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Gopal K, Deb B, Uma N, Balan S, GayathriSivakumar, Chandra Mohan M, Rajendran P. Comparative Evaluation of Bioavailability, Efficacy and Safety of MICROCORE NESC ® with Calcium Carbonate and Calcium Citrate Malate in Osteopenic and Osteoporotic Patients: A Randomized Clinical Trial. Indian J Orthop 2024; 58:535-541. [PMID: 38694695 PMCID: PMC11058142 DOI: 10.1007/s43465-024-01117-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/30/2024] [Indexed: 05/04/2024]
Abstract
Introduction Osteoporosis is a skeletal disease characterized by loss of bone mass, reduced bone strength and increased bone fragility predisposing to fractures. This study was planned to evaluate the efficacy, safety and relative bioavailability of Microcore NESC® (Natural Egg Shell Calcium) in osteopenia and osteoporotic patients. Methods This was a randomized, open label, parallel group interventional clinical trial which included 60 study participants with osteopenia and osteoporosis who were randomized into three groups (20 each). Group 1-Microcore NESC®, Group 2-Shelcal and Group 3-CCM with 12 weeks treatment period. The participants were evaluated for relative oral bioavailability, bone mineral density (BMD), serum osteocalcin, change in VAS pain scale and quality of life-Questionnaires. Results There was significant improvement in the BMD T scores-post-treatment with MICROCORE NESC® and Shelcal. Higher percentage of improvement in calcium absorption as depicted by an increase in serum calcium levels (10.23%) in the MICROCORE NESC®-treated group when compared to Shelcal (7.7%) and CCM (7.2%). The relative bioavailability of MICROCORE NESC® with respect to Shelcal was 93%. Discussion MICROCORE NESC®, has shown a better oral relative bio availability of calcium (93%), better improvement of BMD T score compared to Shelcal and CCM. The general health status has improved to very good/excellent in 83% of patients in MICROCORE NESC®-treated group. Thus, MICROCORE NESC® can be considered a better and safe calcium supplement, as there are very few side effects observed without any clinically significant abnormalities in lab parameters.
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Affiliation(s)
- Krishna Gopal
- Department of Orthopaedics, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - Bijoy Deb
- Integrative Medicine, Medical Affairs, Ki3 Private Limited, Chennai, Tamil Nadu, India
| | - N. Uma
- Department of Pharmacology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - Sakthi Balan
- Department of Pharmacology, Sri Venkateshwaraa Medical College Hospital and Research Centre, Ariyur, Puducherry, India
| | | | | | - Priya Rajendran
- Microcore Research Labs India Pvt Ltd, Erode, Tamil Nadu, India
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Singh RP, Mishra A, Chandel SS, Agarwal M, Chawra HS, Singh M, Dubey G. Unlocking New Approaches to Urolithiasis Management Via Nutraceuticals. Curr Pharm Biotechnol 2024; 25:1124-1131. [PMID: 37608670 DOI: 10.2174/1389201024666230821122416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/15/2023] [Accepted: 07/06/2023] [Indexed: 08/24/2023]
Abstract
Urolithiasis, commonly known as kidney stones, is characterized by the formation of hard deposits in the urinary tract. These stones can cause severe pain and discomfort, and their management typically involves a combination of medical interventions and lifestyle modifications. According to the literature, 30% and 50% of urolithiasis cases recur. Between 9 and 12% of persons in industrialised countries are predicted to have urolithiasis at some time. Due to the high frequency of stone formation, recurrent nature, and prevalence in adults, it has a significant impact on society, the person, and the health care system. Adopting the best prophylactic measures is crucial in light of these developments to decrease the impact of urolithiasis on individuals and society. In recent years, there has been growing interest in the potential role of nutraceuticals in the management of urolithiasis. Nutraceuticals, such as herbal extracts, vitamins, minerals, and probiotics, have gained recognition for their potential in promoting urinary health and reducing the risk of urolithiasis. These compounds can aid in various ways, including inhibiting crystal formation, enhancing urine pH balance, reducing urinary calcium excretion, and supporting kidney function. Additionally, nutraceuticals can help alleviate symptoms associated with urolithiasis, such as pain and inflammation. While medical interventions remain crucial, incorporating nutraceuticals into a comprehensive management plan can offer a holistic approach to urolithiasis, improving patient outcomes and quality of life. Therefore, nutraceuticals may be a desirable choice for treating and avoiding recurring urolithiasis for patients and medical professionals. Therefore, the present study has focused on nutraceuticals' role in preventing urolithiasis.
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Affiliation(s)
- Ravindra Pal Singh
- Department of Pharmacy, NIMS Institute of Pharmacy, NIMS University Rajasthan, Jaipur, India
| | - Anurag Mishra
- Department of Pharmacy, NIMS Institute of Pharmacy, NIMS University Rajasthan, Jaipur, India
| | | | - Mohit Agarwal
- Department of Pharmacy, NIMS Institute of Pharmacy, NIMS University Rajasthan, Jaipur, India
| | - Himmat Singh Chawra
- Department of Pharmacy, NIMS Institute of Pharmacy, NIMS University Rajasthan, Jaipur, India
| | - Mithilesh Singh
- Department of Pharmacy, NIMS Institute of Pharmacy, NIMS University Rajasthan, Jaipur, India
| | - Gaurav Dubey
- Department of Pharmacy, NIMS Institute of Pharmacy, NIMS University Rajasthan, Jaipur, India
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Alsaleem M, Dusin J, Akangire G. Effect of Low Lactose Formula on the Short-Term Outcomes of Neonatal Abstinence Syndrome: A Systematic Review. Glob Pediatr Health 2021; 8:2333794X211035258. [PMID: 34368403 PMCID: PMC8312188 DOI: 10.1177/2333794x211035258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/05/2021] [Indexed: 11/30/2022] Open
Abstract
The use of low lactose formula (LLF) in term and near-term infants in infants with neonatal abstinence syndrome (NAS) has been increasing recently. However, the clinical evidence of such use is limited. Our aim in this paper was to systematically review the current literature about the use of LLF in infants with NAS. We searched PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Database of Systematic Reviews for articles published between 2015 and 2020. Only randomized controlled trials, prospective, and retrospective studies. The risk of bias was assessed by using published tools appropriate for the study type. The certainty of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Forty-one titles and/or abstracts were screened independently by 2 reviewers (MA and GA). After an indepth review, 4 studies answered the study question (1 randomized controlled trial (RCT), 2 retrospective studies, and 1 quality improvement study). A meta-analysis could not be completed due to the study type difference and how the outcomes were reported. The studies found no benefit to feeding LLF to infants with NAS regarding short-term outcomes (length of stay, duration, and need for pharmacological therapy and growth). Certainty in the evidence is low. In conclusion we found no beneficial effects regarding the need for pharmacological therapy, duration of pharmacological treatment, length of hospital stay, and growth of using LLF compared to the standard formula in infants with NAS.
