Racial differences in skeletal calcium retention in adolescent girls with varied controlled calcium intakes

BACKGROUND: Higher bone mass in blacks than in whites has been related to greater calcium utilization efficiency. Dietary calcium requirements for maximal skeletal calcium accretion during puberty may differ between the races. OBJECTIVE: This study compared the relation between calcium intake and calcium retention in black and white adolescent girls. DESIGN: A range of controlled calcium intakes (760-1981 mg Ca/d) were used in 3-wk controlled balance studies. Some subjects were studied more than once; a total of 182 observations from 55 black girls and 66 white girls were analyzed. RESULTS: Blacks had 185 +/- 32 mg/d greater mean skeletal calcium retention than did whites (P < 0.0001) at all calcium intakes as a result of significantly greater net calcium absorption (P < 0.001) and lower calcium excretion (P < 0.0001). CONCLUSIONS: Dietary calcium requirements did not differ with race. Higher calcium retention at all calcium intakes during adolescence may underlie the higher bone mineral content of adult blacks than of adult whites.     

山东省农村育龄妇女代表性膳食下铁、锌、钙吸收率分析

目的:研究山东省农村育龄妇女代表性膳食下铁、锌、钙的吸收率,以及膳食因素对它们吸收利用的影响。方法:用代谢平衡法,使用原子吸收分光光度计(AAS)测定膳食与粪便的铁、锌、钙,计算铁、锌、钙的吸收率。同时测定影响铁、锌、钙吸收的因子:膳食脂肪、蛋白、植酸、纤维素和VitC的含量,计算日平均摄入量,将其结果与我国育龄妇女每日推荐膳食营养素摄入量(RNI)进行比较。结果:铁、锌、钙的吸收率分别为8·26%、21·48%、47·94%,铁的平均日摄入量为13·77mg,占RNI的68·85%,远低于推荐量,锌的平均日摄入量为15·43mg,占RNI的102·87%,高于推荐量,钙的平均日摄入量为409·38mg,占RNI的51·17%,远低于推荐量。蛋白质和VitC的日摄入量分别为65·70g与34·20mg,占RNI的82·12%~109·50%和34·20%,低于推荐量。脂肪、植酸和膳食纤维的摄入量较高。结论:在蛋白质和抗坏血酸的日摄入量较低,脂肪、植酸和膳食纤维的摄入量较高的条件下,铁吸收率较低,铁营养缺乏,锌营养尚可,钙摄入量显著低于RNI,显示钙摄入严重不足。     

Calcium requirements: new estimations for men and women by cross-sectional statistical analyses of calcium balance data from metabolic studies

BACKGROUND: Low intakes of calcium are associated with an increased risk of both osteoporosis and cardiovascular disease. OBJECTIVE: To provide new estimates of the average calcium requirement for men and women, we determined the dietary calcium intake required to maintain neutral calcium balance. DESIGN: Calcium balance data [calcium intake -(fecal calcium + urinary calcium)] were collected from 155 subjects [women: n = 73; weight: 77.1 +/- 18.5 kg; age: 47.0 +/- 18.5 y (range: 20-75 y); men: n = 82; weight: 76.6 +/- 12.5 kg; age: 28.2 +/- 7.7 y (range: 19-64 y)] who participated in 19 feeding studies conducted in a metabolic unit. Balance data from the final 6-12 d of each dietary period (minimum length:18 d) of each study (1-9 observations per subject) were analyzed. Data were excluded if individual intakes of magnesium, copper, iron, phosphorus, or zinc fell below the estimated average requirements or exceeded the 99 th percentile of usual intakes from the 1994 Continuing Survey of Food Intakes by Individuals (for iron, above the upper limit). Daily intakes of calcium ranged between 415 and 1740 mg. The relation between intake and output was examined by fitting random coefficient models. Coefficients were included to test for sex and age differences. RESULTS: The models predicted a neutral calcium balance [defined as calcium output (Y) equal to calcium intake (C)] at intakes of 741 mg/d [95% prediction interval (PI): 507, 1035; Y = 148.29 + 0.80C], 9.4 mg kg body wt(-1) d(-1) [95% PI: 6.4, 12.9; Y = 1.44 + 0.85C], or 0.28 mg kcal(-1) d(-1) [95% PI: 0.19, 0.38; Y = 0.051 + 0.816C]. Neither age nor sex affected the estimates when calcium intakes were expressed as mg/d or as mg kg body wt(-1) d(-1). CONCLUSION: The findings suggest that the calcium requirement for men and women is lower than previously estimated.     

