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Escobedo-Monge MF, Bahillo-Curieses P, Parodi-Román J, Escobedo-Monge MA, Alonso-López P, Marugán-Miguelsanz JM. Calcium, Phosphate, and Vitamin D in Children and Adolescents with Chronic Diseases: A Cross-Sectional Study. Nutrients 2024; 16:1349. [PMID: 38732596 PMCID: PMC11085162 DOI: 10.3390/nu16091349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/25/2024] [Accepted: 04/27/2024] [Indexed: 05/13/2024] Open
Abstract
Chronic diseases may affect the nutritional status of children and adolescents. Calcium (Ca), phosphorus (P), and vitamin D (Vit-D) are crucial nutrients for their growth and development. Proper diagnosis and treatment are critical components of personalized and precision medicine. Hence, we conducted a cross-sectional and comparative study to evaluate Ca, P, and Vit-D levels in their non-skeletal functions and their association with health and nutritional biomarkers in children and adolescents with diverse chronic conditions. We performed anthropometric, body composition, clinical evaluation, biochemical analysis, and dietary survey methods. A total of 78 patients (1-19 years, 43 females, 42 children) took part in this study. Overall, 24, 30, and 24 participants were obese, undernourished, and eutrophic, respectively. Results found that 74% and 35% of individuals had deficient Vit-D and Ca intake, respectively. Most cases were normocalcemic. Results also found that 47% of the subjects had Vit-D deficiency (VDD), 37% were insufficient, and 37% had hypophosphatemia. Of the 46% and 31% of patients with VDD and insufficient levels, 19% and 11% were hypophosphatemic, respectively. Calcium, P, and Vit-D levels were associated with anthropometric parameters, body mass index, body composition, physical activity, diet, growth hormones, and the immune, liver, and kidney systems. These results show the coincident risk of altered Ca, P, and Vit-D metabolism in children and adolescents with chronic diseases.
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Affiliation(s)
- Marlene Fabiola Escobedo-Monge
- Department of Pediatrics of the Faculty of Medicine, University of Valladolid, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain
| | - Pilar Bahillo-Curieses
- Section of Pediatric Endocrinology, University Clinical Hospital of Valladolid, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain;
| | - Joaquín Parodi-Román
- Science Faculty, University of Cadiz, Paseo de Carlos III, 28, 11003 Cádiz, Spain;
| | | | - Pedro Alonso-López
- Section of Gastroenterology and Pediatric Nutrition, University Clinical Hospital of Valladolid, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain (J.M.M.-M.)
| | - José Manuel Marugán-Miguelsanz
- Department of Pediatrics of the Faculty of Medicine, University of Valladolid, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain
- Section of Gastroenterology and Pediatric Nutrition, University Clinical Hospital of Valladolid, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain (J.M.M.-M.)
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Escobedo-Monge MF, Marcos-Temprano M, Parodi-Román J, Escobedo-Monge MA, Alonso-Vicente C, Torres-Hinojal MC, Marugán-Miguelsanz JM. Calcium, Phosphorus, and Vitamin D Levels in a Series of Cystic Fibrosis Patients: A Cross-Sectional Study. Int J Mol Sci 2024; 25:1900. [PMID: 38339178 PMCID: PMC10856093 DOI: 10.3390/ijms25031900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/03/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024] Open
Abstract
Cystic fibrosis (CF) is a monogenic disease with different types of mutations that mainly affect the respiratory-digestive system. Calcium (Ca), phosphorus (P), and vitamin D (Vit-D) are essential nutrients for maintaining adequate growth and development, as well as key components in crucial metabolic pathways. Proper diagnosis, treatment, and response are decisive components of precision medicine. Therefore, we conducted a cross-sectional study to evaluate Ca, P, and Vit-D levels along with health and nutritional indicators, regarding their non-skeletal functions, in a series of CF patients. Anthropometric and clinical evaluation, biochemical analysis, dietary survey, and respiratory and pancreatic status were performed. Even though the results showed that all patients had normal dietary and serum Ca levels, 47% of patients had deficient Vit-D intake, 53% of patients had hypovitaminosis D, 35% had insufficient Vit-D levels, 18% had hypophosphatemia, 76% had elevated alkaline phosphate levels, 29% had hypercalciuria, and 65% had hyperphosphaturia. There were no significant differences between homozygous and compound heterozygous patients. Ca, P, and Vit-D levels were associated with body mass index; body composition; physical activity; diet; growth hormones; and the immune, liver, and kidney systems. We suggest a periodically evaluation of Ca and P losses.
