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Calcium (Ca) is a vital nutrient essential for structural development and signal transmission in both plants and animals. In humans, inadequate calcium intake has been correlated with various diseases, including osteoporosis, cardiovascular and cerebrovascular diseases, and cancer. In areas where plants serve as a main dietary source, calcium intake is significantly lower than the recommended adequate intake, notably in low‐ and middle‐income countries (LMICs). Exploring the connections between calcium consumption and cardiovascular disease (CVD) and cancer has significant implications for public health, given that these two conditions are the primary contributors to global mortality. This study conducted a systematic review of existing literature to assess the evidence regarding calcium intake and its effect on blood pressure control, stroke prevention, and the controversial association with myocardial infarction. Furthermore, the preventive effect of calcium intake on tumor development, particularly in cancer prevention, was discussed. The study explores the potential of agronomic biofortification as a key strategy to enhance plant‐based dietary calcium density and improve human health. By advocating for the incorporation of calcium‐rich plants and plant‐derived products, alongside appropriate calcium supplementation, the study emphasizes the economic and practical benefits of plants as a calcium source. This approach is aligned with global dietary patterns and socioeconomic disparities. The review also highlights the need for further research to better understand the mechanisms through which agronomic biofortification can increase dietary calcium intake and reduce the risks of CVD and cancer associated with calcium deficiency. Ultimately, this study aims to deepen our understanding of the complex relationship between calcium intake and health. [ABSTRACT FROM AUTHOR]

Background: Osteoporosis is a major public health issue with huge socioeconomic implications. Adequate knowledge and a positive attitude regarding osteoporosis with sufficient dietary calcium intake are important to prevent osteoporosis, especially in young adults. Nonetheless, data on the knowledge and attitude regarding osteoporosis, dietary calcium intake and its food sources among the high-risk population, including Malaysian Chinese are limited. Objective: The study aimed to determine the knowledge and attitude regarding osteoporosis, dietary calcium intake, and food sources of calcium among young Malaysian Chinese. Methods: A total of 130 Malaysian Chinese aged 18 to 26 years living in Klang Valley were recruited. Knowledge and attitude regarding osteoporosis were assessed using the Osteoporosis Prevention and Awareness Tool (OPAAT) and Osteoporosis Health Belief Scale (OHBS). Dietary calcium intake and food sources were obtained from a 7-day diet history. Results: Participants had low knowledge regarding osteoporosis (48.8% ± 16.6), but moderate knowledge (53.2% ± 17.9) regarding preventive measures of osteoporosis. The median dietary calcium intake was 546 mg/day and only 6.2% of the participants achieved the Recommended Nutrients Intake (RNI). There was a discernible weak positive correlation between knowledge and dietary calcium intake (r = 0.192, p = 0.029). Conclusion: Young Malaysian Chinese adults exhibited low knowledge about osteoporosis and reported inadequate dietary calcium intake. Thus, there is a need for community-based health education programs focusing on osteoporosis awareness among Malaysian young adults. [ABSTRACT FROM AUTHOR]

Hip fractures are a major health issue considerably impacting patients' quality of life and well-being. This is particularly evident in elderly subjects, in which the decline in bone and muscle mass coexists and predisposes individuals to fall and fracture. Among interventions to be implemented in hip fractured patients, the assessment and management of nutritional status is pivotal, particularly in subjects older than 65. Nutrition plays a central role in both primary and secondary preventions of fracture. An adequate protein intake improves muscle mass and strength and the intestinal absorption of calcium. Other nutrients with recognized beneficial effects on bone health are calcium, vitamins D, K, and C, potassium, magnesium, folate, and carotenoids. With reference to calcium, results from longitudinal studies showed that the consumption of dairy foods has a protective role against fractures. Moreover, the most recent systematic reviews and meta-analyses and one umbrella review demonstrated that the combination of calcium and vitamin D supplementation significantly reduces hip fracture risk, with presumed higher efficacy in older and institutionalized subjects. Owing to these reasons, the adequate intake of calcium, vitamin D, protein, and other macro and micronutrients has been successfully implemented in the Fracture Liaison Services (FLSs) that represent the most reliable model of management for hip fracture patients. In this narrative review, papers (randomized controlled trials, prospective and intervention studies, and systematic reviews) retrieved by records from three different databases (PubMed, Embase, and Medline) have been analyzed, and the available information on the screening, assessment, and management of nutritional and vitamin D status and calcium intake in patients with hip fractures is presented along with specific prevention and treatment measures. [ABSTRACT FROM AUTHOR]

Three recently-completed, large clinical trials in the U.S, New Zealand, and Australia, referred to herein as the ‘mega-trials’, were conducted to determine the impact of supplemental vitamin D on a variety of outcomes including falls and fractures. The trials were similar in design and collectively included over 50,000 generally vitamin D replete, older men and women. The mega-trials established that vitamin D supplementation with the equivalent of 2000 to 3300 IU/d of vitamin D3 had no favorable effect on risk of falls or fractures. This review focuses on specific design elements of the trials and how they likely influenced these trial findings. While these trials were in progress, evidence emerged that circulating 25-hydroxyvitamin D levels have a U-shaped association with risk of falling, raising concern about a potential untoward effect of high dose supplementation. There is compelling evidence that in older, vitamin D- and calcium-insufficient nursing home residents, the combination of vitamin D and calcium in modest replacement doses dramatically reduces the risk of hip and other fractures. Community-dwelling older adults in many populous countries around the globe have widespread vitamin D and calcium insufficiency. It is time to follow the evidence trail and determine the effect of vitamin D and calcium replacement on their risk of falls and fractures.

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BackgroundPeople who are at risk of either cow milk allergies or lactose intolerance may need to avoid consuming milk and milk products, which are well-known abundant sources of calcium (Ca). This limitation in calcium intake could affect bone health. Currently, there is limited knowledge on the impact of avoiding the consumption of milk and milk products on the daily Ca intake and bone mineral density (BMD) of people at risk of cow milk allergies. This study aimed to investigate the differences between the amount of Ca intake and BMD values between people who are at risk of cow milk allergies and those who are not.MethodsA total of 80 participants were recruited, and further divided into two groups, the at-risk cow milk allergies (AR) group (n = 40) and the normal (NOR) group, using the cow milk allergies and lactose intolerance screening questionnaire. The anthropometric assessment, body composition analyses, 3-day dietary record, and bone mass density (wrist and ankle bones) measurement of all participants were collected using the dual x-ray absorptiometry (DEXA) technique to compare the differences of variables between the two groups.ResultsThe participants in the AR group presented a significantly lower amount of Ca intake (317 mg/day) than those in the NOR group (623 mg/day) (p

Aim. To assess physical activity (PA) and nutritional status and their relationship with the sarcopenic phenotype of body composition in women with rheumatoid arthritis (RA). Material and methods. 104 women (mean age 59.58.7 years) with RA underwent clinical and laboratory examination, dual-energy X-ray absorptiometry. The level of PA and nutritional status were assessed using the International Physical Activity Questionnaire (IPAQ) and Mini Nutritional Assessment (MNA) questionnaires, respectively. Results. Sarcopenic phenotype was diagnosed in 37.1% of patients. Moderate and low PA levels were detected in 44.2 and 7.8%, respectively, risk of malnutrition in 50% of persons. In multivariate logistic regression analysis, factors associated with the sarcopenic phenotype were determined: the frequency of vigorous PA3 times a week [odds ratio OR 5.12 (95% confidence interval CI 1.1522.94); p=0.032], walking 1 hour a day [OR 4.98 (95% CI 1.1421.74); p=0.033], risk of malnutrition by MNA [OR 4.13 (95% CI 1.1215.32); p=0.034], body mass index 25 kg/m2 [OR 8.11 (95% CI 1.8635.32); p=0.006] and daily calcium intake 500 mg [OR 4.62 (95% CI 1.0620.08); p=0.041]. Conclusion. 52% of women with RA had moderate оr low PA levels, and 50% of patients were at risk of malnutrition. The risk of sarcopenic phenotype associated with a low frequency of vigorous PA, low walking time, risk of malnutrition, body mass index 25 kg/m2 and insufficient calcium intake.