Determination of the optimal number of dairy servings to ensure a low prevalence of inadequate calcium intake in Americans

BACKGROUND: Many Americans are not getting the recommended amounts of calcium in their diet. Since dairy foods provide most of the calcium in the diet, the number of recommended servings of dairy products may need to be revised. OBJECTIVE: 1. To determine the calcium intake of various age groups that met or exceeded the intake of dairy products recommended by the Food Guide Pyramid (FGP). 2. To determine the optimal level of dairy consumption that ensures a low prevalence of inadequate calcium (Ca) intake by Americans. METHODS: Using data from the Continuing Survey of Food Intake by Individuals, 1994-96, 1998, (CSFII) and the National Health and Nutrition Examination Survey, 1999-2000 (NHANES) we determined the calcium intake in individuals who met the recommended daily dairy servings as well as the minimum number of dairy servings required for the mean Ca intake of various age groups to exceed their respective Adequate Intakes (AI). RESULTS: Objective 1: Meeting or exceeding the FGP dairy recommendation led to calcium intakes that met recommended levels. However, very few individuals in all age groups met or exceeded the number of dairy servings recommended by FGP. Objective 2: Results indicated that in children 2-8 yrs, 2 dairy servings/d were required for the mean Ca intake (835 +/- 72 and 822 +/- 68 mg/d, in CSFII and NHANES IV, respectively) to exceed the AI. In children 9-18 yrs, 4 dairy servings/d) were required for the mean Ca intake of the group (1540 +/- 93 and 1518 +/- 86 mg/d) to exceed the AI. Similar data were observed in adults 19+ yrs, e.g., in adults 51+ yrs, 3 dairy servings/d were required for the mean Ca intake of the group (1241 +/- 53 and 1217 +/- 53 mg/d) to exceed the AI. CONCLUSION: Groups that met or exceeded the FGP dairy recommendations were more likely to have a mean calcium intake above the AI but had an average intake of about one serving higher than current recommendations. In individuals 9 yrs and older, 3-4 servings of dairy products are needed to meet or exceed the Ca AI and to ensure a low prevalence of inadequate Ca intake.     

Dietary protein and phosphorus do not affect calcium absorption

BACKGROUND: Variation in absorption efficiency explains more of the variability in calcium balance than does actual calcium intake. Several investigators have suggested that the relatively high phosphorus and protein intakes of the diets of industrialized nations reduce calcium absorption and thereby aggravate the problem of calcium deficiency. OBJECTIVE: My objective was to test whether variation in phosphorus and protein intakes is associated with variation in calcium absorption. DESIGN: One hundred ninety-one Roman Catholic nuns aged 48.7 +/- 7.0 y were studied approximately 3 times each over a >20-y period with a full metabolic balance regimen; controlled, chemically analyzed diets; and double-tracer measurement of calcium absorption. RESULTS: Although the expected associations with absorption were found for age, calcium intake, and estrogen status, no association was observed for intakes of either phosphorus or protein. CONCLUSION: Phosphorus and protein intakes do not contribute to the wide variability in calcium absorption efficiency.     

Effects of an oxalate load on urinary oxalate excretion in calcium stone formers.