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Affiliation(s)
| | - Marianela Marcos-Temprano
- Castilla y León Cystic Fibrosis Unit, University Clinical Hospital of Valladolid, Avenida Ramón y Cajal, 3, 47005 Valladolid, Spain;
| | - Joaquín Parodi-Román
- Science Faculty, University of Cadiz, Paseo de Carlos III, 28, 11003 Cádiz, Spain;
| | | | - Carmen Alonso-Vicente
- Department of Pediatrics of the Faculty of Medicine, University of Valladolid; Section of Gastroenterology and Pediatric Nutrition, University Clinical Hospital of Valladolid, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain; (C.A.-V.); (J.M.M.-M.)
| | | | - José Manuel Marugán-Miguelsanz
- Department of Pediatrics of the Faculty of Medicine, University of Valladolid; Section of Gastroenterology and Pediatric Nutrition, University Clinical Hospital of Valladolid, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain; (C.A.-V.); (J.M.M.-M.)
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Medina M, Cureau FV, Schaan BD, Leotti VB, Rosa PBZ, Pereira MA, Drehmer M. Association between dairy products consumption and the prevalences of combined prediabetes and type 2 diabetes mellitus in Brazilian adolescents: a cross-sectional study. Br J Nutr 2023; 130:2162-2173. [PMID: 37323002 DOI: 10.1017/s0007114523001356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The association between dairy products consumption in adults and the likelihood of type 2 diabetes mellitus (T2DM) has been described, but more information on the adolescent population is needed. This nationally representative, cross-sectional school-based study aimed to describe the consumption of dairy products and their subtypes and to evaluate their association with prediabetes and T2DM in adolescents. The Study of Cardiovascular Risks in Adolescents (ERICA) includes adolescents aged 12-17 years. Dairy products consumption was evaluated by 24-h food recall. Associations with fasting glucose, glycated hemoglobin (HbA1c) and insulin resistance, as measured by homeostatic model assessment-insulin resistance (HOMA-IR), were evaluated by multivariate linear regression. Poisson regression was also used to assess the association between dairy products consumption and the combined prevalence of prediabetes and T2DM. Models were adjusted for sociodemographic, nutritional, behavioural and anthropometrics. The final sample analysed consisted of 35 614 adolescents. Total intake of dairy products was inversely associated with fasting blood glucose levels after adjusting for all covariates (β = -0·452, 95 % CI -0·899, -0·005). The associations were stronger for overweight and obese adolescents. Findings were similar for full-fat dairy products and yogurt. Higher consumption of low-fat dairy products and cheese were associated with a 46 % (prevalence ratio, PR 1·46, 95 % CI 1·18, 1·80) and 33 % (PR 1·33, 95 % CI 1·14, 1·57) higher combined prevalence of prediabetes and T2DM, respectively. The total consumption of dairy products and full-fat dairy products was associated with a lower combined prevalence of prediabetes and T2DM, while the consumption of cheese and low-fat dairy products was associated with higher combined prevalence of prediabetes and T2DM in Brazilian adolescents.
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Affiliation(s)
- Marcela Medina
- Postgraduate Studies Program in Food, Nutrition and Health, Department of Nutrition, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Facultad de Medicina, Universidad del Azuay, Cuenca, Ecuador
| | - Felipe Vogt Cureau
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Beatriz D Schaan
- Department of Internal Medicine, Graduate Program in Medical Sciences: Endocrinology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Vanessa Bielefeldt Leotti
- Department of Statistics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Postgraduate Studies Program in Epidemiology, Department of Social Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Priscila Bárbara Zanini Rosa
- Postgraduate Studies Program in Epidemiology, Department of Social Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Mark A Pereira
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Michele Drehmer
- Postgraduate Studies Program in Food, Nutrition and Health, Department of Nutrition, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Postgraduate Studies Program in Epidemiology, Department of Social Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Ariyo O, Alabi O, Aleru EO, Ojo TJ. Effect of emotion-based nutrition messages on consumption of calcium-rich foods among early adolescents in Ogbomoso, Nigeria. DIALOGUES IN HEALTH 2023; 2:100130. [PMID: 38515477 PMCID: PMC10953985 DOI: 10.1016/j.dialog.2023.100130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/25/2023] [Accepted: 03/26/2023] [Indexed: 03/23/2024]