Introduction. Milk and derived products occupy a special place in the consumption of the Algerian population. Objective. The objective of this study was to describe the milk and dairy productsplaceineastern Algeria adults population. Material and methods. A cross-sectional study by questionnaire was carried out on 750 subjects recruited in shopping centers, supermarkets and general food stores. The survey questionnaire gatheredgeneral characteristics, consumption of dairy products and their share in income, purchase of dairy products, and daily calcium intake of the subjects.Results were compared by Student, Khi2 and Anova tests. Results. The survey brought together 515 women and 235 men. Their average age was 31.9±7.7 years. The purchase share of dairy products was 37.6±16.6%, compared to other food products purchased at the level of the family home. Processed cheese was the most consumed product (93.7%), followed by sweet fermented fresh dairy products (87.9%). More than half of the subjects were influenced by relatives regarding the consumption of dairy products. Men purchase criteria for dairy products were in relation to taste, brand, price and nutritional value. The average calcium intake of the subjects (585.9±282.3 mg/day) was lower than the international recommendations. Conclusion. Milk and dairy products are widely consumed by all households, their consumption behavior is influenced by their close entourage, and taste is the most frequently selected as a purchasing criterion. [Résumé Introduction. Le lait et ses dérivés occupent une place particulière au sein de la consommation de la population algérienne. Objectif. L’objectif de cette étude était de décrire la place du lait et des dérivés chez une population d’adultes de l’est algérien. Matériel et méthodes. Une étude transversale par questionnaire a été réalisée sur 750 sujets recrutés au niveau de centres commerciaux, de supérettes et de magasins d’alimentation générale. Une fiche d’enquête a porté sur les carac-téristiques générales, la consommation des produits laitiers et leur part dans le revenu, l’achat des produits laitiers et l’apport calcique quotidien des sujets. La comparaison des résultats est effectuée par le test de Student, le Khi2 et l’Anova. Le seuil de signification retenu était de 0,05. Résultats. L’enquête a regroupé 515 femmes et 235 hommes. Leur moyenne d’âge était de 31,9±7,7 ans. La part de l’achat des produits laitiers était de 37,6±16,6%, par rapport aux autres produits alimentaires achetés au niveau du foyer familial. Le fromage fondu était le produit le plus consommé (93,7%), suivi des produits laitiers frais fermentés sucrés (87,9%). Plus de la moitié des sujets étaient influencés par les proches concernant la consommation des produits laitiers. Les critères d’achat des hommes pour les produits laitiers étaient par rapport au goût, la marque, le prix et la valeur nutritive. L’apport calcique moyen des sujets représentait 585,9±282,3 mg/jour et était inférieur aux recommandations internationales. Conclusion. Le lait et les produits laitiers sont très largement consommés par tous les ménages, leur comportement de consommation est influencé par leur entourage proche et le goût est le plus fréquemment sélectionné comme critère d’achat.]

Introduction: Advanced age is a significant factor in changes to brain physiology and cognitive functions. Recent research has highlighted the critical role of the gut microbiome in modulating brain functions during aging, which can be influenced by various factors such as apolipoprotein E (APOE) genetic variance, body mass index (BMI), diabetes, and dietary intake. However, the associations between the gut microbiome and these factors, as well as brain structural, vascular, and metabolic imaging markers, have not been well explored. Methods: We recruited 30 community dwelling older adults between age 55-85 in Kentucky. We collected the medical history from the electronic health record as well as the Dietary Screener Questionnaire. We performed APOE genotyping with an oral swab, gut microbiome analysis using metagenomics sequencing, and brain structural, vascular, and metabolic imaging using MRI. Results: Individuals with APOE e2 and APOE e4 genotypes had distinct microbiota composition, and higher level of pro-inflammatory microbiota were associated higher BMI and diabetes. In contrast, calcium- and vegetable-rich diets were associated with microbiota that produced short chain fatty acids leading to an anti-inflammatory state. We also found that important gut microbial butyrate producers were correlated with the volume of the thalamus and corpus callosum, which are regions of the brain responsible for relaying and processing information. Additionally, putative proinflammatory species were negatively correlated with GABA production, an inhibitory neurotransmitter. Furthermore, we observed that the relative abundance of bacteria from the family Eggerthellaceae, equol producers, was correlated with white matter integrity in tracts connecting the brain regions related to language, memory, and learning. Discussion: These findings highlight the importance of gut microbiome association with brain health in aging population and could have important implications aimed at optimizing healthy brain aging through precision prebiotic, probiotic or dietary interventions. [ABSTRACT FROM AUTHOR]

Copyright of Actualizaciones en Osteología is the property of Asociacion Argentina de Osteologia y Metabolismo Mineral and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This systematic review investigates the potential health and wellness benefits of natural calcium-rich mineral waters. It emphasizes the importance of dietary calcium sourced from natural mineral waters in promoting bone health, maintaining cardiovascular function, aiding in weight management, and enhancing overall well-being. The review process involved the comprehensive analysis of peer-reviewed articles, clinical trials, and experimental studies published within the last decade. Findings reveal that consuming calcium-rich mineral water can contribute significantly to daily calcium intake, particularly for those with lactose intolerance or individuals adhering to plant-based diets. The unique bioavailability of calcium from such waters also appears to enhance absorption, thus potentially offering an advantage over other calcium sources. The potential benefits extend to the cardiovascular system, with some studies indicating a reduction in blood pressure and the prevalence of cardiovascular diseases. Emerging evidence suggests that calcium-rich mineral water might have a role in body weight management, though further research is needed. The review identifies several areas requiring additional research, such as the potential interaction between calcium-rich mineral water and other dietary components, the effects on populations with specific health conditions, and the long-term effects of consumption. In conclusion, natural calcium-rich mineral waters show promise as a readily accessible and bioavailable sources of dietary calcium, potentially beneficial for a broad range of individuals. However, further investigation is required to fully understand its range of health impacts and define optimal intake levels. [ABSTRACT FROM AUTHOR]

The risk of inadequate calcium intake is a worldwide problem. We performed a simulation exercise on the impact, effectiveness, and safety of increasing calcium levels in drinking water using the 2019 Health and Nutrition National Survey of Argentina, which provides water intake and water sources data at the individual level. We simulated the distribution of calcium intake assuming a calcium concentration of 100 mg of calcium per liter of tap water and 400 mg of calcium per liter of bottled water. After the simulation, all population groups had a slightly improved calcium intake. Higher impacts were observed in adults, as reported water intake was higher in adults 19–51 years old. In young adult women, the estimated calcium intake inadequacy decreased from 91.0% to 79.7% when calcium was increased in tap water and to 72.2% when calcium was increased in tap and bottled water. The impact was lower in adolescents and older adults who have higher calcium recommendations and reported lower water intake. Increased calcium concentration of water could improve calcium intake in Argentina, especially in adults as their reported water intake is higher. Combining more than one strategy to improve calcium intake might be required for countries like Argentina with low calcium intake. [ABSTRACT FROM AUTHOR]

Abstract Background This study was to analyze the association of calcium intake and metabolic equivalent (MET) with vertebral fractures, and to explore the role of MET between calcium intake and vertebral fractures. Method This cross-sectional study used data from the National Health and Nutrition Examination Surveys (NHANES) 2013–2014. The study involved individuals aged ≥ 50 years old with complete information on vertebral fracture, calcium intake, and physical activity. Vertebral fracture assessment is obtained using dual-energy x-ray absorptiometry to perform a lateral scan of the thoracolumbar spine. Calcium intake included total nutrient intake and total dietary supplements. The total MET is the sum of the METs for each activity (Vigorous/ moderate work-related activities, walking or bicycling for transportation and vigorous/ moderate recreational activities). Univariate and multivariate logistic regression analyses were utilized to investigate the effect of calcium intake, MET, and their combined effect on vertebral fracture. Results A total of 766 participants were included in the analysis, and 54 participants had vertebral fractures. The median calcium intake and MET were 8.43 mcg and 280.00, respectively. Multivariate results showed that neither calcium intake nor MET as continuous or categorical variables was significantly associated with vertebral fractures. MET

Aim – to evaluate the nutritional status and its relationship with the sarcopenic phenotype of body composition in women with rheumatoid arthritis (RA).Material and methods. The study included 91 women aged 40 to 75 years with RA according to ACR/EULAR criteria (2010) and a disease duration of at least 1 year. A questionnaire, laboratory and densitometric examination were conducted. Nutritional status was assessed using a MNA (Mini Nutricial Assessment) questionnaire.Results. Malnutrition and at risk of malnutrition according to the MNA were detected in 44.0% of patients with RA. These patients differed from those with normal nutritional status with a higher risk of osteoporotic hip fractures according to FRAX (p=0.035), lower appendicular muscle mass (AMM) (p=0.048) and lower self-assessment of health status (p=0.012). Patients significantly differed in nutritional status according to MNA, daily intake of calcium with food, circumferences of the mid-upper arm, calf, waist and hips, depending on the presence of sarcopenic phenotype. Multivariate regression analysis showed that the sarcopenic phenotype was associated with a nutritional status according to MNA less than 24 points (odds ratio (OR) – 6.14; p=0.036), daily calcium intake less than 500 mg (OR=9.55; p=0.007) and mid-upper arm circumference less than 25 cm (OR=9.32; p=0.015).Conclusion. Malnutrition was found in almost half of the patients with RA. It was revealed that a low nutritional status according to the MNA, low calcium intake and mid-upper arm circumference less than 25 cm increased the risk of having a sarcopenic phenotype in women with RA.