OBJECTIVE: To investigate the oxalate intake and the effect of an oxalate load on urinary oxalate excretion in calcium stone-forming (CSF) patients. DESIGN: Prospective study. SETTING: University-affiliated outpatient Renal Lithiasis Unit. Patients and controls: Seventy (70) CSF and 41 healthy subjects (HS) collected a 24-hour urine sample and were submitted to a 3-day dietary record to determine mean oxalate (Ox), calcium (Ca) and vitamin C intake. Fifty-eight (58) CSF patients were randomly selected to receive milk (N = 28) or dark (N = 30) chocolate as an oxalate load. INTERVENTION: Administration of either milk (94 mg Ox + 430 mg Ca) or dark chocolate (94 mg Ox + 26 mg Ca) for 3 days. A 24-hour urine sample was obtained before and after the load to determine calcium, oxalate, sodium, potassium, urea, and creatinine. MAIN OUTCOME MEASURE: Oxalate intake and excretion. RESULTS: CSF patients presented mean Ox intake of 98 +/- 137 mg/d, similar to that of HS (108 +/- 139 mg/d). Mean Ox and vitamin C intake was directly correlated with Ox excretion only in CSF. The consumption of dark chocolate induced a significant increase in mean urinary Ox (36 +/- 14 versus 30 +/- 10 mg/24 hr) not observed in the milk chocolate group. Thus, a 2-fold increase in Ox intake in this population of CSF patients produced a significant 20% increase in oxaluria, not observed when Ca was consumed simultaneously. CONCLUSION: The present study suggests that even small increases in Ox intake affect oxalate excretion and the mitigation of urinary oxalate increase by Ca consumption reinforces that Ca and Ox intakes for CSF patients should be in balance. Further studies are necessary to assess whether or not a 20% increase in oxaluria will lead to a higher risk of stone formation.     

Dietary calcium intakes of urban children at risk of lead poisoning.

Dietary calcium is well known to decrease gastrointestinal lead absorption and thereby reduce the risk for lead poisoning. Because children in economically deprived urban centers are especially likely to have excessive lead exposure, we surveyed dietary calcium intakes of 314 children from the greater Newark, New Jersey, area. The areas of Newark and adjacent communities studied had been previously identified as containing significant sources of environmental lead by geographic information systems technology. An abbreviated National Cancer Institute Health Habits and History Questionnaire, modified to focus on foods high in calcium, was used to determine dietary calcium. Calcium intakes were then compared to the new Dietary Reference Intake (DRI) guidelines. The respondents were primarily the parents of African-American and Hispanic children ranging in age from 1 to 8 years, with a mean age of 3.5 years. The most recent blood lead concentration was 11.4 +/- 0.8 microg/dL (mean +/- standard error), and 48.6% had concentrations at or above the current guideline of 10 microg/dL. Quintiles of calcium intake were: 221 +/- 13; 488 +/- 9; 720 +/- 6; 885 +/- 6; and 1,389 +/- 49 mg/day. Fifty-five of 175 (31.4%) children aged 1-3 years had calcium intakes below the DRI, as did 82 of 139 (59.0%) children aged 4-8 years. The percentage of mothers reporting lactose intolerance in their children was 2.5%. The observation that the children in the highest quintile easily exceeded the DRIs for calcium suggests that urban parents who include dairy foods in their childrens' meals can provide a diet that meets the DRI guidelines. Children in the lowest quintiles are at risk of increased absorption of the environmental lead to which they are inevitably exposed, as well as other problems associated with a low intake of dietary calcium. The data suggest that both lead exposure and low dietary calcium continue to pose significant health risks to urban minority children.     

