Bone Health in Children With Risk Factors for Low Bone Mass

Purpose: To describe clinical and biological characteristics of pediatric patients with at least one risk factor (RF) for low bone mass for chronological age (LBMca)/childhood osteoporosis (cOP) and to assess its influence on bone mineral density (BMD).Methods: Patients between 2 and 20 years of age with at least 1 RF were recruited. Daily calcium intake, number of previous fractures and other RFs and their distribution among different groups were assessed. Spine and whole body DXA and vertebral morphometry were performed.Results: 103 patients were included. Mean age was 9.8 years old. 52.4% were female. Of the RFs, 84.5% presented insufficient calcium intake, 38.8% were receiving or had received corticosteroids, 31.1% were receiving other treatments with osteotoxic potential, 13.6% led a sedentary lifestyle, 12.6% presented history of fractures, and up to 8.1% had hypovitaminosis D. 38% of the cohort had 2 RFs, 31% had 3 RFs, 15% had 4 RFs, and 12% associated 5 or more RFs. 10.5% met LBMca criteria and 4.8% met cOP criteria. 73% of vertebral BMD was justified by age and hypovitaminosis D (positive effect), and male sex and Hispanic ethnicity (negative effect). 82% of total body less head BMD was justified by age (positive effect), and Hispanic ethnicity and sedentary lifestyle (negative effect).Conclusions: Pediatric populations with risk of LBM/cOP have 2 or more risk factors. Up to 10.5% of children with RFs present LBM and 4.8% have an unknown cOP. RFs related to changes in BMD are age, sex, sedentary lifestyle, ethnicity, and hypovitaminosis D.

Hubungan Asupan Kalsium terhadap Status Kepadatan Mineral Tulang pada Wanita Usia Subur di Kota Pekanbaru

ABSTRAK Faktor risiko yang menyebabkan osteoporosis pada wanita yang dibagi menjadi dua antara lain faktor yang tidak dapat dikontrol yaitu usia, jenis kelamin, genetik, menopause, ras, serta faktor yang dapat dikontrol yaitu aktifitas olah raga, konsumsi kafein dan bersoda, asupan kalsium, mengkonsumsi obat kortikosteroid, merokok, Indeks Massa Tubuh, serta minum alkohol. Tujuan Penelitian untuk mengetahui hubunan asupan kalsium terhadap status kepadatan mineral tulang pada Wanita Usia Subur di Pekanbaru. Penelitian ini merupakan penelitian kuantitatif analitik. Sampel dalam penelitian ini adalah wanita usia subur yang berjumlah 399 orang. Analisis dengan uji Chi-Square adanya hubungan antara asupan kalsium terhadap status kepadatan mineral tulang pada wanita usia subur dengan nilai Pvalue 0,000 < Alpha 0,05 dengan besar OR adalah 922.629 (95% CI: 125,039-6807,809) artinya responden yang kurang asupan kalsium berisiko 922 kali menderita osteoporosis. Kata kunci: asupan kalsium; status kepadatan mineral tulang ; wanita usia subur ABSTRACTThe risk factors that cause osteoporosis in women are divided into two, namely factors that cannot be controlled, namely age, gender, genetics, menopause, race, and factors that can be controlled, namely exercise activity, consumption of caffeine and fizzy drinks, calcium intake, taking medication of Corticosteroids, smoking, Body Mass Index, and drinking alcohol. The aim of the study was to determine the relationship between calcium intake and the status of bone mineral density in women of childbearing age in Pekanbaru. This research was an analytical quantitative research. The sample in this study was women of childbearing age, totaling 399 people. The analysis used Chi-Square. The result shows there is a relationship between calcium intake and bone mineral density status in women of childbearing age with a P value of 0.000 < Alpha 0.05 with a large OR of 922.629 (95% CI: 125.039-6807.809), meaning that respondents who lack intake calcium has 922 times the risk of suffering from osteoporosis. Keywords: calcium intake; bone mineral density status; women of childbearing age

Association of Dietary Calcium Intake With Bone Health and Chronic Diseases: Two Prospective Cohort Studies in China