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Affiliation(s)
- Mahdi Alsaleem
- University of Kansas Medical Center, Wichita, KS, USA.,Children's Mercy Hospital, Kansas City, MO, USA
| | | | - Gangaram Akangire
- Children's Mercy Hospital, Kansas City, MO, USA.,University of Missouri-Kansas City, Kansas City, MO, USA.,Kansas University Medical Center, Kansas City, KS, USA
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De Maere D'aertrycke JB, Morlot J, Robeyns K, Filinchuk Y, Leyssens T. Exploring the solid-state phases and thermodynamics of calcium l-lactate. Food Chem 2020; 325:126884. [PMID: 32387949 DOI: 10.1016/j.foodchem.2020.126884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 04/16/2020] [Accepted: 04/20/2020] [Indexed: 10/24/2022]
Abstract
Calcium l-lactate, an organic salt derived from l-lactic acid, is used in many fields such as food, pharmaceutical or cosmetic industry. To this date, its solid-state thermodynamics are still poorly understood: a pentahydrate crystalline and anhydrate amorphous forms were already characterized, and potential other hydrates mentioned in literature. For the development of a robust crystallization process or down-line handling of this compound, it is important to know and understand the relationship between the different solid forms to prevent uncontrolled crystallization or solid-solid transformation during storage. In this paper, we aimed at identifying and characterizing novel solid forms of calcium l-lactate. Combining analytical techniques, we confirmed the existence of the pentahydrate and an amorphous anhydrate. In addition, we played on temperature and relative humidity conditions to discover three new crystalline forms (a crystalline anhydrate, monohydrate and dihydrate). This paper is the first occasion where these forms were successfully isolated and characterized.
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Affiliation(s)
- Jean-Baptiste De Maere D'aertrycke
- Institute of Condensed Matter and Nanosciences, Université Catholique de Louvain, Place Louis Pasteur 1/L4.01.03, 1348 Louvain-la-Neuve, Belgium.
| | - Julien Morlot
- Galactic S.A., Place d'Escanaffles 23, 7760 Escanaffles, Belgium.
| | - Koen Robeyns
- Institute of Condensed Matter and Nanosciences, Université Catholique de Louvain, Place Louis Pasteur 1/L4.01.03, 1348 Louvain-la-Neuve, Belgium.
| | - Yaroslav Filinchuk
- Institute of Condensed Matter and Nanosciences, Université Catholique de Louvain, Place Louis Pasteur 1/L4.01.03, 1348 Louvain-la-Neuve, Belgium.
| | - Tom Leyssens
- Institute of Condensed Matter and Nanosciences, Université Catholique de Louvain, Place Louis Pasteur 1/L4.01.03, 1348 Louvain-la-Neuve, Belgium.
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Liu Z, Sun X, Liang T, Luo Y, Chen X, Li T, Chen L, Wang J, Lin Y, Ye Y, Zhong Z. Preparation and Characterization of the Biological Compound Effervescent Granule of Calcium Acetate. Curr Pharm Biotechnol 2019; 20:934-944. [PMID: 31264545 DOI: 10.2174/1389201020666190628144637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 06/11/2019] [Accepted: 06/13/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Calcium acetate (Ca(CH3COO)2) is commonly used in calcium supplement for medicine, which is used as an auxiliary agent to treat osteoporosis. An effervescent granule is widely used in medical industry due to its palatability. The purpose of this study is to develop a new preparation of compound effervescent granule of the biological calcium acetate (Ca(CH3COO)2 effervescent granule), overcoming the disadvantages of the previous other dosage forms of calcium and thus enhancing the therapeutic efficacy. METHODS The biological Ca(CH3COO)2 effervescent granule was prepared by the wet granulation method. The formulation was optimized by the orthogonal experiment. The effervescent base was comprised of various amounts of citric acid and sodium bicarbonate. Other ingredients were added for optimal performance of effervescent granule. The performed Ca(CH3COO)2 effervescent granule was evaluated for the particle size, repose angle, pH value of solution, calcium acetate content and effervescence time. The in vivo effects of Ca(CH3COO)2 effervescent granule on the bone microarchitecture were investigated via Micro-CT detection, and the serum calcium level was also investigated. RESULTS The optimized formulation of the biological Ca(CH3COO)2 effervescent granules was composed of calcium acetate, citric acid, sodium bicarbonate, PEG6000, aspartame, PVP ethanol solution, lactose and vitamin D. Our findings reveal that this biological Ca(CH3COO)2 effervescent granule exhibited prominent effect on preventing the bone-mass loss and did better in enhancing the bone microarchitecture compared to the other calcium preparations. CONCLUSION The biological Ca(CH3COO)2 effervescent granule is a novel dosage form among so many kinds of calcium preparations. It may perform better functions in the dairy calcium supplement.
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Affiliation(s)
- Zhongbing Liu
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Xuemei Sun
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Tiantian Liang
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Yi Luo
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Xiaoyan Chen
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Ting Li
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Lin Chen
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Junjie Wang
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Yan Lin
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Yun Ye
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Zhirong Zhong
- Department of Pharmaceutical Sciences, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
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Suehiro D, Okada M, Fukami K, Nakagawa T, Hayakawa T. Maltobionic acid enhances intestinal absorption of calcium and magnesium in rats. Biosci Biotechnol Biochem 2019; 83:1766-1773. [PMID: 31056002 DOI: 10.1080/09168451.2019.1611411] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In Experiment 1, the effects of calcium maltobionate (MBCa) on calcium and magnesium absorption were examined using male rats. Four diets were designed in which 25%, 50%, and 100% of calcium carbonate (CaCO3, Control) were substituted with MBCa and were designated as MBCa-25, MBCa-50, and MBCa-100, respectively. The cecal concentration of short-chain fatty acids was significantly higher in groups MBCa-50 and MBCa-100; however, pH of cecal contents did not significantly differ among the groups. Retention rates of calcium and magnesium were significantly higher in all MBCa groups as compared to the Control. In Experiment 2, the efficiency of calcium absorption was compared using everted sacs of jejunum and ileum with CaCO3 and MBCa as calcium sources. More calcium from MBCa was absorbed as the concentration of calcium increased in comparison to CaCO3. It was concluded that MBCa is a better calcium source than CaCO3 in terms of both calcium retention and absorption. Abbreviations: ANOVA: analysis of variance; Ca: Calcium; CaCO3: calcium carbonate; ICP-OES: Inductivity coupled plasma optical emission spectrometer; Mg: magnesium; MBCa: calcium maltobionate; OCPC: o-cresolphthalein complexone; SCFAs: short-chain fatty acids; SE: standard error; TRPM6: transient receptor potential melastatin 6.