12～14岁男童体内强化去植酸豆粉中钙铁锌的吸收利用率研究

目的　为了解我国少年儿童对豆粉、去植酸豆粉和牛奶中钙、铁、锌的吸收利用率 ,通过普及饮用豆粉 ,改善我国居民蛋白质和矿物质的营养状况提供理论依据。方法　选择 57名 1 2～ 1 4岁男童 ,按年龄、身高、体重和血红蛋白含量匹配 ,分成 3组 ,分别给予强化豆粉、强化去植酸豆粉和强化牛奶 2 2 0ml,其中含钙 2 70mg、铁 4mg、锌 4mg。给予受试者用稳定性核素4 4Ca、58Fe和70 Zn标记的受试物 ,以亮蓝和镝标记粪便 ,收集粪便样品 ,测量强化去植酸豆粉、豆粉和强化牛奶中钙、铁、锌的吸收率 ;使用热离子化质谱法测定粪便中4 4Ca含量 ;应用感应耦合等离子质谱法测定粪便中58Fe和70 Zn的丰度及镝的含量 ,计算铁、锌的表观吸收率 ,并以镝的回收率进行校正。结果　豆粉组、牛奶组和去植酸豆粉组的铁吸收率分别为 (6 7± 3 8) %、(1 5 5± 9 2 ) %和 (2 0 6± 7 3) % ,钙吸收率分别为 (43 5±1 0 7) %、(64 2± 1 1 4) %和 (50 9± 6 6) % ,锌吸收率分别为 (1 1 3± 6 5) %、(31 2± 1 0 4) %和 (2 0 1±7 4) %。强化豆粉经去除植酸处理后 ,钙、铁、锌的吸收率显著高于未去植酸的豆粉 ;牛奶中钙和锌的吸收率高于去植酸强化豆粉 ;经去除植酸处理后的豆粉中铁吸收率高于牛奶 ,但差异无显著性。我国儿童由于     

Dietary calcium, phytate, and zinc intakes and the calcium, phytate, and zinc molar ratios of the diets of a selected group of East African children

Dietary zinc, calcium, and phytate intakes of 66 rural Malawian children aged 4-6 y were determined during three seasons on the basis of weighed food records and analyzed food composition data. Height and weight measurements were also recorded and hair samples were collected for zinc analysis. Seasonal daily zinc, calcium, and phytate intakes of females ranged from 6.2 +/- 1.7 to 6.8 +/- 2.1 mg (mean +/- SD), from 335 +/- 170 to 401 +/- 257 mg, and from 1621 +/- 660 to 1729 +/- 592 mg, respectively and, for males, 7.0 +/- 1.7 to 8.0 +/- 2.3 mg, 342 +/- 164 to 473 +/- 310 mg, and 1857 +/- 530 to 2161 +/- 684 mg, respectively. Cereals provided greater than 42% of dietary zinc. Seasonal mean molar ratios of phytate to Zn and Ca x phytate to Zn [per 1000 kcal (4.2 MJ)] and the median Ca to phytate molar ratio ranged from 24 to 27, 151 to 188 mmol/1000 kcal (4.2 MJ), and 3.1 to 3.4, respectively. Over 78% of the children consumed diets with phytate-to-Zn and Ca x phytate.Zn-1 . 1000 kcal-1 molar ratios above values suggested to jeopardize zinc status. Correlations between hair zinc, phytate-to-Zn, and Ca x phytate.Zn-1 . 1000 kcal-1 molar ratios suggest that high phytic acid intakes may compromise zinc status in these children.     

Randomized trial of calcium glycerophosphate-supplemented infant formula to prevent lead absorption.

BACKGROUND: Although additional dietary calcium is recommended frequently to reduce the risk of lead poisoning, its role in preventing lead absorption has not been evaluated clinically. OBJECTIVE: The objective was to determine the safety and to estimate the size of the effect of calcium- and phosphorus-supplemented infant formula in preventing lead absorption. DESIGN: One hundred three infants aged 3.5-6 mo were randomly assigned to receive iron-fortified infant formula (465 mg Ca and 317 mg P/L) or the same formula with added calcium glycerophosphate (1800 mg Ca and 1390 mg P/L) for 9 mo. RESULTS: There was no significant difference between groups in the mean ratio of urinary calcium to creatinine, serum calcium and phosphorus, or change in iron status (serum ferritin, total iron binding capacity). At month 4, the median (+/-SD) increase from baseline in blood lead concentration for the supplemented group was 57% of the increase for the control group (0.04 +/- 0.09 compared with 0.07 +/- 0.10 micromol/L; P = 0.039). This effect was attenuated during the latter half of the trial, with an overall median increase in blood lead concentration from baseline to month 9 of 0.12 +/- 0.13 micromol/L for the control group and 0.10 +/- 0.18 micromol/L for the supplemented group (P = 0.284). CONCLUSIONS: Supplementation did not have a measurable effect on urinary calcium excretion, calcium homeostasis, or iron status. The significant effect on blood lead concentrations during the first 4 mo was in the direction expected; however, because this was not sustained throughout the 9-mo period we cannot conclude that the calcium glycerophosphate supplement prevented lead absorption in this population.     