Abstract
Introduction Calcium is a vital micronutrient for several physiological processes, yet it remains one of the significant shortfall nutrients among Nigerian adolescents. Objective This study was designed to assess the effect of emotion-based nutrition messages on the consumption of calcium-rich foods among early adolescents in Ogbomoso, Nigeria. Methodology The quasi-experimental study involved 220 adolescents (experimental: 110 and control: 110) selected using a three-stage sampling procedure. A semi-structured, interviewer-administered questionnaire was used to collect socio-demographic characteristics, dietary practice, calcium-rich foods consumption pattern, calcium intake, and anthropometric parameters. Second, calcium-rich foods consumption pattern was assessed using a food frequency questionnaire, and intake was evaluated using the multi-pass 24-hour dietary recall to define adequacy at intake level ≥1,300 mg per day. Third, the experimental group had five weeks of nutrition education using emotion-based nutrition messages. Data were analyzed using descriptive statistics and the Chi-square test at p < 0.05. Results The age of respondents (years) in experimental (12.88±1.41) and control (13.4±1.03) groups was similar. Primary dietary calcium sources were meat, chicken, egg, white beans, cheese, soy milk, oranges, and locust beans at baseline. At post-intervention, intake of other calcium-rich foods such as milk, yogurt, ice cream, okra, sardine, and unripe plantain increased, however, calcium intake remains similar in both control (238.41±92.4 mg; 235.40±92.92 mg) and experimental groups (239.76±51 mg; 241.46±100.89 mg) at baseline and post-intervention, respectively. The overall calcium intake of the adolescents remains below the recommended intake level of 1,300 mg. Conclusion Emotion-based nutritional messages did not significantly increase the total calcium intake among early adolescents.
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Affiliation(s)
- Oluwaseun Ariyo
- Department of Human Nutrition and Dietetics, University of Ibadan, Nigeria
| | - Olubunmi Alabi
- Department of Nutrition and Dietetics, Faculty of Food and Consumer Sciences, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Elizabeth O. Aleru
- Department of Human Nutrition and Dietetics, Lead City University Ibadan, Nigeria
| | - Tomilola J. Ojo
- Department of Human Nutrition and Dietetics, University of Ibadan, Nigeria
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Agraib LM, Al Hourani HM, Al-Shami IK, Alkhatib BM, Al-Jawaldeh A. Association between dietary fatty acid patterns and obesity indices in Jordanian adults: A cross-sectional study. Heliyon 2023; 9:e17938. [PMID: 37455990 PMCID: PMC10344746 DOI: 10.1016/j.heliyon.2023.e17938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/03/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023] Open
Abstract
Background The ratios of fatty acids in different diets and their connection to chronic diseases including obesity and CVD have been researched. The current study set out to detect the dietary fatty acid patterns among Jordanian adults and their relationships with obesity indices. Methods The data of 1096 adults were extracted from a household food consumption patterns survey study. Food intake was analyzed, and fatty acid patterns were determined. After anthropometric measurements, obesity indices were calculated. Results Two fatty acid patterns were determined (High fatty acids from Protein and Olive Oil sources pattern, and the low Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) pattern), explaining an overall variance of 41.78% and 24.31%, respectively. A significant difference in obesity scores through fatty acids pattern quartiles was only seen among female participants. Q4 of the "High fatty acids from Protein and Olive Oil sources" pattern had a significantly higher means of body mass index (25.12 ± 0.46; p = 0.015), waist-to-height-ratio (0.51 ± 0.01; p = 0.002), weight-adjusted waist index (10.13 ± 0.09; p = 0.021) and body roundness index (3.61 ± 0.15; p = 0.007) compared to Q1, while Q4 of "Low EPA and DHA" pattern had significantly higher means of waist circumference (WC) (86.28 ± 1.34) and a body shape index (ABSI) (10.12 ± 0.30) in comparison to Q1 (WC = 81.55 ± 1.08 and ABSI = 9.07 ± 0.22; p = 0.025, 0.013; respectively). In females, there was a significant association between the "High fatty acids from Protein and Olive Oil sources" pattern and all the obesity indices. Conclusion Our results suggest that an increase in the high fatty acids from Protein and Olive Oil sources pattern is associated with a reduction in obesity indices, which is opposite to the low EPA and DHA pattern. This was a sex-specific association.