In women of childbearing age, the rate of bone formation will decrease gradually. If a bone formation is reduced continuously then it can cause osteoporosis. Insufficient calcium intake and abnormal body mass index can also cause reduced bone density. The purpose of this study was to analyze the correlation between calcium intake and body mass index with bone density in women of childbearing age in the Medical Faculty Universitas Lampung in 2021. This cross-sectional study of 80 respondents consisting of lecturers, employees, and students aged 20-45 years who were selected by purposive sampling was carried out in November-December 2021. Demographic data, Semi Qualitative-Food Frequency Questionnaire (SQ-FFQ), Kris digital scales 9360A, microtoise GEA, and Quantitative Ultrasound (QUS) were used to measure all variables. Spearmen Correlation Test with a significant level of p-value0.05 was used to see the relationship between variables. The results of the univariate analysis showed that the majority of respondents were aged 20-25 years (76.2%) and college students (78.8%). The average intake of calcium and body mass index was 709.2 and 21.2 and 31 respondents (38.8%) had osteoporosis. The results of the bivariate analysis showed a positive and significant correlation between calcium intake and bone density (p-value=0.000, r=0.687) and bone body mass index with bone density (p-value=0.000, r=0.596). The conclusion, there was a positive and significant correlation between calcium intake and body mass index with bone density in women of childbearing age in the Medical Faculty of Universitas Lampung in 2021.

Prospective cohorts are inconsistent regarding the association between dietary calcium intake and the risk of stroke. The aim was to perform a meta-analysis to determine whether an association exists between them in cohort studies. Relevant studies were identified by searching PubMed, EMBASE and Web of Science databases that published before December 2022. Prospective cohort studies that provided relative risk (RR) estimates with 95% confidence intervals (CIs) for the association were included. Study-specific risk estimates were combined by using a random effects model. Eighteen prospective studies, including 19,557 stroke cases among 882,181 participants, were pooled in the meta-analysis. We observed a nonlinear association between calcium intake and risk of stroke (P nonlinearity < 0.003). Compared with the lowest value of zero assumed as the reference, the RRs (95% CI) of stroke across levels of calcium intake were 0.95 (0.92, 0.98) for 200 mg/day, 0.94 (0.90, 0.98) for 300 mg/day, 0.95 (0.90, 0.99) for 500 mg/day, 0.98 (0.93, 1.03) for 700 mg/day, and 1.04 (0.97, 1.11) for 1000 mg/day. The stratified analyses by geographic region showed nonlinear associations and indicated that the protective effect was observed in Asian countries (P nonlinearity = 0.001) but not in non-Asian regions (P nonlinearity = 0.047). This meta-analysis suggests that dietary calcium intake might play an effective role in the prevention of stroke, especially in Asian countries. Future research among Asia population should attempt to establish whether this association is causal. PROSPERO CRD42022357710. • Dietary calcium intake might play an effective role in the prevention of stroke. • Our result suggested a nonlinear association between calcium intake and stroke risk. • It was significantly associated with lower risk of stroke in Asian countries. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to compare the osteoporosis knowledge, calcium intake, and physical activity level of the students of physical therapy and rehabilitation and nutrition and dietetics departments, which are among the occupational groups that play an important role in the prevention and management of osteoporosis. Methods: This study was carried out with second-, third-, and fourth-grade female students of physical therapy and rehabilitation and nutrition and dietetics departments. Osteoporosis knowledge was evaluated using Osteoporosis Knowledge Test, physical activity level was evaluated using the Sedentary Behavior Questionnaire, and daily calcium intake was evaluated using the Food Consumption Frequency Form. Results: The mean age of 209 female participants was 21.50±1.36 years. There was no significant difference between the students of the two departments in terms of osteoporosis knowledge, physical activity level, and calcium intake (p>0.05). There was no significant difference among students of different grades in terms of evaluated parameters (p>0.05). Discussion and Conclusion: The osteoporosis knowledge, physical activity level, and calcium intake of the students studying in two different departments involved in osteoporosis management and at different grade levels were similar. Although osteoporosis knowledge of the students of both departments was high, their physical activity level and daily calcium intake were low. It is important for these students, who will be practitioners of professional groups that play a primary role in health promotion, to reflect their knowledge on their own attitudes and habits and to be the right role models for their clients and the development of social health. [ABSTRACT FROM AUTHOR]

To evaluate the effect of incorporating calcium advice into early pregnancy counseling on calcium intake during pregnancy in the Netherlands. A multicenter prospective before-after cohort study was conducted introducing risk-based care including calculating individual pre-eclampsia risk. Part of the intervention was to incorporate calcium advice into routine counseling. We calculated individual daily calcium intake and adequacy of calcium intake (≥1,000 mg/day) at 16, 24 and 34 weeks of pregnancy. We performed a multiple logistic regression adjusting for covariates to identify any differences in the risk of inadequate calcium intake between RC and CAC. In regular care (RC, 2013–2015, n=2,477) 60% had inadequate calcium intake, compared to 49% during calcium advice care (CAC, 2017–2018, n=774) (aOR 0.75, 95% CI 0.64–0.88). Specific calcium supplements were used by 2% and 29% in RC and CAC, respectively (OR 25.1, 95% CI 17.8–36.0). Determinants of an inadequate calcium intake were lower age (aOR per additional year 0.96, 95% CI: 0.94–0.98), nulliparity (aOR 1.22, 95% CI: 1.03–1.45) and non-Caucasian origin (aOR 1.83, 95% CI 1.09–3.09). In CAC, risk of inadequate intake decreased with increasing predicted pre-eclampsia risk, which was a trend reversal compared to RC. Incorporating calcium advice into early pregnancy counseling was shown to lead to a decrease in the risk of inadequate calcium intake during pregnancy, but still inadequate intake in half of the women suggesting the need for further study on improving implementation. Awareness of individual increased PE risk had positive effect on calcium intake. [ABSTRACT FROM AUTHOR]

Eloy A Zepeda-Carrillo,1,2,&ast; Omar Ramos-Lopez,3 Erika Martínez-López,4 Elisa Barrón-Cabrera,5 J Antonio Bernal-Pérez,6 Luisa E Velasco-González,6 Ernesto Rangel-Rios,6 J Fausto Bustamante Martínez,2 Rafael Torres-Valadez1,7,&ast; 1Specialized Unit in Research, Development and Innovation in Genomic Medicine, Nayarit Center for Innovation and Technology Transfer, Autonomous University of Nayarit, Tepic, Nayarit, Mexico; 2Civil Hospital “Dr. Antonio González Guevara”, Health Services in Nayarit, Tepic, Nayarit, Mexico; 3Medicine and Psychology School, Autonomous University of Baja California, Tijuana, B.C, Mexico; 4Institute of Translational Nutrigenetics and Nutrigenomics, Department of Molecular and Genomic Biology, University Center of Health Sciences, University of Guadalajara, Guadalajara, Jalisco, Mexico; 5Faculty of Nutrition and Gastronomy Sciences, Autonomous University of Sinaloa, Culiacan, Sinaloa, Mexico; 6Family Medicine Unit No. 24 “Ignacio García Téllez”, Mexican Social Security Institute, Tepic, Nayarit, Mexico; 7Integral Health Academic Unit, Autonomous University of Nayarit, Tepic, Nayarit, Mexico&ast;These authors contributed equally to this workCorrespondence: Rafael Torres-Valadez, Nayarit Center for Innovation and Technology Transfer, Autonomous University of Nayarit, Tepic, Nayarit, Mexico, Tel +52-3312523644, Email rafael.torres@uan.edu.mxPurpose: Differences in metformin effect on glycemic control in type 2 Diabetes (T2D) have been associated with diet, obesity, years since T2D diagnosis and genetic factors, such as the Met408Val (rs628031) SLC22A1/OCT1 gene polymorphism. This study aimed to analyze the effect of metformin and diet on glycemic control and its association with the Met408Val polymorphism in patients with T2D from western Mexico.Patients and Methods: A total of 240 T2D adult patients were enrolled in this cross-sectional study. Anti-hyperglycemic therapy, dietary intake, body composition and glycemic profile were recorded and the determination of genotypes of SLC22A1/OCT1 gene (rs628031) was performed using an allelic discrimination assay.Results: The type of metformin therapy was 47% monotherapy, 45% dual therapy (metformin+glibenclamide or metformin+insulin) and 8% triple therapy (metformin+glibenclamide+insulin). Individuals with metformin monotherapy had a higher glycemic control frequency (%HbA1c < 7.0) compared with the dual and triple treatment schemes (77% vs 35% and 15%, respectively; p< 0.001). Interestingly, a high potassium intake was documented in the three anti-hyperglycemic therapies and a lower intake of micronutrients, including calcium, magnesium, and zinc. An interaction was found between calcium intake and carriers of the risk allele A (408Val) with %HbA1c (P interaction=0.028), and potassium intake with the TyG index (P interaction=0.027). In addition, there was a positive correlation between calcium intake and %HbA1c (r=0.682; p=0.010), and potassium intake vs TyG index (r=0.593; p=0.033) in risk allele A (408Val) carriers with metformin monotherapy. Genotype frequencies were GG homozygotes (76.6%), GA heterozygotes (21.5%) and AA homozygotes (1.9%). The allele frequency was 87.4% for the ancestral allele G and 12.6% for the risk allele A.Conclusion: These findings suggest a differing effect of metformin on glycemic control regarding calcium and potassium intake and the Met408Val SLC22A1/OCT1 gene polymorphism in T2D patients.Keywords: nutrigenetic, pharmacogenetic, SLC22A1/OCT1 gene, gene-nutrient interactions, calcium intake, potassium intake