12～17岁少年钙代谢实验研究

目的通过钙代谢平衡实验探讨中国青春期少年的钙参考摄入量。方法从320名参与1年补钙实验4组12～17岁的少年中,每组随机抽取男、女生各10人,共80人。采用钙代谢平衡实验的方法。实验期共10d,膳食适应3d后,开始7d的代谢试验。收集研究对象试验期内摄入的食品、排出的粪便和尿液样品,用电感耦合等离子体发射光谱法测定样品中的钙含量。结果不同水平钙摄入组间的钙吸收量、粪钙排出量、钙储留量存在差异。钙表观吸收率女生平均为46.4%,男生68.7%。进行曲线拟合后,男生钙吸收率最高时的钙摄入量为665mg/d,女生钙吸收率达到平台时的钙摄入量为650mg。为了达到每日最大储留量,男生钙摄入量要达到545mg/d,女生要达到1055mg/d。结论中国12～17岁男生和女生的钙适宜摄入量有很大差别,男生钙适宜摄入量约为600～700mg/d,女生为1000～1100mg/d。     

Validity and reproducibility of a computerised tool for assessing the iron, calcium and vitamin C intake of Belgian women

OBJECTIVE: To determine the relative validity of a newly developed iron intake assessment tool, designed specifically to assess iron, calcium and vitamin C intake. DESIGN: Estimates of iron, calcium and vitamin C intake from a computerised iron intake assessment tool compared with those from 11-day estimated dietary records. SETTING: Region of Ghent (N= +/- 225,000), a city in Flanders, the Dutch-speaking part of Belgium. SUBJECTS: In all, 50 women aged 18-39 y, participating in a large-scale epidemiological study on iron intake and iron status. MAIN RESULTS: Mean dietary iron intake from the 11-day food record, the unadjusted dietary iron intake assessment tool and the adjusted tool was, respectively, 10.5 +/- 2.7, 10.4 +/- 4.3 and 9.6 +/- 2.9 mg. For the different nutrients, the correlation coefficients vary from 0.45 to 0.60 for adjusted intake. The mean difference of iron intake by the two methods (0.8 +/- 2.9 mg) did not differ significantly from zero. The new method correctly classified 38% (iron), 38% (calcium) and 58% (vitamin C) of the subjects to the correct tertile. The correlation coefficients ranged from 0.48 for adjusted vitamin C intake to 0.73 for adjusted calcium intake between two administrations. CONCLUSION: The newly developed instrument can be used to assess mean group intakes of iron, calcium and vitamin C in women consuming a Western diet. However, since the ranking capability of the new tool is rather weak, further refinement of the tool is required to produce a robust method for assessing iron, calcium and vitamin C intakes of individuals. SPONSORSHIP: This research was supported by the Belgian National Fund for Scientific Research/Flemish Division (Fund No G.0152.01).     