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Affiliation(s)
- Daiki Suehiro
- a Faculty of Life Science and Resources, Graduate School of Applied Biological Sciences, Gifu University , Gifu , Japan.,b San-ei Sucrochemical Co., Ltd ., Chita , Japan
| | - Misato Okada
- a Faculty of Life Science and Resources, Graduate School of Applied Biological Sciences, Gifu University , Gifu , Japan
| | - Ken Fukami
- b San-ei Sucrochemical Co., Ltd ., Chita , Japan
| | - Tomoyuki Nakagawa
- a Faculty of Life Science and Resources, Graduate School of Applied Biological Sciences, Gifu University , Gifu , Japan
| | - Takashi Hayakawa
- a Faculty of Life Science and Resources, Graduate School of Applied Biological Sciences, Gifu University , Gifu , Japan
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Cai J, Zhang Q, Wastney ME, Weaver CM. Calcium Bioavailability and Kinetics of Calcium Ascorbate and Calcium Acetate in Rats. Exp Biol Med (Maywood) 2016; 229:40-5. [PMID: 14709775 DOI: 10.1177/153537020422900105] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The objective was to investigate the bioavailability and mechanism of calcium absorption of calcium ascorbate (ASC) and calcium acetate (AC). A series of studies was performed in adult Sprague-Dawley male rats. In the first study, each group of rats (n = 10/group) was assigned to one of the five test meals labeled with 45Ca: (i) 25 mg calcium as heated ASC or (ii) unheated ASC, (iii) 25 mg calcium as unheated AC, (iv) 3.6 mg Ca as unheated ASC, or (v) unheated AC. Femur uptake indicated better calcium bioavailability from ASC than AC t both calcium loads. A 5-min heat treatment partly reduced bioavailability of ASC. Kinetic studies were performed to further investigate the mechanism of superior calcium bioavailability from ASC. Two groups of rats (n = 10/group) received oral doses of 25 mg Ca as ASC or AC. Each dose contained 20 μCi 45Ca. Two additional groups of rats (n = 10/group) received an intravenous injection (iv) of 10 μCi 45Ca after receiving an unlabeled oral dose of 25 mg calcium as ASC or AC. Sequential blood samples were collected over 48 hrs. Urine and fecal samples were collected every 12 hrs for 48 hrs and were analyzed for total calcium and 45Ca content. Total calcium and 45Ca from serum, urine, and feces were fitted by a compartment kinetics model with saturable and nonsaturable absorption pathways by WinSAAM (Windows-based Simulation Analysis and Modeling). The difference in calcium bioavailability between the two salts was due to differences in saturable rather than passive intestinal absorption and not to endogenous secretion or calcium deposition rate. The higher bioavailability of calcium ascorbate was due to a longer transit time in the small intestine compared with ASC.
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Affiliation(s)
- Jianwei Cai
- Department of Foods and Nutrition, Purdue University, West Lafayette, Indiana 47907, USA
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Szeleszczuk Ł, Pisklak DM, Kuras M, Wawer I. In VitroDissolution of Calcium Carbonate from the Chicken Eggshell: A Study of Calcium Bioavailability. INTERNATIONAL JOURNAL OF FOOD PROPERTIES 2015. [DOI: 10.1080/10942912.2015.1004587] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Patel BN, Krishnaveni N, Jivani NP, Khodakiya AS, Khodakiya MS, Parida SK. Bioavailability study of calcium sandoz-250 by atomic absorption spectroscopy in albino rats. Ayu 2014; 35:438-41. [PMID: 26195909 PMCID: PMC4492031 DOI: 10.4103/0974-8520.159020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Calcium sandoz-250 is an Ayurvedic calcium supplement, containing Khatika Churna. Bioavailability study of the formulation is essential for estimation of peak plasma concentration (C max), time to C max and rate of absorption. AIM To evaluate the absorption parameters of calcium sandoz-250 in albino rats by atomic absorption spectroscopic (AAS) method. MATERIALS AND METHODS Study was carried out as a single dose, open-label, randomized study. Estimation of calcium was carried out by AAS, after validating the method for a few parameters for the estimation. Pharmacokinetic parameters such as C max, time to peak concentration (T max), area under the plasma concentration - time curve were calculated for calcium on administration of calcium sandoz-250. RESULTS Linearity curve was plotted for 0.5-2.5 ppm, given R (2) value 0.9975. The C max, i.e. C max after administration of calcium sandoz-250 was 0.793 mg/ml at 90 min (T max). Measurable calcium-blood levels were noticed in all subjects up to 3.0 h after administration of calcium sandoz-250. CONCLUSION Calcium sandoz-250, consisting of Khatika Churna, increases the blood calcium level in albino rats.
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Affiliation(s)
- Bimalkumar N. Patel
- Department of Pharmaceutical Analysis, C.U. Shah College of Pharmacy and Research, Wadhwan, Gujarat, India
| | - N. Krishnaveni
- Department of Pharmaceutical Analysis, J.S.S. College of Pharmacy, Ooty, Tamil Nadu, India
| | - Nurrrudin P. Jivani
- Department of Pharmaceutical Analysis, C.U. Shah College of Pharmacy and Research, Wadhwan, Gujarat, India
| | - Akruti S. Khodakiya
- Department of Pharmaceutics, C.U. Shah College of Pharmacy and Research, Wadhwan, Gujarat, India
| | - Moorti S. Khodakiya
- Department of Pharmaceutics, C.U. Shah College of Pharmacy and Research, Wadhwan, Gujarat, India
| | - Saswat K. Parida
- Department of Pharmaceutical Analysis, C.U. Shah College of Pharmacy and Research, Wadhwan, Gujarat, India
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One-month of calcium supplementation does not affect iron bioavailability: A randomized controlled trial. Nutrition 2014; 30:44-8. [DOI: 10.1016/j.nut.2013.06.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 03/26/2013] [Accepted: 06/09/2013] [Indexed: 11/21/2022]
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Heber D, Greenway FL, Kaplan LM, Livingston E, Salvador J, Still C. Endocrine and nutritional management of the post-bariatric surgery patient: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2010; 95:4823-43. [PMID: 21051578 DOI: 10.1210/jc.2009-2128] [Citation(s) in RCA: 294] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE We sought to provide guidelines for the nutritional and endocrine management of adults after bariatric surgery, including those with diabetes mellitus. The focus is on the immediate postoperative period and long-term management to prevent complications, weight regain, and progression of obesity-associated comorbidities. The treatment of specific disorders is only summarized. PARTICIPANTS The Task Force was composed of a chair, five additional experts, a methodologist, and a medical writer. It received no corporate funding or remuneration. CONCLUSIONS Bariatric surgery is not a guarantee of successful weight loss and maintenance. Increasingly, patients regain weight, especially those undergoing restrictive surgeries such as laparoscopic banding rather than malabsorptive surgeries such as Roux-en-Y bypass. Active nutritional patient education and clinical management to prevent and detect nutritional deficiencies are recommended for all patients undergoing bariatric surgery. Management of potential nutritional deficiencies is particularly important for patients undergoing malabsorptive procedures, and strategies should be employed to compensate for food intolerance in patients who have had a malabsorptive procedure to reduce the risk for clinically important nutritional deficiencies. To enhance the transition to life after bariatric surgery and to prevent weight regain and nutritional complications, all patients should receive care from a multidisciplinary team including an experienced primary care physician, endocrinologist, or gastroenterologist and consider enrolling postoperatively in a comprehensive program for nutrition and lifestyle management. Future research should address the effectiveness of intensive postoperative nutritional and endocrine care in reducing morbidity and mortality from obesity-associated chronic diseases.
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Affiliation(s)
- David Heber
- David Geffen School of Medicine at University of California, Los Angeles, California 90095, USA
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Can calcium chemoprevention of adenoma recurrence substitute or serve as an adjunct for colonoscopic surveillance? Int J Technol Assess Health Care 2009; 25:222-31. [PMID: 19331713 DOI: 10.1017/s026646230909028x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The aim of this study was to examine the potential cost-effectiveness of calcium chemoprevention post-polypectomy as a substitute or adjunct for surveillance. METHODS We constructed a Markov model of post-polypectomy adenoma recurrence and colorectal cancer (CRC) development, calibrated to data from prospective chemoprevention trials of fiber, calcium, antioxidants, and aspirin. We modeled four scenarios for 50-year-old patients immediately after polypectomy: (i) natural history with no further intervention; (ii) elemental calcium 1,200 mg/day from age 50-80; (iii) surveillance colonoscopy from age 50-80 every 5 years, or 3 years for large adenoma; (iv) calcium + surveillance. Patients were followed up until age 100 or death. RESULTS Calcium was cost-effective compared to natural history ($49,900/life-year gained). However, surveillance was significantly more effective than calcium (18.729 versus 18.654 life-years/patient; 76 percent versus 14 percent reduction in CRC incidence) at an incremental cost of $15,900/life-year gained. Calcium + surveillance yielded a very small benefit (0.0003 incremental life-years/patient) compared with surveillance alone, at a substantial incremental cost of $3,090,000/life-year gained. CONCLUSION Post-polypectomy calcium chemoprevention is unlikely to be a reasonable substitute for surveillance. It may be cost-effective in patients unwilling or unable to undergo surveillance.