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Affiliation(s)
- Lana M. Agraib
- Department of Food and Nutrition, Faculty of Agriculture, Jerash University, Jerash, Jordan
| | - Huda M. Al Hourani
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University. Zarqa, Jordan
| | - Islam K. Al-Shami
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University. Zarqa, Jordan
| | - Buthaina M. Alkhatib
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University. Zarqa, Jordan
| | - Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean, World Health Organization, Cairo 7608, Egypt
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Chen C, Zhou C, Liu S, Jiao X, Wang X, Zhang Y, Yu X. Association between Suboptimal 25-Hydroxyvitamin D Status and Overweight/Obesity in Infants: A Prospective Cohort Study in China. Nutrients 2022; 14:nu14224897. [PMID: 36432582 PMCID: PMC9698418 DOI: 10.3390/nu14224897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022] Open
Abstract
This study aimed to investigate whether 25-hydroxyvitamin D (25(OH)D) concentrations are correlated to overweight/obesity in infants and to explore a threshold of 25(OH)D. A total of 1205 six-month-old infants from two community hospitals in Shanghai were randomly recruited, and 925 of them were followed up at 12 months. Concentration of 25(OH)D, weight, and length were measured at two time points. Overweight/obesity was defined as a weight-for-length Z-score >97th percentile. The prevalence of overweight/obesity at 6 and 12 months was 6.88% and 5.26%, respectively. The occurrence of vitamin D (VitD) deficiency (<20 ng/mL) at 6 and 12 months was 6.56% and 2.05%, respectively. Concentration of 25(OH)D at the corresponding age was negatively associated with weight-for-length percentile (WLP) at both 6 (adjusted β: −0.14; 95% CI: −0.27, −0.02; p = 0.02) and 12 months (adjusted β: −0.22; 95% CI: −0.41, −0.02; p = 0.03), while the relationship between 25(OH)D at 6 months and WLP at 12 months was nonlinear, where 35 ng/mL was identified as an inflection point. Those with a concentration of 25(OH)D <35 ng/mL at 6 months had a higher risk of overweight/obesity (adjusted OR: 1.42; 95% CI: 1.06, 1.91; p = 0.02) compared to the group with a concentration of 25(OH)D ≥35 ng/mL. Moreover, a concentration of 25(OH)D <35 ng/mL at two time points significantly increased the risk of overweight/obesity at 12 months compared to the group with 25(OH)D concentration ≥35 ng/mL at two time points (adjusted OR: 2.91; 95% CI: 1.13, 7.46; p = 0.03). A suboptimal 25(OH)D concentration <35 ng/mL significantly increases the risk of overweight/obesity in infants.
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Affiliation(s)
- Chen Chen
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Chunyan Zhou
- Translational Medicine Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Shijian Liu
- Department of Clinical Epidemiology and Biostatistics, Children Health Advocacy Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Xianting Jiao
- Translational Medicine Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
- Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Xirui Wang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Yue Zhang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Xiaodan Yu
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
- MOE-Shanghai Key Lab of Children’s Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
- Correspondence:
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Adiposity Metabolic Consequences for Adolescent Bone Health. Nutrients 2022; 14:nu14163260. [PMID: 36014768 PMCID: PMC9414751 DOI: 10.3390/nu14163260] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 12/20/2022] Open
Abstract
Infancy and adolescence are crucial periods for bone health, since they are characterized by intense physical growth and bone development. The unsatisfactory acquisition of bone mass in this phase has consequences in adult life and increases the risk of developing bone diseases at more advanced ages. Nutrient deficiencies, especially calcium and vitamin D, associated with a sedentary lifestyle; lack of sun exposure; and epigenetic aspects represent some of the main risk factors for poor bone quality. In addition, recent studies relate childhood obesity to impaired bone health; however, studies on the adiposity effects on bone health are scarce and inconclusive. Another gap concerns the implications of obesity on child sexual maturity, which can jeopardize their genetic potential bone mass and increase fracture risk. Therefore, we reviewed the analyzed factors related to bone health and their association with obesity and metabolic syndrome in adolescents. We concluded that obesity (specifically, accumulated visceral fat) harms bones in the infant–juvenile phase, thereby increasing osteopenia/osteoporosis in adults and the elderly. Thus, it becomes evident that forming and maintaining healthy eating habits is necessary during infancy and adolescence to reduce the risk of fractures caused by bone-metabolic diseases in adulthood and to promote healthy ageing.