Food allergies have become a global epidemic, affecting more than 10% of the population and 8% of children worldwide. Eliminating or limiting a food group from the diet can adversely impact micronutrient consumption. Milk allergies can impact the amount of calcium consumed in the diet, serving as a barrier to meeting daily calcium needs. Previous research evaluates the nutritional impact food allergies may have on children diagnosed with food allergies; however, there is a marked gap in literature that investigates the impact that children's allergy may have on their parent or caregiver. We hypothesized that milk elimination in a child's diet resulting from a milk allergy is associated with inadequate calcium intake among parents. Study participants (n = 55) lived in the United States and included parents or caregivers of a child with a diagnosed milk allergy (experimental group) and parents of a child without a milk allergy (control group). Calcium intake was estimated by using the validated Calcium Assessment Tool. Results demonstrated that the experimental group consumed significantly less calcium (273 mg/d) than the control group (520 mg/d; P <.01). Notably, both groups consumed inadequate calcium relative to the calcium Recommended Dietary Allowance for adults of 1000 mg/d, although calcium supplementation was not assessed in this study. Key findings from this study indicate widespread inadequate dietary calcium intake and suggest a need for increased calcium consumption in this population. [Display omitted] This research study compares estimated daily calcium intake between an experimental group (parents/caregivers of a child with a milk allergy) and a control group (parents/caregivers of a child without a milk allergy). Calcium intake was assessed using the Calcium Assessment Tool, a food frequency questionnaire (FFQ). Results demonstrated higher calcium intake among control group participants compared with the experimental group (520 mg vs. 273 mg, respectively). [ABSTRACT FROM AUTHOR]

Background: This study was to analyze the association of calcium intake and metabolic equivalent (MET) with vertebral fractures, and to explore the role of MET between calcium intake and vertebral fractures. Method: This cross-sectional study used data from the National Health and Nutrition Examination Surveys (NHANES) 2013–2014. The study involved individuals aged ≥ 50 years old with complete information on vertebral fracture, calcium intake, and physical activity. Vertebral fracture assessment is obtained using dual-energy x-ray absorptiometry to perform a lateral scan of the thoracolumbar spine. Calcium intake included total nutrient intake and total dietary supplements. The total MET is the sum of the METs for each activity (Vigorous/ moderate work-related activities, walking or bicycling for transportation and vigorous/ moderate recreational activities). Univariate and multivariate logistic regression analyses were utilized to investigate the effect of calcium intake, MET, and their combined effect on vertebral fracture. Results: A total of 766 participants were included in the analysis, and 54 participants had vertebral fractures. The median calcium intake and MET were 8.43 mcg and 280.00, respectively. Multivariate results showed that neither calcium intake nor MET as continuous or categorical variables was significantly associated with vertebral fractures. MET < 160 and calcium intake ≥ 670 mg group was associated with the decreased risks of vertebral fracture [odds ratio (OR) = 0.47, 95% confidence interval (CI): 0.26–0.83, P = 0.032] after adjusting for age, race, energy, total femur bone mineral density (BMD), and femoral neck BMD. In the group of MET < 160, increased calcium intake was associated with a reduced risk of vertebral fracture, with a decreased OR value. In the group of MET ≥ 160, increased calcium intake was associated with an increased risk of vertebral fracture, with an increased OR value. Conclusion: The combination of MET < 160 and calcium intake ≥ 670 mg was associated with decreased risks of vertebral fractures. There may be an interaction between calcium intake and MET on vertebral fracture risk. [ABSTRACT FROM AUTHOR]

The relationship between calcium intake and bone strength in older Asian individuals, including Japanese, is controversial; therefore, we herein investigated this relationship in older Japanese populations. We performed a cross-sectional analysis of 314 participants older than 65 years who voluntarily participated in a medical examination and responded to questionnaires. The osteo-sono assessment index (OSI) measured at the right calcaneus using a quantitative ultrasonic device was used as an indicator of bone strength. The daily dietary intake of calcium was assessed using a brief-type self-administered diet history questionnaire. A two-way analysis of covariance revealed a significant interaction between sex and calcium intake on the OSI (p < 0.01). A multiple regression analysis showed a positive correlation between calcium intake and the OSI in males (p < 0.01), but not females (p = 0.27). In females, grip strength divided by body weight positively correlated with the OSI (p = 0.04). The present results suggest that a higher calcium intake contributes to bone strength in older Japanese males. Although a higher grip strength may contribute to bone strength in females, the potential of estrogen as a confounding factor needs to be considered. [ABSTRACT FROM AUTHOR]

Context and purpose: In light of the key roles of vitamin D and calcium in adolescent bone health, there is a critical need for representative data on nutritional status for both micronutrients in teenagers. The present work used data from the recent representative National Teens' Food Survey II (2019–2020) to assess calcium and vitamin D intakes of teenagers in Ireland, including adequacy of such intakes, as well as, for the first time, to characterise serum 25-hydroxyvitamin D (25(OH)D) concentrations and their determinants. Methods: Usual calcium and vitamin D intake estimates were generated using food intake data (via 4-day weighed food records) from a nationally representative sample of teenagers aged 13–18 years in Ireland (n 428). Serum 25(OH)D was measured (via LC–MS/MS) in the 57.5% (n 246) who provided a blood sample. Results: Sixty-seven and 94% of Irish teenagers had intakes of calcium and vitamin D below the respective Estimated Average Requirements values, reflecting a high degree of inadequacy of intake for both micronutrients (and higher in girls than boys; P < 0.001). In addition, 21.7% and 33.1% of teenagers had serum 25(OH)D < 30 nmol/L (risk of vitamin D deficiency) and 30–49.9 nmol/L (inadequacy), respectively. Extended winter sampling, being aged 16–18 years, low total vitamin D intake, being overweight/obese or being of non-white skin type were significant (P < 0.05) predictors of serum 25(OH)D < 30 nmol/L. Conclusions: There was a high prevalence of inadequacy of intake of calcium and vitamin D in Irish teenagers, and a fifth were at increased risk of vitamin D deficiency. [ABSTRACT FROM AUTHOR]

Background and aimsMultiple sclerosis (MS) is associated with osteoporosis, possibly due to neurological disability and decreased calcium intake. The objective of this study was to evaluate the efficacy of a personalized nutritional advice program by a dietitian compared to the delivery of a standard advice form to optimize dietary calcium intake in outpatients with MS.MethodsWe performed a randomized, controlled, parallel trial comparing the efficacy of a personalized dietary advice (PDA) program to standard advice form (SAF) to increase daily calcium intake in MS patients. The study population was composed by patients with relapsing-remitting MS aged 18–69 years old. PDA program consisted in dietary advice delivered by a dietitian at baseline, 1 month, and 3 months. Calcium and nutrient intake in patients from both groups was evaluated at baseline and 6 months using a dietary survey.ResultsOf the 194 patients screened for inclusion, 182 patients were included (79% female, median age of 42 years, and median EDSS of 2.0), and randomized to SAF (n = 92) or PDA (n = 90). At 6 months, median calcium intake increased by 241 mg/day in the PDA group and decreased by 120 mg/day in the SAF group (p < 0.0001). However, the median calcium intake was 947 mg/day in the SAF group and 778 mg/day in the PDA group at baseline (p = 0.0077), potentially favoring the effect of dietary advice. Complementary analyses focusing on patients with insufficient calcium intakes at baseline revealed comparable values in both groups (p = 0.69). Of those, patients included in the PDA group obtained significantly higher calcium intakes at 6 months than patients from the SAF group (p = 0.0086) independently of EDSS, PASAT, HADS and EQ-5D scores.ConclusionThis work shows the efficacy of dietary management based on personalized advice program over 3 months to durably increase calcium consumption in MS patients with insufficient calcium intake.Clinical trial registrationclinicaltrials.gov, identifier NCT02664623.