Background: Calcium is an essential element in our diet and the most abundant mineral in the body. A high proportion of Chinese residents are not meeting dietary calcium recommendations. The purpose of this study was to investigate the relationship between calcium intake and the health of residents in two longitudinal studies of Chinese residents.Methods: This study used nationally representative data from the Harbin Cohort Study on Diet, Nutrition, and Chronic Non-communicable Disease Study (HDNNCDS) and China Health Nutrition Survey (CHNS), including 6,499 and 8,140 Chinese adults, respectively, who were free of chronic diseases at recruitment, with mean values of 4.2- and 5.3-year follow-up. Cox's proportional-hazards regression was conducted to explore the relationship between dietary calcium intake and the incidence of obesity, type 2 diabetes, hypertension, and cardiovascular disease (CVD) with adjustment for covariates.Results: Calcium intakes were 451.35 ± 203.56 and 484.32 ± 198.61 (mean ± SD) mg/day in HDNNCDS and CHNS. After adjusting the covariates, the relationship between dietary calcium intake and bone mineral density (BMD) was not statistically significant (p = 0.110). In the multivariate-adjusted Cox's proportional-hazards regression model, dietary calcium intakes were inversely associated with obesity incidence in both cohorts (HR [95% CI]: 0.61 [0.48–0.77] and p trend &lt; 0.001 in fixed-effects model); nevertheless, there was no correlation between dietary calcium intake and the risk of type 2 diabetes (p trend = 0.442 and 0.759) and CVD (p trend = 0.826 and 0.072). The relationship between dietary calcium intake and the risk of hypertension in the two cohorts was inconsistent (p trend = 0.012 and 0.559). Additionally, after further adjusting the vegetable intake in the original multivariate model, both cohorts found no association between dietary calcium intake and the risk of developing obesity (p trend = 0.084 and 0.444).Conclusions: Our data suggest that the current calcium intake of Chinese residents was inversely associated with obesity, which may be related to consumption of vegetables. Meanwhile, the current calcium intake does not increase the risk of type 2 diabetes, CVD, and bone health burden. This research suggested that the Chinese current calcium intake level may have met the needs of the body.

East-Greenland traditional nutrition: a reanalysis of the Høygaard et al. nutritional data (1936-1937)

Greenlandic traditional nutrition was unique in the arctic environment. The aim of the present study was to reanalyze the Høygaard et al. data, focusing on two micronutrients object of discussion, i.e., calcium and vitamin C. Høygaard et al. left Copenhagen in August 1936, and stayed in East-Greenland until August 1937. The members of the expedition recorded nutritional intake whilst residing in families. However, the nutritional intake was analyzed on a household level. In total 35 adults and 41 children participated. Median total energy expenditure in kcal.d−1 was estimated at 2978 and 2627 for male and female adults respectively, and 1997 for children and adolescents. Median (IQR) energy consumption in kcal.d−1 was 3881 (1568) for male and 2910 (882) for female adults. This was 2442 (857) and 2023 (1122) for male and female children and adolescents. Median (IQR) calcium intake in mg.d−1 was 555 (1110) for male and 484 (883) for female adults. This was 458 (747) and 358 (838) for male and female children and adolescents. Median (IQR) vitamin C intake in mg.d−1 was 79 (77) for male and 59 (56) for female adults. This was 44 (47) and 60 (52) for male and female children and adolescents. In this study, the importance of traditional foods in reaching an acceptable energy balance was emphasized, together with the confirmation of a low calcium intake in East-Greenland traditional dietary pattern, and the important role of algae consumption in Inuit traditional dietary pattern to avoid scurvy.