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Dor C, Stark AH, Dichtiar R, Keinan-Boker L, Sinai T. Non-Dairy Animal Protein Consumption Is Positively Associated with Overweight and Obesity in Israeli Adolescents. Foods 2022; 11:foods11142072. [PMID: 35885315 PMCID: PMC9317251 DOI: 10.3390/foods11142072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 11/17/2022] Open
Abstract
Protein consumption apparently plays a role in weight control. This cross-sectional study examined the association of protein consumption in Israeli adolescents with overweight/obesity. 7th−12th grade students participating in a national school-based survey (2015−2016) completed self-administered questionnaires, including a food frequency questionnaire, and height and weight measurements (n = 3443, 48% males, 15.2 ± 1.6 years). WHO growth standards served to define weight status. Intakes of total protein and protein source were calculated. Multivariable logistic regression analyses evaluated associations with overweight/obesity (BMI z-score ≥ 1), adjusting for possible covariates. Total protein intake (median (IQR)) was 62.5 (45.5, 85.7) g/d, accounting for 12.0 (10.5, 13.6) percent of daily energy. Of participants, 31.4% were overweight/obese. In multivariable models, overweight/obesity was positively associated with incremental increases of 10 g/d in total protein intake (OR = 1.07, 95% CI: 1.02−1.12, p < 0.01), total animal protein intake (OR = 1.05, 95% CI: 1.01−1.10, p = 0.026), and non-dairy animal protein intake (OR = 1.06, 95% CI: 1.01−1.11, p = 0.029). No associations were found with plant or dairy protein intake. These associations remained when protein intake was reported as a percentage of daily energy and when overweight and obesity were analyzed individually. High daily protein intakes, principally from non-dairy animal sources, were positively associated with overweight/obesity in adolescents. Additional studies are needed to establish causality of these findings.
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Affiliation(s)
- Chen Dor
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan 5262100, Israel; (C.D.); (R.D.); (L.K.-B.)
| | - Aliza Hannah Stark
- School of Nutritional Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 7610001, Israel;
| | - Rita Dichtiar
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan 5262100, Israel; (C.D.); (R.D.); (L.K.-B.)
| | - Lital Keinan-Boker
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan 5262100, Israel; (C.D.); (R.D.); (L.K.-B.)
- School of Public Health, University of Haifa, Haifa 3498838, Israel
| | - Tali Sinai
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan 5262100, Israel; (C.D.); (R.D.); (L.K.-B.)
- School of Nutritional Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 7610001, Israel;
- Correspondence: ; Tel.: +972-3-7371568; Fax: +972-2-5655994
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Moraes ABDVD, Veiga GVD, Azeredo VBD, Sichieri R, Pereira RA. High dietary calcium intake and low adiposity: findings from a longitudinal study in Brazilian adolescents. CAD SAUDE PUBLICA 2022; 38:e00144521. [PMID: 35703666 DOI: 10.1590/0102-311xen144521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 03/10/2022] [Indexed: 11/21/2022] Open
Abstract
Epidemiological studies have supported the hypothesis that dietary calcium intake is protective for adiposity. This study aimed to estimate the association of dietary calcium with adiposity indicators during adolescence. This is a cohort study with high school adolescents (n = 962) from selected schools of the Metropolitan Region of Rio de Janeiro, Brazil, which were followed from 2010 to 2012. Calcium intake was assessed by a validated self-reported food frequency questionnaire. Cross-sectional and longitudinal analyses of dietary calcium intake were performed regarding body mass index (BMI), waist circumference (WC), body fat percentage (%BF), fat mass (FM), fat-free mass (FFM), fat mass index (FMI), and fat-free mass index (FFMI). The analysis of variance was used for cross-sectional analysis with baseline data and linear mixed models applied to assess changes across the follow-up. At baseline, BMI, %BF, fat mass, and FMI (p for trend < 0.05) had lower means at the highest quintile of calcium intake whereas FFM and FFMI had higher means (p for trend < 0.05), especially for boys. During follow-up, boys had decreased FMI at the 4th and 5th quintiles of calcium intake (p < 0.05); among girls, only WC was significantly lower at the 4th quintile than in the 1st. These results support the hypothesis that low calcium intake increases adiposity among adolescents.