The increase in sedentary activity among older adults could result in lowering bone mineral density (BMD), thus increasing the risk of osteoporosis. Physical activity and adequate dietary calcium intake (DCI) are important to optimize bone health. Therefore, this study was conducted to determine ethnic differences in bone health status (BHS) and to investigate the association between lifestyle factors and BHS among Malaysian older adults. A total of 120 older adults aged between 60 to 84 years old of three major ethnicities residing in Bangi and Kajang, Selangor, Malaysia were recruited in this cross-sectional study. They were asked to fill out food frequency questionnaire and the international physical activity questionnaires for the quantification of DCI and physical activity level (PAL) assessments. BMD was quantified using QUS-2 Calcaneal Ultrasonometer. The results showed that the Chinese participants had significantly lower body mass index (BMI) (p<0.001) than their counterparts. Malay participants had significantly higher DCI (p=0.027) compared to other groups. However, none of the participants met the recommended daily intake of calcium (1000 mg/day). The Indian participants had significantly higher (p=0.007) PAL compared to the Malay and Chinese groups. BMD analysis showed that the Chinese have significantly lower (p=0.001) T-scores (-0.54 ± 1.35) compared to Malay (0.78 ± 1.72) and Indian (0.61 ± 1.91), respectively. BMI and DCI were positively correlated with BMD (correlation coefficient, r= 0.320, p<0.001; r=0.383, p<0.001, respectively). In conclusion, the reduced BMI among the Chinese and DCI among all Malaysian older adults need to be concerned and addressed immediately. Future intervention programs should be focusing on optimizing DCI, not only among the older adults but should be emphasized and initiated at younger ages to prevent osteoporosis during old age. [ABSTRACT FROM AUTHOR]

Raksaworn Jaisaard,1 Tipaporn Kanjanarach,2 Sutin Chanaboon,3 Borey Ban4 1Pharmacy and Health System Graduate Program, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand; 2Department of Social and Administrative Pharmacy and Center for Research and Development of Herbal Health Product, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand; 3Department of Community Health, Sirindhorn College of Public Health Khon Kaen, Khon Kaen, 40000, Thailand; 4Technical School for Medical Care, University of Health Sciences, Phnom Penh, CambodiaCorrespondence: Tipaporn KanjanarachDepartment of Social and Administrative Pharmacy and Center for Research and Development of Herbal Health Product, Faculty of Pharmaceutical Sciences, Khon Kaen University, 123 Moo 16, Mittraphap Road, Nai Mueang Subdistrict, Mueang District, Khon Kaen, 40002, ThailandTel +66 81 739 2822Fax +66 043 202 379Email otipkan@kku.ac.thBorey BanTechnical School for Medical Care, University of Health Sciences, Phnom Penh, CambodiaTel +855 17 436 496Email boreyban89@gmail.comObjective: A three study research program was conducted to identify high calcium products available in the market (study I), identify high calcium products that were known or consumed by lower secondary school students in the last three months (study II), and identify the amount and sources of calcium that students had consumed in the prior 24 hours, their knowledge about sources of high calcium and how to interpret calcium information on nutrition labels of food packages (study III).Methods: In study I, a cross-sectional market survey was employed. In studies II and III, a school-based cross-sectional survey was employed. The survey population was students enrolled in grades 7– 9 (11– 14 years old) in a medium-sized lower secondary school in semi-urban Khon Kaen, Thailand. A total of 309 students were invited, with 168 and 209 students participating in studies II and III, respectively. Data were collected with self-administered questionnaires.Results: Ninety-three high calcium products were identified. Only 49 were known or consumed by students in the last three months. The median amount of calcium consumed in the previous 24 hours was 410 mg (IQR: 160, 983). Only 31.1% of students (65/209) consumed more than the Thai recommended daily intake (TRDI) of calcium (800mg) in the previous 24 hours. Their main source of calcium was milk. Other high calcium items that were consumed were malt drink, minnow, canned fish, calcium fortified soy milk and Chinese kale. The overall average knowledge score was 6.5± 2.4 out of a maximum of 17. The average knowledge scores for high calcium food sources and for interpreting the calcium information on a sample nutrition label were 4.6+1.8 (out of 12), and 1.9± 1.2 (out of 5), respectively.Discussion: Students should be introduced to high calcium products in their community such as hard tofu, minnow, and small freshwater shrimp. Educational programs on nutrition label interpretation are needed.Keywords: calcium intake, adolescent, calcium-rich food, calcium knowledge, source of calcium, nutrition fact

This systematic review investigates the potential health and wellness benefits of natural calcium-rich mineral waters. It emphasizes the importance of dietary calcium sourced from natural mineral waters in promoting bone health, maintaining cardiovascular function, aiding in weight management, and enhancing overall well-being. The review process involved the comprehensive analysis of peer-reviewed articles, clinical trials, and experimental studies published within the last decade. Findings reveal that consuming calcium-rich mineral water can contribute significantly to daily calcium intake, particularly for those with lactose intolerance or individuals adhering to plant-based diets. The unique bioavailability of calcium from such waters also appears to enhance absorption, thus potentially offering an advantage over other calcium sources. The potential benefits extend to the cardiovascular system, with some studies indicating a reduction in blood pressure and the prevalence of cardiovascular diseases. Emerging evidence suggests that calcium-rich mineral water might have a role in body weight management, though further research is needed. The review identifies several areas requiring additional research, such as the potential interaction between calcium-rich mineral water and other dietary components, the effects on populations with specific health conditions, and the long-term effects of consumption. In conclusion, natural calcium-rich mineral waters show promise as a readily accessible and bioavailable sources of dietary calcium, potentially beneficial for a broad range of individuals. However, further investigation is required to fully understand its range of health impacts and define optimal intake levels.

Background Prostate cancer is the most common noncutaneous cancer in American males. Causal links between dairy, or dietary calcium, and this cancer are considered suggestive but limited. Objectives To evaluate these associations in a large North American cohort, including many with no (or very low) dairy intake and much calcium from nondairy sources. Methods A prospective cohort study of 28,737 Seventh-day Adventist men in the United States and Canada, of whom 6389 were of black ethnicity. Diet was measured by FFQ, and 275 male participants also provided repeated 24-h dietary recalls as a calibration substudy. Incident cancers were mainly found by matching with cancer registries. Analyses used multivariable proportional hazards regressions and regression calibration for some analyses. Results In total, 1254 (190 advanced) incident prostate cancer cases were found during an average 7.8 y of follow-up. Men at the 90th percentile of dairy intake (430 g/d) compared with the 10th percentile (20.2 g/d) had higher prostate cancer risk (HR: 1.27; 95% CI: 1.12, 1.43). Similar findings, comparing the same g/d intakes, were demonstrated for advanced prostate cancers (HR: 1.38; 95% CI: 1.02, 1.88), for nonadvanced cases (HR: 1.27; 95% CI: 1.11, 1.45), in black participants (HR: 1.24; 95% CI: 0.98, 1.58), and when excluding vegan participants (HR: 1.22; 95% CI: 1.03, 1.43). Calibrated dairy (g/d) regressions (all participants and all prostate cancers), adjusting for dietary measurement error, found a HR of 1.75 (95% CI: 1.32, 2.32). Comparing 90th percentile intake to zero intakes (uncalibrated), the HR was 1.62 (95% CI: 1.26, 2.05). There was no evidence of an effect of higher (905 mg/d) compared with lower (349 mg/d) intakes of nondairy calcium (HR: 1.16; 95% CI: 0.94, 1.44). Conclusions Men with higher intake of dairy foods, but not nondairy calcium, had a higher risk of prostate cancer compared with men having lower intakes. Associations were nonlinear, suggesting greatest increases in risk at relatively low doses. [ABSTRACT FROM AUTHOR]

Background: Mental health has become a major public health issue worldwide. Biological and epidemiological studies have suggested that diet and physical fitness play a role in the prevention or cure of mental disorders. However, further research is required to elucidate the relationship between diet, physical fitness, and mental health. The study aims to provide a theoretical basis for promoting an adolescent healthy lifestyle and preventing mental problems by exploring the relationship between physical fitness, calcium intake, calorie intake, and adolescent mental health. Methods: A cross-sectional study of a sample of adolescents (N = 253, 12-13 years) was conducted. The study involved adolescents from three middle schools in Central Jiangsu Province, including 136 boys and 117 girls. Weight, height, and body mass index were measured. Physical fitness was scored using the Chinese National Student Physical Fitness Standard. Diet data were collected using a weighed 7-day food diary to estimate energy intake and dietary calcium intake. The mental health status of the participants was assessed using the Chinese Middle School Student Mental Health Scale. A T-test and analysis of variance were used to analyze the differences of variables between different genders and body mass index, and Pearson correlation and stepwise multiple regression were used to explore the relationship between physical fitness, dietary intake, and mental health. Results: The height (165.13 ± 8.07), weight (55.24 ± 13.00), and strength quality (64.93 ± 21.66) of boys are higher than those of girls (161.67 ± 6.44,48.99 ± 8.97, 58.40 ± 23.75, P < 0.05), and the flexibility quality (74.59 ± 14.75) of girls is higher than that of boys (68.30 ± 20.84) (P < 0.05). There were significant differences in the total scores of speed and physical fitness (F values were 4.02187.73, 3.07, 5.95, 10.33, and 9.52, respectively, P < 0.05). There was a significant positive correlation between calcium intake, cardiopulmonary fitness, and mental health (r = 0.276, P < 0.01; r = 0.159, P < 0.05). Calcium intake and cardiopulmonary fitness could explain 8.4% of the changes in the mental health of adolescents aged 12-13(1R2 = 0.084, P < 0.05). Conclusion: Adequate calcium intake and the improvement of cardiopulmonary fitness in adolescents aged 12-13 are essential for the good development of their mental health. Future research in this field should examine the prospective associations between multiple measures of physical fitness composition and other nutrients ingested and mental health outcomes, as well as intervention studies that seek to provide evidence of causality. [ABSTRACT FROM AUTHOR]

