiovascular diseases such as hypertension. The prevalence of hypertension is high in Koreans along with their low dietary calcium consumption. Thus, the aim of this study was to evaluate the status of calcium intake between the hypertension and normotension groups and to investigate the correlation between dietary calcium intake and blood pressure, blood lipid parameters, and blood/urine oxidative stress indices. A total of 166 adult subjects participated in this study and were assigned to one of two study groups: a hypertension group (n = 83) who had 140 mmHg or higher in systolic blood pressure (SBP) or 90 mmHg or higher in diastolic blood pressure (DBP), and an age- and sex-matched normotension group (n = 83, 120 mmHg or less SBP and 80 mmHg or less DBP). The hypertension group consumed 360.5 mg calcium per day, which was lower than that of the normotension group (429.9 mg) but not showing significant difference. In the hypertension group, DBP had a significant negative correlation with plant calcium (P < 0.01) after adjusting for age, gender, body mass index (BMI), and energy intake. In the normotension group, total calcium and animal calcium intake were significantly and positively correlated with serum triglycerides. No significant relationship was found between calcium intake and blood/urine oxidative stress indices in both groups. Overall, these data suggest reconsideration of food sources for calcium consumption in management of the blood pressure or blood lipid profiles in both hypertensive and normotensive subjects.