Long-term calcium supplementation does not affect the iron status of 12-14-y-old girls

BACKGROUND: Single-meal studies have established that calcium has an acute inhibitory effect on the absorption of iron. However, there is growing evidence that high calcium intakes do not compromise iron status. OBJECTIVE: We evaluated whether long-term calcium supplementation taken with the main meal affected biomarkers of iron status in adolescent girls with high requirements of both iron and calcium. DESIGN: The study was a randomized, double-blind, placebo-controlled trial of supplementation with 500 mg Ca/d for 1 y among 113 adolescent girls aged 13.2 +/- 0.4 y at enrollment. Participants were advised to take the supplement with their evening meal, which usually contributes the majority of dietary iron. Iron status was assessed at baseline and after 1 y of supplementation by measuring hemoglobin and serum concentrations of ferritin and transferrin receptors (TfRs). RESULTS: The mean (+/-SD) hemoglobin at enrollment was 134 +/- 9 g/L, geometric mean serum ferritin was 26.3 microg/L (interquartile range: 18.6-39.4 microg/L), and serum TfR was 4.19 mg/L (3.52-5.10 mg/L). Daily calcium supplementation had no effect on the least-squares mean concentrations of iron-status markers adjusted for their baseline values (hemoglobin: 136 and 134 g/L, P = 0.31; ferritin: 25.4 and 26.1 microg/L, P = 0.73; TfR: 4.1 and 4.4 mg/L, P = 0.12; and the ratio of TfR to ferritin: 160 and 161 in the calcium and placebo groups, respectively; P = 0.97). CONCLUSION: Although it remains to be shown in iron-deficient persons, long-term iron status does not seem to be compromised by high calcium intakes.     

Calcium retention in adolescent boys on a range of controlled calcium intakes

BACKGROUND: National calcium requirements in the United States for boys are based on data from girls. On average, boys develop larger skeletons than do girls, yet it is unknown whether the additional skeletal accretion in boys requires additional dietary calcium intake. OBJECTIVE: The objective was to determine calcium retention in adolescent boys in response to a range of controlled intakes and to compare the intake needed for maximal retention in boys with that needed in adolescent girls studied under the same conditions. DESIGN: Thirty-one boys aged 12-15 y participated in 3-wk metabolic balance studies testing a range (700-2100 mg/d) of calcium intakes in a crossover study design with a 2-wk washout period. Calcium intake was varied by using a beverage fortified with calcium citrate malate. After a 1-wk equilibration period, calcium retention was calculated as dietary calcium intake minus the calcium excreted in the feces and urine over the following 2 wk. The dietary intake at which maximal calcium retention occurred was determined by using a nonlinear regression model. The results in boys were compared with those obtained in 35 adolescent girls previously studied under the same protocol. RESULTS: Maximal calcium retention in boys was achieved at an intake of 1140 mg/d. Calcium retention was higher (by 171 +/- 38 mg/d) in boys than in girls at all calcium intakes studied. CONCLUSION: The higher calcium retention in boys than in girls was attained through higher net calcium absorption and lower urinary excretion than in girls.     

Longitudinal calcium intake is negatively related to children's body fat indexes

OBJECTIVE: To determine if dietary calcium was negatively related to children's body fat (BF), if BF indexes and calcium intakes changed over time, and to identify variables related to BF and calcium intake. DESIGN: Percent BF and kg BF were assessed by dual energy x-ray absorptiometry (DEXA) in 8-year-old children. In a prospective design, height, weight, dietary intakes, and related variables were monitored longitudinally from ages 2 months to 8 years during in-home interviews. SUBJECTS: Fifty-two white children, (n=25 boys, 27 girls) participated in a longitudinal study with their mothers. At 8 years of age, mean BMI was 17.3+/-2.1 (standard deviation) for boys and 17.1+/-2.5 for girls. ANALYSES: Regression analysis of all variables, followed by further regression analysis on selected models. RESULTS: At 8 years, percent BF was 22.7+/-6.7 for boys and 26.2+/-7.9 for girls, as assessed by DEXA. Dietary calcium (mg) and polyunsaturated fat intake (g) were negatively related to percent BF (P=.02 to.04) in 3 statistical models, which predicted 28% to 34% of the variability in BF among children. Variables positively associated with percent BF were total dietary fat (g) or saturated fat (g), female gender, sedentary activity (hours/day), father's BMI, and mothers' percent BF. Calcium intakes were significantly correlated over time. Dietary variety was positively related to calcium intake, and intakes of carbonated beverages and other sweetened beverages were negatively related. APPLICATIONS/CONCLUSIONS: Children should be strongly encouraged to regularly include calcium-rich foods and beverages in their diets.     