Aims: Findings of prior investigations on the association between calcium intake and lipid profiles were inconsistent. We performed a systematic review and meta-analysis on epidemiologic studies to evaluate the relationship of dietary calcium intake with blood lipids and lipoproteins.Data Synthesis: A systematic search up to April 2021 was performed in different electronic databases, including MEDLINE (PubMed), Scopus, Web of Science (ISI), and Google Scholar for epidemiological studies that considered dietary calcium intake as the exposure and reported risk of dyslipidemia or blood lipids and lipoproteins concentrations (as mean ± SD or mean ± SE or median (Inter Quartile Range) as the outcomes of interest in adult populations from both genders (18 years or older), regardless of their health status. Nineteen cross-sectional studies were included in the analysis. Combining estimates from 11 studies (including 33,304 subjects) revealed that individuals in the highest category of calcium intake, compared to the lowest one, had 5.94 mg/dL lower circulating triglyceride (TG) concentration (weighted mean difference (WMD): -5.94; 95% CI: -8.27, -3.62), 4.02 mg/dL lower circulating low-density lipoprotein cholesterol (LDL-c) levels (WMD: -4.02; 95% CI: -7.08, -0.95), and 1.56 mg/dL higher blood high-density lipoprotein cholesterol (HDL-c) (WMD: 1.56; 95% CI: 0.81, 2.30). Although meta-analysis on 13 studies (including 38,714 participants) did not reveal a significant relationship between dietary calcium intake and odds of dyslipidemia or hyperlipidemia in the whole population, the highest vs. lowest level of calcium intake was related to 42% decreased odds of low blood HDL-c levels in females (95% CI: 0.40, 0.84) and 41% increased odds in males (95% CI: 1.21, 1.65).Conclusions: This meta-analysis demonstrated that individuals with the highest dietary calcium intake might have lower blood TG, LDL-c, and higher HDL-c concentrations as compared to those with the lowest calcium intake. However, the linkage between dietary calcium intake with odds of hyperlipidemia or dyslipidemia was not significant. Because of the cross-sectional nature of included studies, causality could not be proven. Further prospective studies are needed to affirm these findings. [ABSTRACT FROM AUTHOR]

We assessed longitudinal association between calcium intake during adolescence and hypertension in adulthood. Longitudinal study data of 1611 participants from the China Health and Nutrition Survey during 1991–2011 were used. On average they were followed for 11·4 years. Dietary calcium intake during adolescence was assessed based on three 24-hour dietary recalls collected in each visit/survey between 1991 and 2009 (seven waves). The intake was recoded into quartiles. Cumulative mean±SD calcium intake was 199·9±144·8 mg/1000 kcal/day during adolescence. In total 102 participants had hypertension in adulthood (97 men and 5 women). There was a clear U-shaped association between adolescence calcium intake quartiles and adulthood hypertension: across the quartiles, hypertension prevalence was 6·7%, 4·0%, 5·2% and 9·5%, respectively. After adjustment for potential confounders including weight status and dietary pattern, odds ratios (OR, 95% CI) for hypertension were 2·32 (95% CI 1·07–5·00) for lowest quartile, 1·00 (reference), 1·34 (95% CI 0·61–2·97), and 3·10 (95% CI 1·49–6·46) across the quartiles. Lower or higher calcium intake during adolescence was associated with hypertension in adulthood independent of weight status and dietary pattern. [ABSTRACT FROM AUTHOR]

Summary: The objective of this study was to examine the effectiveness of an osteoporosis prevention program on knowledge and perception of self-efficacy in adopting preventive osteoporosis behaviors in premenopausal women working in sedentary occupations. Results show the improvement in knowledge and self-efficacy was statistically significant respectively (p < 0.001) and (p = 0.001). Introduction: The main purpose of the study was to evaluate the effectiveness of an osteoporosis prevention educational program on knowledge and perception of self-efficacy in adopting preventive osteoporosis behaviors in Tunisian premenopausal women working in sedentary occupations. Methods: A quasi-experimental pre-post intervention study design. Our study population was composed of female employees, aged 35–50 years, of a company located in the industrial zone Sousse, situated in the center East of Tunisia. Three data collection methods were used: a questionnaire exploring socio-demographic characteristics and anthropometric measures, the Osteoporosis Knowledge Test, and the Osteoporosis Self-Efficacy Scale. The intervention consisted of an educational program relating to the promotion of calcium intake and physical activity. We are referred to the "Health Belief Model." Results: A survey conducted on 97 women. Only 81 subjects completed the study and are included in data analyses. The total knowledge score regarding osteoporosis improved by + 14.57 which corresponds to percentage of 109% between the pre- (T1) and post-test (T2). This improvement in knowledge was statistically significant (p < 0.001), going from 13.41 ± 3.94 at T1 to 27.98 ± 2.49 at T2. The total osteoporosis self-efficacy score has increased by + 9.56, or a percentage of 15% between the pre- and post-test. This improvement in self-efficacy was statistically significant (p = 0.001), going from 64.18 ± 20.84 at T1 to 73.73 ± 14.35 at T2. Conclusion: It is important to create an appropriate environment for the adoption of favorable behaviors to healthy bones and to promote health education with political commitment and collaboration with different sectors. [ABSTRACT FROM AUTHOR]

Promoting calcium intake is a cornerstone for osteoporosis management. Some individuals limit dairy product consumption, a major calcium source, due to their high content in saturated fats and their perceived negative impact on lipid profiles. This study explored the associations of calcium from various sources with blood lipids in community-dwelling elderly (n = 717) from the GERICO cohort. Dietary calcium intake was assessed at several timepoints using a validated food frequency questionnaire (FFQ) and calcium supplement use was recorded. Blood lipids were treated as categorical variables to distinguish those with normal and abnormal levels. Increasing total calcium intake was associated with lower risks for high total cholesterol (p = 0.038) and triglycerides (p = 0.007), and low HDL-cholesterol (p = 0.010). Dairy calcium (p = 0.031), especially calcium from milk (p = 0.044) and milk-based desserts (p = 0.039), i.e., low-fat (p = 0.022) and non-fermented (p = 0.005) dairy products, were associated with a lower risk of high total cholesterol. Greater calcium intakes from total dairies (p = 0.020), milk (p = 0.020) and non-fermented dairies (p = 0.027) were associated with a lower risk of hypertriglyceridemia. No association was observed between calcium from non-dairy sources, cheese or high-fat dairies and blood lipids. Increasing calcium through supplements was associated with lower risks for hypertriglyceridemia (p = 0.022) and low HDL-cholesterol (p = 0.001), but not after adjustments. Our results suggest that higher calcium intakes from dietary sources or supplements are not adversely associated with blood lipids in the elderly, whilst total, and particularly low-fat, dairy products are valuable calcium sources potentially related to favorable lipid profiles. [ABSTRACT FROM AUTHOR]

Background: Major reasons for long-term care insurance certification in Japan are stroke, dementia, and fracture. These diseases are reported to be associated with calcium intake. This study examined the association between calcium intake and impaired activities of daily living (ADL) using the data from NIPPON DATA90, consisting of representative sample of the Japanese population. Methods: A population-based nested case-control study was performed. A baseline survey was conducted in 1990, followed by ADL surveys of individuals ≥65 years old in 2000. Individuals with impaired ADL and selected age- and sex-matched controls were then identified. We obtained 132 pairs. Calcium intake was energy-adjusted using the residual method. The association between calcium intake and impaired ADL was examined using conditional logistic regression models. To assess the accuracy of the estimates, we conducted bootstrap analyses. Results: The adjusted odds ratios (ORs) for impaired ADL compared with the group with a calcium intake of

Abstract Background The high prevalence of low bone mass in young women in Japan has emerged as a serious health issue in recent years. Therefore, the aim of the present study was to reevaluate the relationship between genetic and dietary factors, as well as its influence on bone mass in young Japanese women, with particular emphasis on vitamin D receptor (VDR) gene polymorphisms and calcium intake. Methods A total of 499 Japanese women aged 20–24 years were enrolled in the study. The bone mass of the calcaneus was assessed using the quantitative ultrasound method and expressed as the osteo sono-assessment index (OSI). VDR gene polymorphisms (BsmI, TaqI, ApaI, and FokI) were analyzed using DNA extracted from saliva. Calcium intake was assessed using the Food Frequency Questionnaire based on food groups (FFQg) and adjusted with the energy intake. Participants were divided into two groups based on the median calcium intake (250 mg/1000 kcal). Results Consequently, bone mass was significantly different among the BsmI and TaqI genotypes after adjusting for body mass index (BMI) (p = 0.030 and 0.019, respectively). In addition, the BsmI AA and ApaI GT genotypes showed significant differences in bone mass between the calcium-intake groups, with low OSI in the low-calcium intake group and high OSI in the high-calcium intake group, respectively, even after adjusting for BMI (p = 0.020 and 0.038, respectively). Conclusions These findings may prove instrumental in developing a logical approach towards preventing bone loss in young Japanese women.