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Saunders-Blades JL, MacIsaac JL, Korver DR, Anderson DM. The effect of calcium source and particle size on the production performance and bone quality of laying hens. Poult Sci 2009; 88:338-53. [PMID: 19151349 DOI: 10.3382/ps.2008-00278] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The efficacy of 3 local limestone sources as potential Ca sources for laying hens was studied. Limestone sources were assessed for in vitro solubility. Four Ca sources (control, A, B, or C) and 2 particle size combinations (ground, 100% ground; or mixed, 67% ground+33% large particle) was used. The control consisted of a commercial ground limestone for the ground Ca source and oyster shell of the large particle Ca source. DeKalb laying hens were randomly placed in 32 battery cage units (n=12/cage). At 19 wk of age, hens received 1 of 8 Ca source and particle size treatments (4 replicates/treatment) until 74 wk. Egg production, feed consumption, BW, and egg quality were measured throughout. Bone mineral density (by quantitative computed tomography), breaking strength, ash, and Ca were assessed at the end of lay. In vitro solubility was dependent upon Ca source and particle size (P<0.0001) with oyster shell generally having a greater in vitro solubility than test limestone sources A, B, and C of similar particle sizes. Feed consumption (100 to 117 g/bird per day), BW (1,500 to 1,800 g), egg production (92% peak egg production), egg weight (55 to 67 g), and egg specific gravity (1.090 to 1.078) did not differ among hens fed the different Ca sources (P>0.05). Tibia bone mineral density indicated the oyster shell treatment had a lower trabecular density than Ca source A; however, all other Ca sources had similar bone mineral density for all measures (P>0.05). Hens fed the mixed Ca particle treatments consistently had greater feed consumption from 27 to 70 wk than those fed the 100% ground Ca source (P<0.05). Bone mineralization was enhanced in hens that received the mixed Ca particle treatments (P<0.05). Overall, the results of this study indicate that the local limestone sources A, B, and C would be suitable alternatives to current commercial sources of Ca for laying hens. In addition, large particle Ca did improve bone quality.
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Affiliation(s)
- J L Saunders-Blades
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Canada T6G 2P5
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Park HS, Ahn J, Kwak HS. Effect of nano-calcium-enriched milk on calcium metabolism in ovariectomized rats. J Med Food 2009; 11:454-9. [PMID: 18800891 DOI: 10.1089/jmf.2007.0086] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study was designed to examine the effect of different kinds of calcium enrichment on serum and urine indices of mineral status in ovariectomized rats. Twenty-four 7-week-old Sprague-Dawley female rats were divided into four groups, ovariectomized, and fed diets containing the following: (1) Control, non-Ca-enriched milk; (2) OVX1, calcium carbonate-enriched milk; (3) OVX2, ionized Ca-enriched milk; and (4) OVX3, nano-Ca-enriched milk. After 18 weeks of feeding, the food efficiency ratio in the nano-Ca-fed group was significantly lower compared with those in the Control and OVX2 groups. There was no difference in serum and fecal Ca among the groups. The bone/total alkaline phosphatase ratio was significantly higher in rats fed milk enriched with nano-Ca (59%) and calcium carbonate (62%) than in control (44%) animals. Urinary Ca was the highest in the nano-Ca-enriched group; however, urinary excretions of deoxypyridinoline and hydroxyproline were significantly decreased in the nano-Ca-enriched group. The present results indicate that consumption of nano-Ca-enriched milk resulted in an increase of urinary excretion of calcium and a decrease in deoxypyridinoline and hydroxyproline in ovariectomized rats.
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Affiliation(s)
- Heung-Sik Park
- Department of Food Science and Technology, Sejong University, Seoul, Republic of Korea
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Kamasaka H, To-o K, Nishimura T, Kimura T, Matsuzawa N, Sakamoto R. Studies on Mass Production and Application of Phosphoryl Oligosaccharides from Potato Starch. J Appl Glycosci (1999) 2009. [DOI: 10.5458/jag.56.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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16
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Mechanick JI, Kushner RF, Sugerman HJ, Gonzalez-Campoy JM, Collazo-Clavell ML, Guven S, Spitz AF, Apovian CM, Livingston EH, Brolin R, Sarwer DB, Anderson WA, Dixon J. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Endocr Pract 2008; 14 Suppl 1:1-83. [PMID: 18723418 DOI: 10.4158/ep.14.s1.1] [Citation(s) in RCA: 144] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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17
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Mechanick JI, Kushner RF, Sugerman HJ, Gonzalez-Campoy JM, Collazo-Clavell ML, Guven S, Spitz AF, Apovian CM, Livingston EH, Brolin R, Sarwer DB, Anderson WA, Dixon J. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical Guidelines for Clinical Practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Surg Obes Relat Dis 2008; 4:S109-84. [PMID: 18848315 DOI: 10.1016/j.soard.2008.08.009] [Citation(s) in RCA: 191] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical Guidelines for Clinical Practice are systematically developed statements to assist healthcare professionals in medical decision making for specific clinical conditions. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment was applied. These guidelines are a working document that reflects the state of the field at the time of publication. Because rapid changes in this area are expected, periodic revisions are inevitable. We encourage medical professionals to use this information in conjunction with their best clinical judgment. The presented recommendations may not be appropriate in all situations. Any decision by practitioners to apply these guidelines must be made in light of local resources and individual patient circumstances. The American Society for Parenteral & Enteral Nutrition fully endorses sections of these guidelines that address the metabolic and nutritional management of the bariatric surgical patient.
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Sakata Y, Shiraishi S, Takayama K, Otsuka M. Effect of pulverization and dehydration on the pharmaceutical properties of calcium lactate pentahydrate tablets. Colloids Surf B Biointerfaces 2006; 51:149-56. [PMID: 16905296 DOI: 10.1016/j.colsurfb.2006.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2006] [Revised: 06/02/2006] [Accepted: 07/07/2006] [Indexed: 11/20/2022]
Abstract
The effects of heat conduction and pulverization on dehydration kinetics and tablet hardness were studied by a variety of kinetic equations and physical models. The dehydration behavior of unpulverized calcium lactate pentahydrate (UCLP) and pulverized calcium lactate pentahydrate (PCLP) tablets was investigated by using differential scanning calorimetry (DSC) and powder X-ray diffraction (PXRD). The hardness of both UCLP and PCLP tablets was significantly decreased after dehydration. The relationship between the extent of dehydration and the tablet hardness of both UCLP and PCLP tablets was linear. The results suggest that the reduction in tablet hardness is dependent on the dehydration of crystal water, and the values of the slopes indicate that the bonding energy of the UCLP was stronger than that of the PCLP. The dehydration of both UCLP and PCLP tablets at 55 degrees C followed a one-dimensional diffusion mechanism, whereas dehydration at storage temperatures of 60-80 degrees C followed a three-dimensional diffusion mechanism. UCLP and PCLP tablets contracted in thickness and diameter during dehydration, but final contraction ratios showed that PCLP tablets were more affected than UCLP tablets. In contrast, the micropore radius of both UCLP and PCLP tablets increased after dehydration. Thus, the pharmaceutical properties of calcium lactate pentahydrate (CLP) tablets are affected both by pulverization and by the extent of dehydration of the bulk powder in the tablet formulation.