Effect of magnesium on the intestinal absorption of calcium in man.

In view of the widespread use of magnesium (Mg) as a nutritional supplement, we investigated whether Mg would affect the absorption of calcium (Ca) as the intestinal absorption sites for Mg and Ca differ.

The intestinal absorption of Ca, using 47CaCl2 as the tracer, and metabolic balances of Ca, phosphorus (P) and Mg were determined in five adult males under strictly controlled dietary conditions in control studies and during Mg supplementation. Mg was given as magnesium oxide (MgO) in 10 studies during two Ca intakes: five studies during a low Ca intake of 241 mg/day and five studies during a normal Ca intake of 812 mg/day. Dietary Mg intake ranged from 241 to 264 mg/day in control studies. During Mg supplementation, the total Mg intake ranged from 789 to 826 mg/day.

There was no change of the intestinal Ca absorption during Mg supplementation during the two Ca intakes. The only change was the higher 1-hour 47Ca plasma level in the 47Ca absorption studies during the high Mg intake. Urinary Ca increased during Mg supplementation only during the low Ca intake, the Ca balance became more negative but this difference was not significant. There was also no change in Ca excretion or Ca balance during the high Mg intake at the normal Ca intake of 800 mg/day. P balance studies showed a slight decrease in urinary P and an increase in fecal P, but the P balances did not change. Mg balances were negative in control studies during the two Ca intakes. Supplemental Mg increased both urinary and fecal Mg excretion and the Mg balance became positive, but these differences were not significant.

The increased Mg intake of 826 mg did not affect intestinal Ca absorption determined with tracer doses of 47Ca during Ca intakes of 241 and 812 mg/day.     

Premenopausal overweight women do not lose bone during moderate weight loss with adequate or higher calcium intake

BACKGROUND: Weight loss is associated with bone loss, but this has not been examined in overweight premenopausal women. OBJECTIVE: The aim of this study was to assess whether overweight premenopausal women lose bone with moderate weight loss at recommended or higher than recommended calcium intakes. DESIGN: Overweight premenopausal women [n = 44; x (+/-SD) age: 38 +/- 6.4 y; body mass index (BMI): 27.7 +/- 2.1 kg/m(2)] were randomly assigned to either a normal (1 g/d) or high (1.8 g/d) calcium intake during 6 mo of energy restriction [weight loss (WL) groups] or were recruited for weight maintenance at 1 g Ca/d intake. Regional bone mineral density and content were measured by dual-energy X-ray absorptiometry, and markers of bone turnover were measured before and after weight loss. True fractional calcium absorption (TFCA) was measured at baseline and during caloric restriction by using a dual-stable calcium isotope method. RESULTS: The WL groups lost 7.2 +/- 3.3% of initial body weight. No significant decrease in BMD or rise in bone turnover was observed with weight loss at normal or high calcium intake. The group that consumed high calcium showed a strong relation (r = 0.71) between increased femoral neck bone mineral density and increased serum 25-hydroxyvitamin D. No significant effect of weight loss on TFCA was observed, and the total calcium absorbed was adequate at 238 +/- 81 and 310 +/- 91 mg/d for the normal- and high-calcium WL groups, respectively. CONCLUSION: Overweight premenopausal women do not lose bone during weight loss at the recommended calcium intake, which may be explained by sufficient amounts of absorbed calcium.     