Nutritional status reflects the level of satisfaction of a person’s physiological needs for nutrients. Adequate consumption of calcium, which is one of the nutrients, is important for individuals of all age groups. However, it is more important for women to take this nutrient at a sufficient level due to their physiological structure. The study was a cross-sectional study conducted on 400 women aged 18-30 years in Ardabil district, Iran. Data were collected using socio-economic and food habits questionnaires. “24-hour recall” was used to determine the food intake status. The daily energy and nutrients consumed were evaluated according to the dietary recommended intake (DRI). The obtained data were evaluated using the SPSS 16.0 statistical computer program. Results showed that the energy and protein intake in urban areas was higher than in rural areas, and these differences were significant respectively (p<0.001, p<0.05). The mean protein intake in urban and rural areas was above the DRI value (46 g/d). Energy, magnesium, zinc and calcium intakes were determined below the DRI value. The difference between women living in urban and rural areas in terms of calcium intake is significant (p<0.001). The difference between the average calcium intake of high school graduate women living in urban and rural areas is significant (p<0.001). This study showed that the amount of calcium intake of women living in urban and rural areas was lower than the recommendations. In addition, calcium intake in rural areas was less than in urban areas, and this difference was significant. [ABSTRACT FROM AUTHOR]

Background: Inadequate osteoporosis education can make patients ill-informed concerning preventive and therapeutic interventions and creates misconceptions and unnecessary concerns about the disease. Aim: Our study aimed to assess whether patients referred to the DXA exam by their general practitioner are informed about risk factors for osteoporosis, comparing patients who received a diagnosis of osteoporosis before the exam with those without this diagnosis. Methods: An observational single-center study was performed among patients who were referred to the DXA exam at the Osteoporosis Service of Marche Nord Hospital (Fano, Italy) between April and July 2019. Socio-demographic and clinical characteristics, awareness of suffering from osteoporosis, femoral and lumbar spine T-score and bone mineral density, risk of fracture and the I-FOOQ score were assessed. Results: A pilot study was carried out to validate the questionnaire in the Italian language (alpha-Cronbach 0.75). After that, a sample of 128 patients was enrolled (response rate 93.3%). Mean age was 66 ± 10.6 years, 95.6% were women. Overall, I-FOOQ mean score was 12 ± 3.5. Age, educational level, menopausal age, body mass index, femoral T-score were not associated with a better knowledge (p > 0.05). A comparison between who know to suffer from osteoporosis and others found no differences (12.2 ± 3.4 and 12 ± 3.5, respectively, p = 0.772). Effect of walking, recommended calcium intake, and familiar predisposition are the less known topics. Conclusion: Patients who undergo the DXA exam are poorly informed about risk factors for osteoporosis, independently of age, education, bone mineral density and risk of fracture. Knowing to suffer from osteoporosis does not increase the likelihood to be informed. It is mandatory to improve the education that is provided to the patients, as there are effective non-pharmacological interventions to prevent and treat osteoporosis. [ABSTRACT FROM AUTHOR]

Objective: Evaluate the prevention behaviors for osteoporosis (OP) in women (physical activity and calcium intake) and their readiness to perform these behaviors. Method: Women aged ≥30 years in four large cities of Mexico were interviewed. The geographical areas were selected randomly and stratified according to socioeconomic status and age. A questionnaire designed to assess OP-related prevention behaviors, as well as attitudes and stages of change of the transtheoretical model toward these behaviors, was used. Results: Eight hundred and six women were interviewed: 4.2% reported diagnosis of osteopenia, 5% of OP, 2.3% had suffered a fracture, and 11.9% had a family history of OP. A large proportion of participants did not do physical activity (56.2%) and did not have the recommended intake of calcium (61.3%). More than 80% of these participants were in lower stages of change (precontemplation and contemplation) for performing physical activity and 86.4% for calcium intake, which means a lack of readiness to change their behaviors. The absence of readiness to change preventive behaviors was related to negative attitudes toward both behaviors (OR = 1.81, 95% CI [1.04, 3.14] physical activity; OR = 3.09, 95% CI [1.81, 5.29] calcium intake). Both of these behaviors were associated with known risk factors for OP. Conclusion: Very high percentage of women are not ready to perform the behaviors necessary to maintain bone health. This phenomenon was not as a result of clinical risk factors for OP but because of the negative attitudes and beliefs of women related to physical activity and calcium intake. [ABSTRACT FROM AUTHOR]

Abstract Objective To describe the calcium concentration of tap and bottled waters from Argentina and to estimate the contribution of drinking water to calcium recommendations. Results Calcium concentrations provided by water authorities ranged from 6 to 105 mg/L. The mean calcium level of samples analysed at the Laboratorio de Ingeniería Sanitaria, National University of La Plata was 15.8 (SD ± 13.2) mg/L and at the Bone Biology Laboratory of the National University of Rosario was 13.1 (± 10.0) mg/L. Calcium values of samples from supply systems and private wells was similar. Most bottled waters had calcium levels well below 50 mg/L. The intake of one litre of drinking water from Argentina could represent in average between 1.2 and 8.0% of the calcium daily values for an adult.

Abstract Background Determining the appropriate preconception care to reduce the occurrence of hypertensive disorder of pregnancy (HDP) remains a challenge in modern obstetrics. This study aimed to examine the association between pre-pregnancy calcium (Ca) intake and HDP in normotensive primiparas. Methods We used data from the Japan Environment Children’s study (JECS), which is the largest birth cohort study. A total of 33,894 normotensive Japanese primiparas were recruited for JECS between January 2011 and March 2014. Participants were categorized into five groups according to pre-pregnancy Ca intake quintiles (Q1 and Q5 were the lowest and highest Ca intake groups, respectively) to compare their basic background and obstetrics outcome. Multiple logistic regressions were performed to identify the effect of pre-pregnancy Ca intake on HDP, early onset HDP, and late-onset HDP, using Ca intake thresholds of 500, 550, 650, 700, 1000, 1500, and 1500 mg. Results We found significant differences in maternal background among the Ca intake groups; in particular, there were more participants with low socioeconomic status, indicated by low education level and low household income, and smokers in the lowest Ca intake group. Multiple logistic regression did not show any significant difference with regard to HDP, early onset HDP, and late-onset HDP in each Ca intake threshold. Conclusions Despite considerable recommendations concerning Ca intake for women of reproductive age, the present study indicates that pre-pregnancy Ca intake was not associated with an increased risk of new-onset hypertension among primiparas during pregnancy. Further studies examining the effect of other pre-pregnancy dietary factors on obstetric outcomes should be considered in the formulation of earlier preventive strategies for primiparas.

Introduction Osteoporosis, a disease associated with ovarian hormone deficiency following menopause, is the most common cause of age-related bone loss. Although an optimal intake of Ca is vital – both bone accretion during growth and maintenance in adult life – a great percentage of the population consumes far below the recommended amounts of this mineral. On the other hand, there are evidences that fructans enhance not only Ca absorption, but bone calcium as well. Objective In the knowledge that estrogen deficiency and insufficient Ca in the diet during postmenopause cause serious problems with resultant osteoporosis, the aim of this study is to assess the effects of a diet enriched in fructan-containing sources alone, or in the “strawberry matrix”, on the structure of bone in OVX rats under calcium hypoalimentation. Material and methods Experimental animals were female Wistar rats, sham-operated or ovariectomized. The treatment with Ca-restricted diets also contained one of the sources of fructan (Jerusalem artichoke, yacon, Beneo Orafti Synergy1), in the amount providing 8% of fructans. Femur architecture of rats was assessed by tomography and Ca content by the AAS method. Results Ovariectomy led to a significant decrease in femoral Ca content, total mineral content and bone density of rats. This study shows that a diet containing inulin-type fructan (especially as a component of strawberry product) improved bone quality (i.e. increase in Ca content in femur, total density in middle part of bone, as well as decrease of endosteal circumference) in OVX rats under calcium hypoalimentation. Conclusions These findings suggest that a fructan-enriched diet could be potentially useful for postmenopausal osteoporosis. It is important to determine an optimal dietary level of fructan with the long-term goal of developing a dietary strategy in osteoporosis prevention.

Elderly people, especially those who live in nursing homes, are at high risk for getting osteoporosis and bone fractures. Knowing that an adequate calcium intake is important for prevention and therapy of osteoporosis, we aimed to estimate calcium intake in old people living in nursing homes in Zagreb. In a cross-sectional study, calcium intake was estimated using previously validated food frequency questionnaire especially designed for calcium intake, among 292 nursing homes residents (232 women and 60 men), mean age 82.4±6.5 years. Mean dietary calcium intake in men was 653±297 mg/day and in women 528±279 mg/day (p=0.004). Only 10 % of women and no men were taking calcium supplements. Calcium intake below the 750 mg/day was present in 67.3 % of men and 77.5 % of women. Very low calcium intake, below the half of the recommended value, was present in 18.3 % of men and 31.0 % of women. Milk and dairy products were the main source of calcium intake in our study and contributed more than 80% of total daily calcium intake. No significant correlation was found between the body mass index and calcium intake in both genders. We conclude that the mean calcium intake in nursing home residents was below the recommended values.