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Affiliation(s)
- Yukoh Sakata
- Healthcare Research Institute, Wakunaga Pharmaceutical Co., Ltd., Akitakata-shi, Hiroshima 739-1195, Japan.
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Sakata Y, Shiraishi S, Otsuka M. Characterization of dehydration and hydration behavior of calcium lactate pentahydrate and its anhydrate. Colloids Surf B Biointerfaces 2005; 46:135-41. [PMID: 16293401 DOI: 10.1016/j.colsurfb.2005.10.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2005] [Revised: 09/22/2005] [Accepted: 10/12/2005] [Indexed: 11/22/2022]
Abstract
The use of calcium lactate pentahydrate (CLP) as an additional filler-binder for direct compaction of tablets has been reported to result in a short disintegration time and rapid drug release. The aim of this study was to understand the dehydration and hydration behavior of CLP and calcium lactate anhydrate (CLA) under various conditions of storage temperature and relative humidity. The removal and acquisition of crystal water were investigated by using differential scanning calorimetry (DSC), thermogravimetry-differential thermal analysis (TG-DTA), powder X-ray diffraction (PXRD) and scanning electron microscopy (SEM). The PXRD results indicated that CLP exists as a crystalline solid and CLA as an amorphous solid. Dehydration of CLP resulted in aggregated particles of CLA with an increase in average particle size. The dehydration and hydration kinetics of CLP were analyzed with the Hancock-Sharp equation on the basis of the isothermal DSC data. The dehydration of CLP followed a zero-order mechanism (Polany-Winger equation). In contrast, the surface roughness of CLA was significantly decreased by hydration. The hydration of CLA followed a three-dimensional diffusion model (Ginstling-Brounshtein equation).
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Affiliation(s)
- Yukoh Sakata
- Healthcare Research Institute, Wakunaga Pharmaceutical Co., Ltd., 1624 Shimokotachi, Kodacho, Akitakatashi, Hiroshima 739-1195, Japan.
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Lanou AJ, Berkow SE, Barnard ND. Calcium, dairy products, and bone health in children and young adults: a reevaluation of the evidence. Pediatrics 2005; 115:736-43. [PMID: 15741380 DOI: 10.1542/peds.2004-0548] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Numerous nutrition policy statements recommend the consumption of 800 to 1500 mg of calcium largely from dairy products for osteoporosis prevention; however, the findings of epidemiologic and prospective studies have raised questions about the efficacy of the use of dairy products for the promotion of bone health. The objective of this study was to review existing literature on the effects of dairy products and total dietary calcium on bone integrity in children and young adults to assess whether evidence supports (1) current recommended calcium intake levels and (2) the suggestion that dairy products are better for promoting bone integrity than other calcium-containing food sources or supplements. METHODS A Medline (National Library of Medicine, Bethesda, MD) search was conducted for studies published on the relationship between milk, dairy products, or calcium intake and bone mineralization or fracture risk in children and young adults (1-25 years). This search yielded 58 studies: 22 cross-sectional studies; 13 retrospective studies; 10 longitudinal prospective studies; and 13 randomized, controlled trials. RESULTS Eleven of the studies did not control for weight, pubertal status, and exercise and were excluded. Ten studies were randomized, controlled trials of supplemental calcium, 9 of which showed modest positive benefits on bone mineralization in children and adolescents. Of the remaining 37 studies of dairy or unsupplemented dietary calcium intake, 27 studies found no relationship between dairy or dietary calcium intake and measures of bone health. In the remaining 9 reports, the effects on bone health are small and 3 were confounded by vitamin D intake from milk fortified with vitamin D. Therefore, in clinical, longitudinal, retrospective, and cross-sectional studies, neither increased consumption of dairy products, specifically, nor total dietary calcium consumption has shown even a modestly consistent benefit for child or young adult bone health. CONCLUSION Scant evidence supports nutrition guidelines focused specifically on increasing milk or other dairy product intake for promoting child and adolescent bone mineralization.
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Affiliation(s)
- Amy Joy Lanou
- Physicians Committee for Responsible Medicine, 5100 Wisconsin Ave NW, Suite 400, Washington, DC 20016, USA.
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Mitsui J, Tofani I, Okura H, Hashimoto T, Maki K, Kimura M. Effect of grape seed proanthocyanidins extract on alteration of mechanical properties of metaphysis tibia bone in rats fed a low-calcium diet. PEDIATRIC DENTAL JOURNAL 2005. [DOI: 10.1016/s0917-2394(05)70026-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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22
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Quintas ME, Ortega RM, López-Sobaler AM, Garrido G, Requejo AM. Influence of dietetic and anthropometric factors and of the type of sport practised on bone density in different groups of women. Eur J Clin Nutr 2003; 57 Suppl 1:S58-62. [PMID: 12947455 DOI: 10.1038/sj.ejcn.1601817] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The aim of this work was to analyse the influence of dietetic and anthropometric data, as well as the sport practised, on the bone density of different groups of sportswomen. SUBJECTS AND METHODS Dietetic, anthropometric and bone density data were collected from 74 women who practised different sports (15 skiers, 26 basketball players and 33 ballet dancers), and compared to those of 90 women who led sedentary lifestyles. RESULTS The sportswomen had higher bone mineral contents and bone densities than controls. However, the dancers showed similar spinal and hip values as those of controls, and lower forearm values. Low body weight and body mass index, and insufficient energy intake-characteristic of the dancers-were associated with poorer bone mineralisation status. Increased energy, protein, vitamin D, calcium, zinc and magnesium intakes were associated with greater bone density and mineral content at different sites. CONCLUSIONS The worst bone density status was that of the dancers, who, as a group, displayed characteristics that have negative impacts in this respect (low energy intakes and low body weight). Dancers should therefore take steps to avoid suffering fractures and skeleto-muscular lesions which could negatively influence their health and physical performance. The greater consumption of milk products and calcium and better Ca/P ratio seen in the dancers could help this group to avoid bone deterioration.
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Affiliation(s)
- M E Quintas
- Centro de Salud Pública Area 1, Instituto de Salud Pública, Comunidad de Madrid, Madrid, Spain
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24
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Theodorou DJ, Theodorou SJ, Sartoris DJ. Treatment of osteoporosis: current status and recent advances. COMPREHENSIVE THERAPY 2002; 28:109-22. [PMID: 12085458 DOI: 10.1007/s12019-002-0048-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
With the advent of new treatment choices, osteoporosis should no longer be considered an inevitable part of aging but rather a disease that can be treated. This article provides an overview of recent advances in treatment of osteoporosis.
