Calcium intake and serum calcium status in Mongolian children

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 < 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.

The roles of vitamin D and dietary calcium in nutritional rickets

The etiology and pathogenesis of nutritional rickets are becoming progressively clearer. Vitamin D deficiency has generally been considered the major or only player in the pathogenesis of nutritional rickets. However, recent research into calcium deficiency has now provided clinicians with reasons to investigate and manage patients with nutritional rickets more appropriately.

The important question when assessing cases of nutritional rickets is: “Is it calcium or vitamin D deficiency or both that play a major role in the pathogenesis of the disease?”

The case presentation in this review highlights the risk factors, clinical presentation and pathophysiology of nutritional rickets in a young South African black child from a semi-urban area in Johannesburg, a city with abundant sunshine throughout the year.

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Vitamin D and calcium deficiencies play synergistic roles in nutritional rickets.

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Dietary calcium intake of <300 mg/day increases the risk of nutritional rickets.

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Vitamin D status is worsened by dietary calcium deficiency itself.

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Marked elevation of 1,25-dihydroxyvitamin D is characteristic of calcium deficiency.

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Preventative strategies needed to decrease the prevalence of nutritional rickets.

Dietary Calcium Intake and Adherence to the Mediterranean Diet in Spanish Children: The ANIVA Study

The aim of this study was to evaluate the relationship of dietary calcium intake with anthropometric measures, physical activity and adherence to the Mediterranean diet (MedDiet) in 1176 Spanish children aged 6-9 years. Data were obtained from "Antropometría y Nutrición Infantil de Valencia" (ANIVA), a cross-sectional study of a representative sample. Dietary calcium intake assessed from three-day food records was compared to recommended daily intakes in Spain. Anthropometric measures (weight and height) were measured according to international standards and adherence to the MedDiet was evaluated using the Mediterranean Diet Quality Index (KIDMED) test. For the total sample of children, 25.8% had inadequate calcium intake, a significantly higher prevalence in girls (p = 0.006) and inadequate calcium intake was associated with lower height z-score (p = 0.001) for both sexes. In girls, there was an inverse relationship between calcium intake and body mass index (p = 0.001) and waist/hip ratio (p = 0.018). Boys presented a polarization in physical activity, reporting a greater level of both physical and sedentary activity in comparison with girls (p = 0.001). Children with poor adherence to MedDiet, even if they consume two yogurts or cheese (40 g) daily, adjusted by gender, age, total energy intake, physical activity and father's level of education, are at risk of inadequate total calcium intake (odds ratio adjusted [ORa]: 3.36, 95% confidence interval [CI]: 1.13-9.94, p = 0.001). The intake of these dairy products was insufficient to cover calcium intake recommendations in this age group (6-9 years). It is important to prioritize health strategies that promote the MedDiet and to increase calcium intake in this age group.

Calcium Intake and Nutritional Adequacy in Spanish Children: The ANIVA Study

Calcium is an important nutrient for child development. The main objective of this study was to assess calcium intake and its adequacy with dietary reference intake (DRI) in Spanish children. The ANIVA (Antropometría y Nutrición Infantil de Valencia) study is a descriptive cross-sectional study. During two academic years 2013–2014 and 2014–2015, 1176 schoolchildren aged 6–9 years were selected from 14 primary schools in Valencia (Spain). Three-day food records were used to assess dietary intake, completed by parents/guardian. Anthropometric data (weight and height) were evaluated in all subjects. Nutritional intake was compared to estimated average requirements (EARs) and adequate intake (AI) values to determine nutritional adequacy. A percentage of 25.77% had inadequate calcium intake, and a significantly higher prevalence was observed in girls (p = 0.006). Adequate calcium intake showed a positive association with the height z-score (p = 0.032). When assessing dietary patterns, schoolchildren with adequate calcium intakes had better nutritional adequacy in all nutrients, except cholesterol (p = 0.086) and fluorine (p = 0.503). These results suggest a public health problem that must be addressed through nutrition education programs to increase intake of calcium-rich food and to correct the associated dietary pattern.

