Effect of calcium supplementation on bone mineral content and calcium absorption in Chinese children with habitually low calcium intake.

by Warren Tak-keung Lee.
Thesis (Ph.D.)--Chinese University of Hong Kong, 1995.
Includes bibliographical references (leaves 161-186).
Chapter CHAPTER 1: --- INTRODUCTION --- p.1
Chapter 1.1 --- Background --- p.1
Chapter 1.2 --- Objectives --- p.3
Chapter CHAPTER 2: --- LITERATURE REVIEW --- p.4
Chapter 2.1 --- Calcium intakes of Hong Kong Chinese: past and present --- p.4
Chapter 2.1.1 --- Adults --- p.4
Chapter 2.1.2 --- Children --- p.5
Chapter 2.2 --- Calcium Metabolism --- p.6
Chapter 2.2.1 --- Calcium and bone mass --- p.9
Chapter 2.2.2 --- Ethnicity and bone mass --- p.9
Chapter 2.2.3 --- Physical activity and bone mass --- p.10
Chapter 2.2.4 --- Hormonal control of calcium metabolism --- p.11
Chapter 2.2.5 --- Intestinal calcium absorption --- p.14
Chapter (1) --- Calcium transport across the intestine
Chapter (2) --- Active Calcium Transport
Chapter (3) --- Passive calcium transport
Chapter (4) --- Age and calcium absorption
Chapter 2.2.6 --- Dietary components in relation to calcium bioavailability and absorption --- p.17
Chapter (1) --- Habitual calcium intake
Chapter (2) --- Vitamin D nutritional status
Chapter (3) --- Protein
Chapter (4) --- Phosphorous and Ca:P ratio
Chapter (5) --- Sodium
Chapter (6) --- Lactose
Chapter (7) --- Glucose and Glucose Polymers
Chapter (8) --- Phytate
Chapter (9) --- Oxalate
Chapter (10) --- Plant estrogen (phyto-estrogen)
Chapter 2.2.7 --- Bioavailability from calcium salts --- p.23
Chapter 2.3 --- Calcium intakes and requirements --- p.25
Chapter 2.3.1 --- Calcium requirements in adulthood --- p.28
Chapter 2.3.2 --- Calcium requirements in childhood --- p.29
Chapter 2.3.3 --- Manifestation of calcium deficiency in children --- p.30
Chapter 2.4 --- Assessment of Dietary Intakes --- p.32
Chapter 2.4.1 --- Food weighing method --- p.32
Chapter 2.4.2 --- Food Recording method --- p.34
Chapter 2.4.3 --- 24-hour dietary recall --- p.35
Chapter 2.4.4 --- Food frequency method --- p.36
Chapter 2.4.5 --- Dietary history method --- p.38
Chapter 2.4.6 --- Chemical analysis of duplicate meals --- p.39
Chapter 2.4.7 --- Photographic method --- p.40
Chapter 2.4.8 --- Selecting suitable methods for the present study --- p.40
Chapter 2.5 --- Food composition database --- p.41
Chapter 2.6 --- Evaluation of bone mass in vivo --- p.43
Chapter 2.6.1 --- Single photon absorptiometry --- p.44
Chapter 2.6.2 --- Dual photon absorptiometry --- p.46
Chapter 2.6.3 --- Dual energy X-ray absorptiometry --- p.47
Chapter 2.6.4 --- Quantitative computerized tomography --- p.47
Chapter 2.6.5 --- The techniques selected to quantify bone mass in the present study --- p.48
Chapter 2.7 --- Measurement of intestinal calcium absorption --- p.49
Chapter 2.7.1 --- Metabolic balance study --- p.49
Chapter 2.7.2 --- Isotopic techniques (radioisotope or stable isotope) --- p.50
Chapter (1) --- Radio isotope vs stable isotope
Chapter (2) --- The single-label isotope technique
Chapter (3) --- The double-label isotope technique
Chapter (4) --- "Preparation of stable isotopes for human study, and determination of stable isotopes in body fluids"
Chapter (I) --- Dosage considerations
Chapter (II) --- Intrinsic or Extrinsic labelling
Chapter (III) --- Oral and intravenous administration of isotopes
Chapter 2.7.3 --- The technique selected to determine calcium absorption in the present study --- p.60
Chapter 2.8 --- Mass spectrometry --- p.60
Chapter 2.8.1 --- Thermal ionization mass spectrometry --- p.60
Chapter 2.8.2 --- Fast atom bombardment mass spectrometry --- p.61