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Affiliation(s)
- Daphne J Theodorou
- Department of Radiology, University of California, San Diego Veterans Affairs Medical Center, San Diego, Calif., USA
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25
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Keller JL, Lanou A, Barnard ND. The consumer cost of calcium from food and supplements. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 2002; 102:1669-71. [PMID: 12449293 DOI: 10.1016/s0002-8223(02)90355-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Nutritional authorities encourage consumers to include calcium-rich foods in their daily diets. However, consumer purchases are driven not only by health considerations and dietary preferences, but also by cost. This study assessed the cost of calcium from a wide variety of food sources, as well as supplements, based on retail prices in Seattle, San Francisco, Raleigh, NewYork City, and Washington, D.C., while controlling for seasonal variation. Costs were adjusted based on calcium absorption fractions. Calcium carbonate supplements emerged as the least expensive source of calcium, at roughly one-third the cost of the least expensive food source of calcium. The least expensive food sources of calcium were Total cereal, skim milk, and calcium-fortified orange juice from frozen concentrate. This information is useful for dietitians, health professionals, and consumers in meeting calcium requirements on a budget.
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Affiliation(s)
- Jennifer L Keller
- Physicians Committee for Responsible Medicine, Washington, DC 20016, USA
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Mei Y, Zhao Y, Yang J, Furr H. Using Edible Coating to Enhance Nutritional and Sensory Qualities of Baby Carrots. J Food Sci 2002. [DOI: 10.1111/j.1365-2621.2002.tb08753.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Csako G, McGriff NJ, Rotman-Pikielny P, Sarlis NJ, Pucino F. Exaggerated levothyroxine malabsorption due to calcium carbonate supplementation in gastrointestinal disorders. Ann Pharmacother 2001; 35:1578-83. [PMID: 11793625 DOI: 10.1345/aph.1a031] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To describe a patient with primary hypothyroidism in whom ingestion of levothyroxine with calcium carbonate led to markedly elevated serum thyrotropin concentrations. CASE SUMMARY A 61-year-old white woman with primary hypothyroidism, systemic lupus erythematosus, celiac disease, and history of Whipple resection for pancreatic cancer was euthyroid with levothyroxine 175-188 micrograms/d. After taking a high dose of calcium carbonate (1250 mg three times daily) with levothyroxine, she developed biochemical evidence of hypothyroidism (thyrotropin up to 41.4 mU/L) while remaining clinically euthyroid. Delaying calcium carbonate administration by four hours returned her serum thyrotropin to a borderline high concentration (5.7 mU/L) within a month. Serum concentrations of unbound and total thyroxine and triiodothyronine tended to decrease, but remained borderline low to normal while the patient concomitantly received levothyroxine and calcium carbonate. DISCUSSION Concomitant administration of levothyroxine and calcium carbonate often results in levothyroxine malabsorption. While in most patients the clinical consequences of this interaction, even with prolonged exposure, are relatively small, overt hypothyrodism may develop in patients with preexisting malabsorption disorders. However, as the current case illustrates, the clinical manifestations of the initial levothyroxine deficit may not always be apparent and, of all usual laboratory thyroid function tests, only thyrotropin measurement will reliably uncover the exaggerated levothyroxine malabsorption. CONCLUSIONS Decreased absorption of levothyroxine when given with calcium carbonate may be particularly pronounced in patients with preexisting malabsorption disorders. Once recognized, a change in drug administration schedule usually minimizes or eliminates this interaction.
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Affiliation(s)
- G Csako
- Department of Laboratory Medicine, Warren G Magnuson Clinical Center, National Institutes of Health, Bethesda, MD, USA.
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Bolhuis GK, Eissens AC, Zoestbergen E. DC calcium lactate, a new filler-binder for direct compaction of tablets. Int J Pharm 2001; 221:77-86. [PMID: 11397569 DOI: 10.1016/s0378-5173(01)00657-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
In this paper, a directly compressible form of calcium lactate is introduced as a filler-binder for direct compaction of tablets. Calcium lactate is one of the most important calcium sources and has, in comparison with other organic calcium salts, a good solubility and bioavailability. Two different modifications, calcium lactate trihydrate and calcium lactate pentahydrate are described in the main pharmacopoeias. This paper describes that the compaction properties of calcium lactate pentahydrate (Puracal DC) are much better than those of the calcium lactate trihydrate (Puracal TP). Calcium lactate pentahydrate has better compaction properties than dicalcium phosphate dihydrate, even if lubricated with magnesium stearate. Moreover, as a consequence of its crystalline structure, calcium lactate pentahydrate has a low compaction speed sensitivity. This means that, in combination with its excellent flow properties, calcium lactate pentahydrate is a suitable filler-binder in tablets prepared by high-speed compaction. In a number of formulation examples it will be illustrated that tablets containing calcium lactate pentahydrate as main or additional filler-binder have a short disintegration time and a fast drug release. Directly compressible calcium lactate can be considered as a promising excipient in both pharmaceutical tablets and tablets for the nutraceutical market.
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Affiliation(s)
- G K Bolhuis
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, Netherlands.
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29
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Dietary therapy for calcium insufficiency in growing age: Endochondral ossification. Oral Radiol 2001. [DOI: 10.1007/bf02489728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Song YM, Sheu WH, Lee WJ. Acute biochemical variations induced by calcium citrate and calcium carbonate in Type 2 diabetic patients: impaired calcium absorption in Type 2 diabetic patients with prolonged gastric emptying time. J Diabetes Complications 2001; 15:97-102. [PMID: 11274906 DOI: 10.1016/s1056-8727(00)00128-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Calcium supplementation is important in the treatment of osteoporosis, a disease that may also occur in diabetic patients. The acute effects of calcium supplementation and their relationship to gastric emptying time, however, have rarely been studied in type 2 diabetic patients. We evaluated the acute biochemical variations induced by the administration of two different calcium preparations, calcium citrate and calcium carbonate, in 16 (male/female: 13/3) Chinese diabetic patients. Serum free calcium, intact parathyroid hormone (i-PTH), and amount of urinary excretion of calcium (uCal/uCr) were evaluated after a single dose of 1200 mg of elemental calcium in each preparation. The free calcium levels did not change significantly in either group. However, significant suppression of i-PTH after calcium citrate administration at 1 h (17.1+/-2.0 pg/ml, P=.023), and after calcium carbonate administration at 2 h (14.2+/-2.5 pg/ml, P=.000), was noted when compared with individual basal level (21.2+/-2.5 and 19.3+/-2.4 pg/ml, respectively). The suppressive effect on i-PTH lasted for 6 h after calcium citrate and 5 h after calcium carbonate preparation of the 6-h study period. After administration of calcium citrate, the uCal/uCr of 2-to-4-h collection was significantly higher than that of the basal and 0-to-2-h collections: 0.25+/-0.04 vs. 0.19+/-0.03, P=.025; and 0.25+/-0.04 vs. 0.19+/-0.02, P=.014, respectively. A similar finding was observed for calcium carbonate: 0.23+/-0.03 vs. 0.18+/-0.02, P=.019; and 0.23+/-0.03 vs. 0.18+/-0.02, P=.011, respectively. We conclude that, in this group of Chinese type 2 diabetic patients in our study, the oral administration of 1200 mg elemental calcium in either calcium citrate or calcium carbonate preparation can induce a significant suppression of i-PTH. This may be helpful in preventing or treating osteoporosis. A prolonged gastric emptying time in these diabetic subjects may contribute to the non-significant alteration in free calcium levels after the administration of either calcium preparation.