Nutrient Intake Is Insufficient among Senegalese Urban School Children and Adolescents: Results from Two 24 h Recalls in State Primary Schools in Dakar

Due to rapid urbanization and high food prices and in the absence of nutrition programs, school children from urban areas in West Africa often have insufficient and inadequate diet leading to nutrient deficiencies that affect their health and schooling performance. Acute malnutrition and micronutrient deficiencies are prevalent in children from primary state schools of Dakar (Senegal). The objectives of the present study were to assess the overall diet of these children, to report insufficient/excessive energy and nutrient intakes and to investigate association between insufficient nutrient intake and micronutrient deficiencies. Children attending urban state primary schools in the Dakar area were selected through a two-stage random cluster sampling (30 schools × 20 children). Dietary intake data were obtained from two 24 h recalls and blood samples were collected from 545 children (aged 5-17 years, 45% < 10 years, 53% girls) and adjusted for intra-individual variability to estimate nutrient usual intakes. Energy intake was insufficient and unbalanced with insufficient contribution of protein and excessive contribution of fat to global energy intake in one third of the children. Proportions of children with insufficient intake were: 100% for calcium, 100% for folic acid, 79% for vitamin A, 69% for zinc, 53% for vitamin C and 46% for iron. Insufficient iron and protein intake were risk factors for iron deficiency (odds ratio, OR 1.5, 2.2). Insufficient zinc intake and energy intake from protein were risk factors for zinc deficiency (OR 1.8, 3.0, 1.7, 2.9). Insufficient iron and vitamin C intake, and insufficient energy intake from protein were risk factors for marginal vitamin A status (OR 1.8, 1.8, 3.3). To address nutritional deficiencies associated with a diet deficient in energy, protein and micronutrients, nutrition education or school feeding programs are needed in urban primary schools of Senegal.

An Assessment of the Consumption of Energy and Selected Minerals and Their Content in the Hair of Children Aged 1-4 Years

The aim of this study was to assess the consumption of energy and selected minerals (Ca, Mg, Fe, Zn, Cu) and their content in the hair of children aged 1-4 years. Seventy-five children were divided into three age subgroups: 12-24-month-olds, 25-36-month-olds and 37-48-month-olds. The data on energy intake and consumption of nutrients were obtained by means of a nutritional interview. The content of elements in the hair was measured by means of flame atomic absorption spectrometry (AAS) with an AAS-3 spectrophotometer (Zeiss). The daily food rations of children aged 12-36 months were characterised by adequate energy value, but the values of Ca and K were too low, whereas the content of Mg, Zn and Cu was high. On the other hand, the daily food rations of children aged 37-48 months provided sufficient amounts of Mg and Zn, but the value of Cu was too high, whereas energy, Ca, K and Fe were too low. About 42.7% of the children under study were characterised by an abnormal state of nutrition. An inadequately balanced diet needs to be corrected by educating parents or guardians in appropriate nutrition. There are significant correlations (r > 0.9) between the supply of Ca in the diet of children aged 1-4 years and the content of this element in their hair.

Eating habits of preschool children and the risk of obesity, insulin resistance and metabolic syndrome in adults

Background & Objective : Nutrient excess and nutrient deficiency in the diets of preschool children can lead to permanent modification of metabolic pathways and increased risk of diet-dependent diseases in adults. Children are most susceptible to the adverse consequences of bad eating habits.The objective of this study was to evaluate the eating habits and the diets of preschool children as risk factors for excessive weight, obesity, insulin resistance and the metabolic syndrome. Methods : The study was conducted on 350 randomly selected preschool children attending kindergartens in south-eastern Poland. Three-day dietary recalls were processed and evaluated in the Dieta 5 application. Results : The analyzed diets were characterized by low diversity and a high share of processed foods, such as pate, sausages, ketchup, mayonnaise, fried meat, French fries and fast-food. The dietary content of vegetables, raw fruit, dairy products and whole grain products was alarmingly low. Conclusions : Diets characterized by excessive energy value and nutritional deficiency can lead to health problems. In most cases, excessive weight gain in children can be blamed on parents and caretakers who are not aware of the health consequences of high-calorie foods rich in fats and sugar.