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Affiliation(s)
| | | | | | - Rosely Sichieri
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
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Guo X, Gao J, Meng X, Wang J, Zhang Z, Song Q, Hu K, Sun C, Li Y. Association of Dietary Calcium Intake With Bone Health and Chronic Diseases: Two Prospective Cohort Studies in China. Front Nutr 2022; 8:683918. [PMID: 35004796 PMCID: PMC8740131 DOI: 10.3389/fnut.2021.683918] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 11/29/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Calcium is an essential element in our diet and the most abundant mineral in the body. A high proportion of Chinese residents are not meeting dietary calcium recommendations. The purpose of this study was to investigate the relationship between calcium intake and the health of residents in two longitudinal studies of Chinese residents. Methods: This study used nationally representative data from the Harbin Cohort Study on Diet, Nutrition, and Chronic Non-communicable Disease Study (HDNNCDS) and China Health Nutrition Survey (CHNS), including 6,499 and 8,140 Chinese adults, respectively, who were free of chronic diseases at recruitment, with mean values of 4.2- and 5.3-year follow-up. Cox's proportional-hazards regression was conducted to explore the relationship between dietary calcium intake and the incidence of obesity, type 2 diabetes, hypertension, and cardiovascular disease (CVD) with adjustment for covariates. Results: Calcium intakes were 451.35 ± 203.56 and 484.32 ± 198.61 (mean ± SD) mg/day in HDNNCDS and CHNS. After adjusting the covariates, the relationship between dietary calcium intake and bone mineral density (BMD) was not statistically significant (p = 0.110). In the multivariate-adjusted Cox's proportional-hazards regression model, dietary calcium intakes were inversely associated with obesity incidence in both cohorts (HR [95% CI]: 0.61 [0.48–0.77] and p trend < 0.001 in fixed-effects model); nevertheless, there was no correlation between dietary calcium intake and the risk of type 2 diabetes (p trend = 0.442 and 0.759) and CVD (p trend = 0.826 and 0.072). The relationship between dietary calcium intake and the risk of hypertension in the two cohorts was inconsistent (p trend = 0.012 and 0.559). Additionally, after further adjusting the vegetable intake in the original multivariate model, both cohorts found no association between dietary calcium intake and the risk of developing obesity (p trend = 0.084 and 0.444). Conclusions: Our data suggest that the current calcium intake of Chinese residents was inversely associated with obesity, which may be related to consumption of vegetables. Meanwhile, the current calcium intake does not increase the risk of type 2 diabetes, CVD, and bone health burden. This research suggested that the Chinese current calcium intake level may have met the needs of the body.
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Affiliation(s)
- Xiaoyu Guo
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Jian Gao
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Xing Meng
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Jiemei Wang
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Ziwei Zhang
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Qingrao Song
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Ke Hu
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Changhao Sun
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Ying Li
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
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11
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Torres-Costoso A, Martínez-Vizcaíno V, Fernández-Rodríguez R, Sequí-Dominguez I, Reina-Gutiérrez S, Núñez de Arenas-Arroyo S, Garrido-Miguel M. Dietary Calcium Intake and Fat Mass in Spanish Young Adults: The Role of Muscle Strength. Nutrients 2021; 13:nu13124498. [PMID: 34960051 PMCID: PMC8705271 DOI: 10.3390/nu13124498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/07/2021] [Accepted: 12/13/2021] [Indexed: 01/01/2023] Open
Abstract
Obesity is declared as a chronic multifaceted health problem, and young adults may be particularly vulnerable to weight gain. This study aims to identify the role of dietary calcium intake and the muscle strength index in handling excess of fat mass in young adults and to examine if the relationship between dietary calcium intake and fat mass percentage is mediated by muscle strength. A cross-sectional study including 355 Spanish college students (aged 21.05 ± 3.11) was performed during the 2017–2018 academic year. Pearson correlation coefficients were estimated to determine the relationship between dietary calcium intake, fat mass percentage, body mass index, muscle strength components, and total energy intake. ANCOVA models were used to analyze the differences in the muscle strength index by total dietary calcium intake categories, as well as the differences in % fat mass by total dietary calcium intake and muscle strength index categories, controlling for different sets of confounders. A mediator analysis was conducted to test if the relationship between dietary calcium intake and fat mass percentage was explained by muscle strength. Data on the fat mass percentage, dietary calcium intake, and muscle strength index as the sum of the standardized z-score of the standing long jump and z-score of handgrip/weight were collected. The muscle strength index was significantly better in young adults with higher dietary calcium intake. Moreover, the fat mass percentage was significantly lower in those with a higher dietary calcium intake and a better muscle strength index. Finally, the relationship between dietary calcium intake and fat mass percentage was fully mediated by muscle strength (z = −1.90; p < 0.05), explaining 33.33% of this relationship. This study suggests that both a major dietary calcium intake and muscle strength are associated with fat mass percentage. Moreover, muscle strength mediates the link between dietary calcium intake and fat mass percentage. Therefore, both high dietary calcium intake and exercise activities aimed at improving muscle strength levels may help to prevent the cardiometabolic risk associated with an excess of fat mass in young people.