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Affiliation(s)
- Y M Song
- Division of Endocrinology/Metabolism, Department of Medicine, Taichung Veterans General Hospital, No. 160, Section 3, Taichung-Kang Road, Taichung 407, Taiwan.
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Nishida M, Grossi SG, Dunford RG, Ho AW, Trevisan M, Genco RJ. Calcium and the risk for periodontal disease. J Periodontol 2000; 71:1057-66. [PMID: 10960010 DOI: 10.1902/jop.2000.71.7.1057] [Citation(s) in RCA: 114] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Dietary calcium has long been a candidate to modulate periodontal disease. Animal as well as human studies of calcium intake, bone mineral density, and tooth loss provide a rationale for hypothesizing that low dietary intake of calcium is a risk factor for periodontal disease. METHODS We evaluated the role of dietary calcium intake as a contributing risk factor for periodontal disease utilizing the Third National Health and Nutrition Examination Survey (NHANES III), which is representative of the U.S. civilian non-institutionalized population. Dietary calcium intake was determined from a 24-hour dietary recall. The U.S. Department of Agriculture Nutrient Database was used as a source of nutrient composition data. Periodontal disease was measured by attachment loss. In addition, serum calcium was assessed using venous blood samples. Logistic regression analysis was used to examine the association between periodontal disease and dietary calcium intake or serum calcium levels after adjusting for covariants including age, gender, tobacco consumption, and gingival bleeding. RESULTS The association of lower dietary calcium intake with periodontal disease was found for young males and females (20 to 39 years of age), and for older males (40 to 59 years of age). The relationship between low dietary calcium intake and increased levels of periodontal disease showed an estimated odds ratio (OR) of 1.84 (95% CI: 1.36 to 2.48) for young males, 1.99 (95% CI: 1.34 to 2.97) for young females, and 1.90 (95% CI: 1.41 to 2.55) for the older group of males. These odds ratios were adjusted for gingival bleeding and tobacco consumption. The dose response was also seen in females, where there was 54% greater risk of periodontal disease for the lowest level of dietary calcium intake (2 to 499 mg) and 27% greater risk in females who took moderate levels of dietary calcium (500 to 799 mg) as compared to those who took 800 mg or more dietary calcium per day. A statistically significant association between low total serum calcium and periodontal disease was found in younger females aged 20 to 39 with OR = 6.11 (95% CI: 2.36 to 15.84) but not for males or older females, after adjusting for tobacco use, gingival bleeding, and dietary calcium intake. CONCLUSIONS These results suggest that low dietary intake of calcium results in more severe periodontal disease. Further studies will be needed to better define the role of calcium in periodontal disease and to determine the extent to which calcium supplementation will modulate periodontal disease and tooth loss.
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Kushner R. Managing the obese patient after bariatric surgery: a case report of severe malnutrition and review of the literature. JPEN J Parenter Enteral Nutr 2000; 24:126-32. [PMID: 10772194 DOI: 10.1177/0148607100024002126] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Surgery is now considered to be the most effective treatment for reducing weight and maintaining weight loss in patients with clinically severe obesity. Although the jejuno-ileal bypass has been abandoned, the vertical banded gastroplasty (VBG) and Roux-en-Y gastric bypass (RYGB) operations are now commonly performed. A third operation, the bilio-pancreatic diversion (BPD), is performed less frequently. The RYGB and BPD procedures cause predictable selective micronutrient deficiencies that can be avoided by early supplementation. Surgical complications from all of these procedures may result in more severe forms of malnutrition. This article is intended to familiarize the nutrition support specialist with the anatomic and physiologic changes produced by these procedures, the resulting nutritional deficiencies and recommended supplementation, and the manifestations of severe malnutrition caused by complications. A case of severe malnutrition after RYGB surgery is reported for illustration.
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Affiliation(s)
- R Kushner
- Northwestern University Medical School, Chicago, Illinois 60611, USA.
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Rigo J, De Curtis M, Pieltain C, Picaud JC, Salle BL, Senterre J. Bone mineral metabolism in the micropremie. Clin Perinatol 2000; 27:147-70. [PMID: 10690569 DOI: 10.1016/s0095-5108(05)70011-7] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Environmental factors, nutritional supplies, hormonal status, diseases, and treatments appear to affect postnatal skeletal growth and mineralization in VLBW infants. Compared with their term counterparts, ELBW infants are at risk of postnatal growth deficiency and osteopenia at the time of hospital discharge. From recent data, DXA is becoming one of the reference techniques to evaluate mineral status, whole-body composition, and effects of dietary manipulations on weight gain composition and mineral accretion in preterm infants. Weight gain and length increases need to be evaluated carefully during the first weeks of life, in the intensive care unit and out of it, in the step down unit. Nutritional survey is required to improve the nutritional supply and to maximize linear growth. As the critical epoch of growth extends, during the first weeks or months after discharge, follow-up and nutritional support need to be provided during the first years to promote early catch-up growth and mineralization. Further studies need to determine precisely the most optimal feeding regimen during this period but also need to evaluate the long-term implications of such a policy on stature, peak bone mass, and general health at adulthood.
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Affiliation(s)
- J Rigo
- Department of Pediatrics, University of Liège, CHR Citadelle, Belgium.
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Bioavailability, biodistribution and toxicity of biocalTM a new calcium source. Comparative studies in rats. Nutr Res 1999. [DOI: 10.1016/s0271-5317(99)00083-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Toba Y, Takada Y, Tanaka M, Aoe S. Comparison of the effects of milk components and calcium source on calcium bioavailability in growing male rats. Nutr Res 1999. [DOI: 10.1016/s0271-5317(99)00013-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
This study evaluates the influence of different concentrations of calcium on blood pressure of normotensive rats. Four groups of Wistar rats (A, B, C and D) had free access to modified isocaloric and isoproteic diets containing 0.2, 0.5, 2 and 4 g% calcium as calcium carbonate for a period of 30 days. Systolic and diastolic arterial blood pressures were monitored in awake rats by the indirect tail cuff method using a Physiograph equipped with transducers and preamplifiers. Body weight and length and food intake were monitored. Under the conditions of the present experiment, the systolic and diastolic arterial blood pressures of group D rats fed a diet containing 4 g% calcium were significantly (P < 0.05) lower compared to rats of the other groups.