Factors that influence peak bone mass formation: a study of calcium balance and the inheritance of bone mass in adolescent females

We suggested that calcium may be an important determinant of peak bone mass. For further elucidation, calcium balances in adolescent females with different calcium intakes (270-1637 mg/d), and a 2-y intervention study of calcium supplementation were performed. Hereditary influences on bone status were also evaluated by comparing subjects' and parents' bone mass. The main determinant of calcium balance was calcium intake; net calcium absorption increased with intake and urinary calcium did not change. Adolescent females retained 200-500 mg Ca/d, suggesting that inadequate calcium intake may translate into inadequate calcium retention and a reduction in peak bone mass. There was a more pronounced increase in bone mass over time in the calcium-supplemented group (1640 mg Ca/d) than in the control group (750 mg Ca/d), but the differences between bone mass measurements were not statistically significant, possibly because of a type II error. By the age of 16 y daughters had accumulated 90-97% of the bone mass of their premenopausal mothers.     

An inulin-type fructan enhances calcium absorption primarily via an effect on colonic absorption in humans

Calcium absorption efficiency and bone mineral mass are increased in adolescents who regularly consume inulin-type fructans (ITF). The mechanism of action in increasing absorption is unknown but may be related to increased colonic calcium absorption. We conducted a study in young adults designed to evaluate these mechanisms with a kinetic technique using (42)Ca orally and (46)Ca dosed i.v. Those who responded to 8 wk of supplementation with 8 g of a mixed short and long degree of polymerization ITF by increasing their calcium absorption had kinetic measurements analyzed to evaluate the time course of absorption. The area under the curve of the oral tracer in the blood during the 26 h after dosing was calculated and the time dependence of increased absorption determined. Eight young adults (of 13 studied), with mean calcium intake approximately 900 mg/d, responded to the ITF with an increased calcium absorption of at least 3%. In responders, absorption increased from 22.7 +/- 11.3% to 31.0 +/- 15.3%. Colonic absorption, defined as absorption that occurred >7 h after oral dosing, represented 69.6 +/- 18.6% of the increase, or 49 +/- 28 mg/d. These findings suggest that, in those who respond to ITF, its effects on calcium absorption occur principally in the colon. This benefit to ITF may be especially important when absorption in the small intestine is impaired for anatomic or physiological reasons.     

Relationship of urinary sodium/potassium excretion and calcium intake to blood pressure and prevalence of hypertension among older Chinese vegetarians

OBJECTIVE: To examine the associations of dietary sodium and potassium, as reflected by the urinary sodium/potassium excretion, and calcium intake with blood pressure and the prevalence of hypertension among older Chinese vegetarians in Hong Kong. DESIGN: Cross-sectional study. SETTING: Research clinic in a teaching hospital in Hong Kong. SUBJECTS: A total of 111 ambulatory vegetarians over the age of 55 were recruited from members of religious organizations or old age hostels. MAIN OUTCOME MEASURES: Hypertension was defined as supine blood pressure >140/90 mmHg or a history of hypertension. Dietary sodium, potassium and calcium intakes were assessed by 24 h recall method or fasting urinary sodium or potassium/creatinine ratios. RESULTS: Seventy-one subjects (64%) were found to have hypertension. Compared with normotensive subjects, hypertensive subjects had lower calcium intake (411+/-s.d. 324 vs 589+/-428 mg, P=0.04), but higher urinary sodium/creatinine ratio (32.6+/-19.3 vs 21.0+/-12.4, P=0.00) and sodium/potassium ratio (4.7+/-2.8 vs 3.4+/-2.3, P=0.02). Among 88 subjects not taking diuretics or antihypertensive drugs, systolic blood pressure was related to calcium intake (r=-0.40), urinary sodium/creatinine ratio (r=0.39), urinary sodium/potassium ratio (r=0.30) and age (r=0.23). Diastolic blood pressure was related to urinary sodium/creatinine (r=0.29). Twenty-three subjects with high urinary sodium/potassium and low calcium intake and 16 subjects with low urinary sodium/potassium ratio and high calcium intake differed markedly with respect to systolic blood pressure (159+/-26 vs 130+/-15 mmHg) and prevalence of hypertension (78% vs 25%). CONCLUSIONS: Older Chinese vegetarians are predisposed to hypertension because of their sodium-rich but calcium-deficient diets.