The Effect of Smoking on Salivary Calcium Levels, Calcium Intake, and Bleeding on Probing in Female

Introduction. Smoking is a bad habit that affects both systemic and oral conditions. Nicotine in cigarettes reduces estrogen production that can alter salivary calcium levels. Nicotine also causes vasoconstriction of the gingival blood vessels and decreases gingival bleeding. Low dietary calcium intake is also suspected to influence the low serum calcium levels in smokers. In this study, we evaluated the effect of smoking on salivary calcium levels, calcium intake, and BOP in women. Method. This was an analytical study using a cross-sectional approach. The subjects were 26 female smokers and 37 nonsmokers. Unstimulated saliva was collected by the spitting method. Salivary calcium levels were measured using an Atomic Absorption Spectrophotometer (AAS). The calcium intake was obtained by the Semiquantitative Food Frequency Questionnaire. BOP was measured by a gingival bleeding index by Ainamo and Bay in 1975. Results. All the basic characteristics including age, BMI, level of education, and occupation were statistically different between groups. The mean calcium level of female smokers was significantly lower than that of nonsmokers, whereas the mean BOP of female smokers was significantly higher. The total calcium intake per day of the two groups was not statistically different. The mean salivary calcium level and BOP decreased when the duration of smoking was longer. There was a positive correlation between salivary calcium level and BOP in the smokers’ group. Conclusion. A low level of education may be contributing to the smoking habit of subjects in this study. Salivary calcium levels were correlated with BOP in female smokers, which might be affected by the duration of smoking.

Dietary Calcium Intake and Fat Mass in Spanish Young Adults: The Role of Muscle Strength

Obesity is declared as a chronic multifaceted health problem, and young adults may be particularly vulnerable to weight gain. This study aims to identify the role of dietary calcium intake and the muscle strength index in handling excess of fat mass in young adults and to examine if the relationship between dietary calcium intake and fat mass percentage is mediated by muscle strength. A cross-sectional study including 355 Spanish college students (aged 21.05 ± 3.11) was performed during the 2017–2018 academic year. Pearson correlation coefficients were estimated to determine the relationship between dietary calcium intake, fat mass percentage, body mass index, muscle strength components, and total energy intake. ANCOVA models were used to analyze the differences in the muscle strength index by total dietary calcium intake categories, as well as the differences in % fat mass by total dietary calcium intake and muscle strength index categories, controlling for different sets of confounders. A mediator analysis was conducted to test if the relationship between dietary calcium intake and fat mass percentage was explained by muscle strength. Data on the fat mass percentage, dietary calcium intake, and muscle strength index as the sum of the standardized z-score of the standing long jump and z-score of handgrip/weight were collected. The muscle strength index was significantly better in young adults with higher dietary calcium intake. Moreover, the fat mass percentage was significantly lower in those with a higher dietary calcium intake and a better muscle strength index. Finally, the relationship between dietary calcium intake and fat mass percentage was fully mediated by muscle strength (z = −1.90; p < 0.05), explaining 33.33% of this relationship. This study suggests that both a major dietary calcium intake and muscle strength are associated with fat mass percentage. Moreover, muscle strength mediates the link between dietary calcium intake and fat mass percentage. Therefore, both high dietary calcium intake and exercise activities aimed at improving muscle strength levels may help to prevent the cardiometabolic risk associated with an excess of fat mass in young people.

Evaluation of calcium-fortified municipal water as a public health intervention to mitigate lead burdens

Lead has adverse effects on health, society, and the economy. Lead exposure results in increased blood lead levels and storage in bones. Calcium and lead are competitively absorbed and as such calcium can be used to mitigate the body lead burden. Twenty-eight quantitative research studies were reviewed that examined lead exposure (in blood, bone, or breastmilk) and calcium intake or serum calcium to evaluate the efficacy and safety of fortifying potable water supplies with calcium to mitigate lead absorption or resorption. Eighteen of the studies reported a significant inverse relationship between biomarker lead levels and calcium intake or serum calcium. The relationship was most evident with high calcium intake, suggesting a dose-dependent relationship. An intervention with calcium-fortified water could offer an accessible source of supplemental calcium to help meet the recommended dietary allowance (RDA) and mitigate lead absorption. A concentration of 60 mg-Ca/L can supply 22.0 and 16.3% of a 1,000 mg-Ca RDA for men and women, respectively, at the recommended daily water intake.