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Affiliation(s)
- N Buassi
- Departamento de Ciências Fisiológicas, Universidade Estadual de Londrina, PR, Brasil
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Praet JP, Peretz A, Mets T, Rozenberg S. Comparative study of the intestinal absorption of three salts of calcium in young and elderly women. J Endocrinol Invest 1998; 21:263-7. [PMID: 9624602 DOI: 10.1007/bf03347313] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A daily ingestion of 1000 to 1500 mg elemental calcium associated with vitamin D supplement is presently considered to be the adequate and least expensive therapy for senile osteoporosis. There exists only scarce data about calcium absorption with available calcium salts in elderly patients. We have compared the digestive absorption of calcium (Ca) citrate in soluble and solid form and calcium gluconolactate-carbonate in 15 young and 20 elderly, healthy women using the oral calcium loading test. The subjects were divided into two groups. In the first group, the absorption of solid Ca citrate (1000 mg Ca element) was compared to the absorption of Ca gluconolactate-carbonate (1000 mg Ca element) both in young (n = 7) and elderly women (n = 10). In the second group, the absorption of soluble Ca citrate (1000 mg Ca element) was compared to the absorption of Ca gluconolactate-carbonate (1000 mg Ca element) in young (n = 8) and elderly (n = 10) women. In the preload phase, basal calciuria was increased in elderly women (p < 0.01) although basal calcemia was similar in young and elderly women. After oral administration of the calcium salts, an increase in plasma Ca was observed in both groups which was greater for soluble Ca citrate and Ca gluconolactate than for solid Ca citrate. In young women, the increase in plasma calcium was significantly higher with soluble Ca citrate compared to Ca gluconolactate (p < 0.05). In elderly women, the postload calciuria was significantly higher for soluble Ca citrate (p < 0.05) and Ca gluconolactate (p < 0.05) compared to solid Ca citrate. A similar pattern was observed in young women, although it was not significant. In conclusion, an oral load of 1000 mg soluble Ca citrate and Ca gluconolactate-carbonate induces significant biochemical changes suggesting a better digestive absorption compared to Ca citrate in solid form, both in young and elderly women. We did not observe different response, between young and old patients.
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Affiliation(s)
- J P Praet
- Geriatric Unit, Universitair Ziekenhuis St. Pieter, Brussels, Belgium
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Ashton BA, Ambrosini GL, Marks GC, Harvey PW, Bain C. Development of a dietary supplement database. Aust N Z J Public Health 1997; 21:699-702. [PMID: 9489185 DOI: 10.1111/j.1467-842x.1997.tb01783.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Data describing the composition of dietary supplements are not readily available to the public health community. As a result, intake from dietary supplements is generally not considered in most dietary surveys and, hence, little is known about the significance of supplement intake in relation to total diet or disease risk. To enable a more comprehensive analysis of dietary data, a database of the composition of various dietary supplements has been compiled. Active ingredients of all dietary supplements sold in Australia are included in the Australian Register of Therapeutic Goods (ARTG), maintained by the Therapeutic Goods Administration. Products included in the database were restricted to those vitamin, mineral and other supplements identified in dietary data collected from studies conducted in southeast Queensland and New South Wales (850 supplements). Conversion factors from ingredients compounds to active elements were compiled from standard sources. No account has been made for bioavailability, consistent with current practice for food composition databases. The database can be queried by ARTG identification number, brand, product title, or a variety of other fields. Expected future developments include development of standard formulations for use when supplements are incompletely specified, and expansion of products included for more widespread use.
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Affiliation(s)
- B A Ashton
- Nutrition Program, Australian Centre for International & Tropical Health & Nutrition, University of Queensland, Brisbane
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Henderson CJ, Cawkwell GD, Specker BL, Sierra RI, Wilmott RW, Campaigne BN, Lovell DJ. Predictors of total body bone mineral density in non-corticosteroid-treated prepubertal children with juvenile rheumatoid arthritis. ARTHRITIS AND RHEUMATISM 1997; 40:1967-75. [PMID: 9365085 DOI: 10.1002/art.1780401108] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To determine the extent of significant osteopenia in prepubertal patients with juvenile rheumatoid arthritis (JRA) not treated with corticosteroids and to identify variables that are highly related to bone mineralization in this population. METHODS In a cross-sectional study, 48 JRA patients and 25 healthy control subjects ages 4.6-11.0 years were evaluated. Total body bone mineral density (TB BMD) was determined by Hologic dual energy x-ray absorptiometry. All patients were prepubertal (Tanner stage I or II) and had never taken corticosteroids. For comparison, JRA patients were divided into "low" TB BMD (Z score < or =-1) or "normal" TB BMD (Z score >-1). RESULTS The overall mean +/- SD TB BMD scores did not differ between the JRA subjects (0.75 +/- 0.06 gm/cm2) and controls (0.73 +/- 0.07 gm/cm2; P > 0.30). However, 29.2% of the JRA patients had low TB BMD, whereas only 16% would be expected to have low TB BMD based on the standard normal distribution (goodness of fit chi(2) = 4.84, P = 0.01). The mean Z score for the JRA patients with low TB BMD was -1.43, and for those with normal TB BMD, it was 0.32. The JRA subjects with low TB BMD were significantly younger, had more active articular disease, greater physical function limitation, higher erythrocyte sedimentation rate, higher joint count severity score, lower body mass index, lower lean body mass, less participation in organized sports, and more protein and vitamin D in their diet compared with JRA patients with normal TB BMD (all P < 0.05). Using logistic regression, a model including age at JRA onset, Juvenile Arthritis Functional Assessment Report (JAFAR) score, triceps skin-fold percentiles, percentage US recommended daily allowance for dietary magnesium intake, and serum 1,25-dihydroxyvitamin D levels was able to accurately segregate 79.6% of the JRA subjects into either the low or normal TB BMD groups (chi(2) = 20.5, P = 0.001). CONCLUSION This study demonstrated that in a mildly to moderately ill prepubertal JRA population that had never been exposed to corticosteroids, almost 30% had significantly low TB BMD. The patients with low TB BMD had more active and severe articular disease and greater physical function limitation. Disease-related parameters in JRA appear to exert a negative effect on bone mineralization even in prepubertal children, which can be demonstrated despite the exclusion of corticosteroid-treated patients.
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Affiliation(s)
- C J Henderson
- Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA
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Yan L, Prentice A, Dibba B, Jarjou LM, Stirling DM, Fairweather-Tait S. The effect of long-term calcium supplementation on indices of iron, zinc and magnesium status in lactating Gambian women. Br J Nutr 1996; 76:821-31. [PMID: 9014651 DOI: 10.1079/bjn19960089] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The effect of long-term supplementation with CaCO3 on indices of Fe, Zn and Mg status was investigated in a randomized, double-blind intervention study of sixty lactating Gambian women. The supplement contained 1000 mg Ca and was consumed between meals 5 d/week, for 1 year starting 1.5 weeks postpartum. Compliance was 100%. Plasma ferritin concentration, plasma Zn concentration and urinary Mg output were measured before, during and after supplementation at 1.5, 13, 52 and 78 weeks postpartum. No significant differences in mineral status were observed at any time between women in the supplement and placebo groups. Analysis of the longitudinal data series showed that plasma ferritin and Mg excretion were characteristic of the individual (P < 0.001). Within individuals, ferritin concentration was higher at 1.5 weeks postpartum than later in lactation (P = 0.002). Plasma Zn concentration was lower at 1.5 weeks postpartum than at other times (P < 0.001), an effect which disappeared after albumin correction. Low plasma concentrations of ferritin and Zn indicated that the Gambian women were at high risk of Fe and Zn deficiency. Measurements of alpha 1-antichymotrypsin suggested that the results were not confounded by acute-phase responses. The results of the present study indicate that 1000 mg Ca as CaCO3 given between meals does not deleteriously affect plasma ferritin and Zn concentrations or urinary Mg excretion in women who are at risk of Fe and Zn deficiency.
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Affiliation(s)
- L Yan
- Medical Research Council Dunn Nutrition Unit, Cambridge, The Gambia
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Ashton BA, Ambrosini GL, Marks GC, Harvey PW, Bain C. Development of a dietary supplement database. Aust N Z J Public Health 1977. [DOI: 10.1111/j.1467-842x.1977.tb01520.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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