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Affiliation(s)
- Ana Torres-Costoso
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, 45071 Toledo, Spain;
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
| | - Vicente Martínez-Vizcaíno
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca 3467987, Chile
- Correspondence: ; Tel.: +34-969179100
| | - Rubén Fernández-Rodríguez
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
| | - Irene Sequí-Dominguez
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
| | - Sara Reina-Gutiérrez
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
| | - Sergio Núñez de Arenas-Arroyo
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
| | - Miriam Garrido-Miguel
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
- Facultad de Enfermería de Albacete, Universidad de Castilla-La Mancha, 02006 Ciudad Real, Spain
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12
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Rahmani R, Stevens E, Rackovsky N, O'Brien KO, Schwartz GJ, Weber DR. Female Sex and Obesity Are Risk Factors for Inadequate Calcium Intake in Youth With Type 1 Diabetes. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2021; 2. [PMID: 34713272 PMCID: PMC8547769 DOI: 10.3389/fcdhc.2021.723855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
People with type 1 diabetes (T1D) are at increased risk of developing low bone mineral density and fractures. Optimization of calcium intake is a key component of pediatric bone health care. Despite the known risk factors for impaired bone health in T1D and the known benefits of calcium on bone accrual, there are limited data describing calcium intake in youth with T1D. In this cross-sectional study, calcium intake was assessed in 238 youth with T1D. One third of study participants were found to have inadequate calcium intake. Female sex, especially during adolescence, and obesity were identified as specific risk factors for inadequate calcium intake. Given the known adverse effects of T1D on bone health, efforts to promote calcium intake in youth with T1D should be considered.
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Affiliation(s)
- Roman Rahmani
- Department of Pediatrics, Endocrinology, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, NY, United States
| | - Elizabeth Stevens
- Department of Pediatrics, Endocrinology, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, NY, United States
| | - Noya Rackovsky
- Department of Pediatrics, Endocrinology, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, NY, United States
| | - Kimberly O O'Brien
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
| | - George J Schwartz
- Department of Pediatrics, Endocrinology, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, NY, United States
| | - David R Weber
- Department of Pediatrics, Endocrinology, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, NY, United States
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13
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Extra-skeletal effects of dietary calcium: Impact on the cardiovascular system, obesity, and cancer. ADVANCES IN FOOD AND NUTRITION RESEARCH 2021; 96:1-25. [PMID: 34112350 DOI: 10.1016/bs.afnr.2021.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Calcium is well known to be integral to bone and muscle health, with deleterious effects such as osteoporosis associated with inadequate calcium intake. Recent studies have also highlighted the significant effects of calcium in extra-musculoskeletal functioning, including the cardiovascular system, obesity, and cancer. Calcium impacts the cardiovascular system as an antagonist associated with a reduction in hypertension, increase vasodilation, and improvement in blood vessel function when obtained in the diet as an organic source, through food. However, the inorganic source of calcium, found in supplements, may be negatively associated with the cardiovascular system due to plaque deposits and atherogenesis when taken in excess. Some studies suggest that calcium intake may impact obesity by regulation of adipogenesis and reducing fat deposits with resulting weight loss. The pathogenesis of calcium for reducing obesity is thought to be related in part to its impact on gut microbiota profile, with the suggestion that calcium may have prebiotic properties. Animal and some human studies propose that calcium may also have a role in cancer prevention and/or treatment due to its function in the cell proliferation process and the impact on hormonal regulation, and thus warrants more investigations in the human population. Some prospective and small clinical studies suggest that calcium may be beneficial for colorectal cancer. Overall, emerging research in various areas continues to highlight the essentiality of dietary calcium for functioning at the molecular and biochemical level toward improvement in health and some chronic disease conditions.
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Segovia-Siapco G, Khayef G, Pribis P, Oda K, Haddad E, Sabaté J. Animal Protein Intake Is Associated with General Adiposity in Adolescents: The Teen Food and Development Study. Nutrients 2019; 12:nu12010110. [PMID: 31906138 PMCID: PMC7019331 DOI: 10.3390/nu12010110] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 12/21/2019] [Accepted: 12/26/2019] [Indexed: 12/12/2022] Open
Abstract
Protein plays a crucial role in the growth and development of adolescents. However, being a secondary energy source, protein’s role in obesity has been sidelined. We examined whether intake of protein (total, animal, plant), branched-chain (BCAAs), and sulfur-containing (SCAAs) amino acids are associated with general body and central obesity and body composition in a cross-sectional study among healthy adolescents. Students aged 12–18 years old (n = 601) in schools near two major Adventist universities in California and Michigan provided dietary data via a validated web-based food frequency questionnaire (FFQ) and anthropometric data during school visits. Intakes of total, animal, and plant proteins, and BCAAs and SCAAs were derived from FFQ data. We defined general body obesity with body-mass-index-for-age (BMIz) z-scores and central obesity with waist-to-height ratios (WHtR). After full adjustment for covariates, multiple regression analyses showed significant positive associations between intakes of total protein (β = 0.101, 95% CI: 0.041, 0.161), animal protein (β = 0.118, 95% CI: 0.057, 0.178), BCAAs (β = 0.056, 95% CI: 0.025, 0.087), and SCAAs (β = 0.025, 95% CI: 0.012, 0.038) with general body adiposity. Animal protein (β = 0.017, 95% CI: 0.001, 0.033) and SCAAs (β = 0.004, 95% CI: 0.000, 0.008) were also associated with central obesity. Total and animal protein and BCAA and SCAA were also significantly associated with fat mass. Our findings suggest that high protein intake may pose a possible detriment to adolescent health. Longitudinal and safety evaluation studies are recommended.