We estimated the percentage and number of all incident cancer cases diagnosed in Texas in 2015 that were attributable to inadequate diet and examined for racial/ethnic differences. We calculated population attributable fractions for cancers with a causal relationship with red and processed meat consumption, insufficient fiber intake, and insufficient calcium intake, using prevalence estimates from the National Health and Nutrition Examination Survey and relative risk estimates from the World Cancer Research Fund/American Institute for Cancer Research 2018 Third Expert Report. Overall, 3.3% of all new cancers (3,428 cases) diagnosed in Texas in 2015 were attributable to inadequate diet. More diet-associated cancers were diagnosed in men (3.8%) than women (2.9%). Insufficient fiber intake (1.2%) contributed more cancers than processed meat consumption (1.0%), insufficient calcium intake (0.8%), and red meat consumption (0.4%). Non-Hispanic Blacks (4.4%) had a higher proportion of cancers attributable to inadequate diet than Hispanics (3.7%) and non-Hispanic Whites (3.1%). Considering only colorectal cancers, inadequate diet caused 39.6% of cases in non-Hispanic Blacks, compared to 33.6% in non-Hispanic Whites and 33.4% in Hispanics. Inadequate diet serves as an important but preventable source of cancer. In general, and for minority populations specifically, cancer prevention programs should continue to advocate for universal compliance with recommended dietary guidelines.

Background: Improved bone health during adolescence can have lifelong implications, reducing the risk of bone fragility., Objective: This study aims to evaluate the effectiveness of an e-book in increasing knowledge about and promoting healthy practices related to bone health among Malay adolescents in Kuala Lumpur, Malaysia., Methods: A total of 72 adolescents (female: n=51, 71%; age: mean 15, SD 0.74 y) were recruited from selected secondary schools. The participants answered a pretest web-based questionnaire on sociodemographic data, knowledge about osteoporosis, and physical activity. A video call was conducted to assess dietary calcium intake. Participants were provided with a link to an e-book on bone health and instructed to read it within 2 weeks. Postintervention assessments included those for knowledge, physical activity, dietary calcium intake, and acceptance of the e-book., Results: There was a significant increase in the median knowledge score, which was 40.6% (IQR 31.3%-46.9%) during the pretest and 71.9% (IQR 53.9%-81.3%) during the posttest (P<.001). However, no changes were observed in dietary calcium intake or physical activity levels. Most participants did not meet the recommended calcium requirements (61/62, 98%) and exhibited sedentary behavior (pretest: 51/62, 82%; posttest: 48/62, 77%). The e-book, however, was well accepted, with the majority reporting that they understood the contents (70/72, 97%), liked the graphics (71/72, 99%), and approved of the layout (60/72, 83%) and font size (66/72, 92%) used., Conclusions: The developed e-book effectively increases knowledge levels related to bone health and is well accepted among participants. However, this educational material did not improve bone health practices. Additional strategies are necessary to bridge the gap between knowledge and behavior change., (© Nor Aini Jamil, Jashwiny Dhanaseelan, Nurin Athirah Buhari. Originally published in JMIR Pediatrics and Parenting (https://pediatrics.jmir.org).)

Background: People who are at risk of either cow milk allergies or lactose intolerance may need to avoid consuming milk and milk products, which are well-known abundant sources of calcium (Ca). This limitation in calcium intake could affect bone health. Currently, there is limited knowledge on the impact of avoiding the consumption of milk and milk products on the daily Ca intake and bone mineral density (BMD) of people at risk of cow milk allergies. This study aimed to investigate the differences between the amount of Ca intake and BMD values between people who are at risk of cow milk allergies and those who are not., Methods: A total of 80 participants were recruited, and further divided into two groups, the at-risk cow milk allergies (AR) group ( n  = 40) and the normal (NOR) group, using the cow milk allergies and lactose intolerance screening questionnaire. The anthropometric assessment, body composition analyses, 3-day dietary record, and bone mass density (wrist and ankle bones) measurement of all participants were collected using the dual x-ray absorptiometry (DEXA) technique to compare the differences of variables between the two groups., Results: The participants in the AR group presented a significantly lower amount of Ca intake (317 mg/day) than those in the NOR group (623 mg/day) ( p  < 0.05). The bone mineral density (BMD) parameters indicated that the NOR group presented significantly higher T-scores and BMD values of the wrist (T-score = -0.27 and BMD = 0.57 g/cm2) and ankle (T-score = -0.01 and BMD = 0.59 g/cm2) bones when compared with the AR group (T-score = -1.96 and BMD = 0.48 g/cm2 for the wrist bone, and T-score = -1.18 and BMD = 0.47 g/cm2 for the ankle bone) ( p  < 0.05). In addition, the results indicated significantly positive correlations between the amount of Ca intake and the T-scores and BMD values of both the wrist and ankle bones among all participants ( p  < 0.05)., Conclusion: In this responding sample, participants at risk of cow milk allergies experienced a significantly negative impact on the amount of Ca intake and BMD values. Professionals in nutrition and dietetics should provide nutrition education and strategies that can enhance the Ca intake among this population to help them meet the daily Ca intake recommendation, ultimately leading to better bone health., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Kongpharm, Nakklay, Kongtong, Tanapumchai, Prapkree, Rueangsri and Singhato.)

Three recently-completed, large clinical trials in the U.S, New Zealand, and Australia, referred to herein as the 'mega-trials', were conducted to determine the impact of supplemental vitamin D on a variety of outcomes including falls and fractures. The trials were similar in design and collectively included over 50,000 generally vitamin D replete, older men and women. The mega-trials established that vitamin D supplementation with the equivalent of 2000 to 3300 IU/d of vitamin D 3 had no favorable effect on risk of falls or fractures. This review focuses on specific design elements of the trials and how they likely influenced these trial findings. While these trials were in progress, evidence emerged that circulating 25-hydroxyvitamin D levels have a U-shaped association with risk of falling, raising concern about a potential untoward effect of high dose supplementation. There is compelling evidence that in older, vitamin D- and calcium-insufficient nursing home residents, the combination of vitamin D and calcium in modest replacement doses dramatically reduces the risk of hip and other fractures. Community-dwelling older adults in many populous countries around the globe have widespread vitamin D and calcium insufficiency. It is time to follow the evidence trail and determine the effect of vitamin D and calcium replacement on their risk of falls and fractures., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author.)

Introduction: Adolescence is a critical period for the accrual of bone mass. However, few studies have assessed the bone geometry in slum-dwelling girls/young women. We thus conducted this study: (1) to assess bone health in Indian adolescent girls and young women residing in slum vs nonslum (NS) areas and (2) to identify factors associated with poor bone health., Methods: This cross-sectional case-control study was performed on 110 apparently healthy unmarried, nonpregnant, nonlactating, postmenarchal adolescent girls and young women aged 11 to 24 years residing in urban slums with the same number of age-matched controls from NS areas. Anthropometric, dietary, physical-activity and bone-health parameters (using dual-energy X-ray absorptiometry and peripheral quantitative computed tomography-DXA and pQCT-respectively) were evaluated using standard protocols. A P value of < 0.05 was considered statistically significant., Results: Slum girls were significantly shorter and lighter and had lower dietary intakes of calcium and protein after adjusting for total daily calorie intake than NS girls ( P < 0.05). Areal bone-mineral density (BMD) at lumber spine (0.940 ± 0.13 vs1.042 ± 0.15 g/cm 2 ), femur and total body (less-head), bone-mineral apparent density adjusted for volume at the lumbar spine (0.295 ± 0.04 vs 0.319 ± 0.04 g/cm 3 ) and height-adjusted bone density at femur (0.862 ± 0.011 vs 0.905 ± 0.011 g/cm 2 ) were significantly lower in slum dwelling participants as compared to their NS counterparts ( P < 0.05). After adjusting for confounders like sunlight exposure, anthropometric parameters and dietary calcium intake, area of dwelling was still a significant factor for the difference in BMD., Conclusions: The potential determinants of poor bone density and geometry in girls and young women residing in slums include residential location, dietary habits, and physical activity levels. Despite adjustments for confounding factors, differences in bone health between those in slum and nonslum areas suggest adaptations developed over generations of deprivation in these individuals, necessitating urgent intervention., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Indian Journal of Endocrinology and Metabolism.)

The relationship between calcium intake and bone strength in older Asian individuals, including Japanese, is controversial; therefore, we herein investigated this relationship in older Japanese populations. We performed a cross-sectional analysis of 314 participants older than 65 years who voluntarily participated in a medical examination and responded to questionnaires. The osteo-sono assessment index (OSI) measured at the right calcaneus using a quantitative ultrasonic device was used as an indicator of bone strength. The daily dietary intake of calcium was assessed using a brief-type self-administered diet history questionnaire. A two-way analysis of covariance revealed a significant interaction between sex and calcium intake on the OSI (p < 0.01). A multiple regression analysis showed a positive correlation between calcium intake and the OSI in males (p < 0.01), but not females (p = 0.27). In females, grip strength divided by body weight positively correlated with the OSI (p = 0.04). The present results suggest that a higher calcium intake contributes to bone strength in older Japanese males. Although a higher grip strength may contribute to bone strength in females, the potential of estrogen as a confounding factor needs to be considered.