Chapter 2.8.3 --- Inductively coupled plasma mass spectrometry --- p.61
Chapter 2.8.4 --- Electron impact mass spectrometry and Gas chromatography mass spectrometry --- p.62
Chapter 2.8.5 --- Neutron activation analysis --- p.62
Chapter 2.8.6 --- The type of mass spectrometry used to determine stable isotopic ratios in the present study --- p.63
Chapter 2.9 --- Assessment of physical activity in children --- p.63
Chapter 2.9.1 --- Activity questionnaire or record --- p.64
Chapter 2.9.2 --- Direct measurement of physical activity --- p.65
Chapter (1) --- Accelerometer
Chapter (2) --- Pedometer
Chapter (3) --- Actometer
Chapter (4) --- Video-recording
Chapter (5) --- Heart-rate recording
Chapter 2.9.3 --- Selection of a suitable physical activity assessment method --- p.67
Chapter CHAPTER 3 --- RANDOMIZED DOUBLE-BLIND CONTROLLED CALCIUM SUPPLEMENTATON TRIALS IN RELATION TO BONE AND HEIGHT ACQUISITION IN 7-YEAR OLD CHINESE CHILDREN FROM JIANGMEN (CHINA) AND HONG KONG --- p.71
Chapter 3.1 --- Chapter summary --- p.71
Chapter 3.2 --- Chapter Introduction --- p.72
PART I --- p.73
Chapter 3.3 --- Double-blind Controlled Randomized Calcium Supplementation and Bone and Height Acquisition in Chinese Children Accustomed to Mean Calcium Intake at About 300mg/d --- p.73
Chapter 3.3.1 --- Introduction --- p.73
Chapter 3.3.2 --- Objectives --- p.74
Chapter 3.3.3 --- Subject and Methods --- p.74
Chapter 3.3.4 --- Results --- p.81
Chapter 3.3.5 --- Discussions --- p.83
Chapter 3.3.6 --- Conclusion --- p.84
PART II --- p.84
Chapter 3.4 --- Randomized double-blind controlled calcium supplementation in relation to bone mineral accretion and height increment of Hong Kong Chinese children --- p.84
Chapter 3.4.1 --- Introduction --- p.84
Chapter 3.4.2 --- Objectives --- p.85
Chapter 3.4.3 --- Subjects and Methods --- p.85
Chapter 3.3.4 --- Results --- p.91
Chapter 3.4.5 --- Discussions --- p.95
Chapter 3.4.6 --- Conclusion --- p.97
Chapter 3.5 --- Comparisons of the two calcium supplementation trials from Jiangmen and Hong Kong --- p.97
Chapter 3.6 --- Chapter Discussions --- p.99
Chapter 3.7 --- Chapter Conclusion --- p.103
Chapter CHAPTER 4 --- TRUE FRACTIONAL CALCIUM ABSORPTION OF CHINESE CHILDREN AND THE EFFECTS OF DOUBLE-BLIND CONTROLLED CALCIUM SUPPLEMENTATION ON CALCIUM ABSORPTION IN CHILDREN MEASURED WITH STABLE ISOTOPES (42Ca and 44Ca) --- p.117
Chapter 4.1 --- Chapter summary --- p.117
Chapter 4.2 --- Chapter introduction --- p.118
PART I --- p.119
Chapter 4.3 --- True fractional calcium absorption in Chinese children measured with stable isotopes (42Ca and 44Ca) --- p.119
Chapter 4.3.1 --- Introduction --- p.119
Chapter 4.3.2 --- Objectives --- p.120
Chapter 4.3.3 --- "Subjects, Materials and Methods" --- p.120
Chapter 4.3.4 --- Results --- p.127
Chapter 4.3.5 --- Discussions & Conclusion --- p.131
Part II --- p.131
Chapter 4.4 --- Effects of double-blind controlled calcium supplementation on calcium absorption in Chinese children measured with stable isotopes (42Ca and 44Ca) --- p.131
Chapter 4.4.1 --- Introduction --- p.131
Chapter 4.4.2 --- Objective --- p.132
Chapter 4.4.3 --- "Subjects, Materials and Methods" --- p.132
Chapter 4.4.4 --- Results --- p.135
Chapter 4.4.5 --- Discussions --- p.137
Chapter 4.4.6 --- Conclusion --- p.139
Chapter 4.5 --- Chapter Conclusion and Discussions --- p.140
Chapter CHAPTER 5 --- GENERAL DISCUSSIONS AND RECOMMENDATIONS FOR FURTHER STUDY --- p.156
Chapter 5.1 --- Ethnic differences in bone acquisition and calcium absorption --- p.156
Chapter 5.2 --- Calcium requirements for Chinese children --- p.157
Chapter 5.3 --- Indications for further studies --- p.158
REFERENCES --- p.161
APPENDIXES
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