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Affiliation(s)
- Gina Segovia-Siapco
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA; (K.O.); (E.H.); (J.S.)
- Correspondence: ; Tel.: +1-909-558-4300 (ext. 47110)
| | - Golandam Khayef
- Don B. Huntley College of Agriculture, California State Polytechnic University, 3801 West Temple Avenue, Pomona, CA 91768, USA
| | - Peter Pribis
- Department of Individual, Family & Community Education, Nutrition and Dietetics Program, College of Education, University of New Mexico, Albuquerque, NM 87131, USA;
| | - Keiji Oda
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA; (K.O.); (E.H.); (J.S.)
| | - Ella Haddad
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA; (K.O.); (E.H.); (J.S.)
| | - Joan Sabaté
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA; (K.O.); (E.H.); (J.S.)
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Association between Dietary Calcium Intake and Adiposity in Male Adolescents. Nutrients 2019; 11:nu11071454. [PMID: 31252547 PMCID: PMC6682862 DOI: 10.3390/nu11071454] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 06/18/2019] [Accepted: 06/25/2019] [Indexed: 01/08/2023] Open
Abstract
The aim was to investigate the possible association of dietary calcium intake with adiposity, insulin resistance, and adipocytokine values in adolescent boys. In this cross-sectional study, participants were 123 adolescent boys aged 13–15 years, who were divided into tertiles according to their dietary calcium intake. Dietary calcium intake was assessed using three 24 h dietary recalls. In addition, energy intake, body composition, physical activity (PA), and blood biochemical values were also measured. Mean body fat%, fat mass (FM), trunk FM, trunk fat%, and leptin differed between high and low tertiles of calcium intake after adjustment for age, pubertal stage, and PA. For the entire cohort, mean calcium intake was 786 ± 380 mg/day and was related to body mass index (BMI), FM, and trunk fat% but not to insulin resistance or adipocytokine values after adjusting for possible confounders. In addition, only 15.4% of the participants obtained or exceeded their mean dietary calcium intake requirements. These subjects who met their dietary calcium intake had significantly lower body fat% in comparison with subjects not meeting their dietary calcium intake. Odds ratio of being in the highest tertile of FM, trunk FM, and trunk fat% was 3.2–4.4 (95% confidence interval 1.19–12.47; p < 0.05) times higher for boys in low calcium intake tertile, compared to those boys in high calcium intake tertile. In conclusion, dietary calcium intake is inversely associated with total body and abdominal adiposity values in a specific group of healthy male adolescents with different body mass values.
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Anti-Obesity Effects of Dietary Calcium: The Evidence and Possible Mechanisms. Int J Mol Sci 2019; 20:ijms20123072. [PMID: 31234600 PMCID: PMC6627166 DOI: 10.3390/ijms20123072] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 06/18/2019] [Accepted: 06/20/2019] [Indexed: 02/07/2023] Open
Abstract
Obesity is a serious health challenge worldwide and is associated with various comorbidities, including dyslipidemia, type 2 diabetes, and cardiovascular disease. Developing effective strategies to prevent obesity is therefore of paramount importance. One potential strategy to reduce obesity is to consume calcium, which has been implicated to be involved in reducing body weight/fat. In this review, we compile the evidence for the anti-obesity roles of calcium in cells, animals, and humans. In addition, we summarize the possible anti-obesity mechanisms of calcium, including regulation of (a) adipogenesis, (b) fat metabolism, (c) adipocyte (precursor) proliferation and apoptosis, (d) thermogenesis, (e) fat absorption and excretion, and (f) gut microbiota. Although the exact anti-obesity roles of calcium in different subjects and how calcium induces the proposed anti-obesity mechanisms need to be further investigated, the current evidence demonstrates the anti-obesity effects of calcium and suggests the potential application of dietary calcium for prevention of obesity.
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