RESEARCH PAPER
Influence of dietary calcium intake on quantitative and qualitative parameters of bone tissue in Polish adults
 
More details
Hide details
1
Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Poland
 
2
Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute, Warsaw, Poland
 
 
Corresponding author
Andrzej Lewiński   

Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Poland
 
 
Ann Agric Environ Med. 2016;23(3):495-501
 
KEYWORDS
ABSTRACT
Introduction:
The objective of the study was to assess dietary calcium intake in the Polish population and its influence on selected parameters of bone tissue.

Material and Methods:
1,129 osteoporosis treatment–naive subjects, aged 20–80 years, randomly selected, were involved in the study. Bone status was established using densitometry of spine and hip and quantitative ultrasound of the calcaneus. Dietary calcium intake was calculated according to data gathered in a questionnaire.

Results:
Median calcium intake was 746 mg; 72% of subjects had calcium intake below the recommended dose. Calcium intake correlated negatively with age (r = -0.15; p<0.001) and positively with BMD in the spine (r = 0.06; p<0.05) and in the femoral neck (r = 0.07; p<0.05). In subjects with the lowest calcium intake, a significantly lower femoral neck BMD and heel stiffness was noticed than in subjects with the highest calcium intake. However, multiple regression analysis showed that dietary calcium was not a predictor of low BMD, both in the hip and spine, as well as of bone stiffness in contrast to age, low BMI and female gender (p<0.0001). In all factors regression analysis, a weak influence of calcium intake on BMD was shown only in the subgroup of premenopausal women (β = 0.1; p<0.05).

Conclusions:
In most subjects, dietary calcium intake was below the recommended dose; however, its influence on bone seems to be weak, except for persons with the greatest deficiency of dietary calcium and the subgroup of premenopausal women.

 
REFERENCES (37)
1.
Joo NS, Dawson-Hughes B, Kim YS, Oh K, Yeum KJ. Impact of calcium and vitamin D insufficiencies on serum parathyroid hormone and bone mineral density: analysis of the Fourth and Fifth Korea National Health and Nutrition Examination Survey (KNHANES IV-3, 2009 and KNHANES V-1, 2010). J Bone Miner Res. 2013; 28: 764–770.
 
2.
Wosje KS, Specker BL. Role of calcium in bone health during childhood. Nutr Rev. 2000; 58: 253–268.
 
3.
Chapuy MC, Arlot ME, Duboeuf F, Brun J, Crouzet B, Arnaud S, et al. Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med. 1992; 327: 1637–1642.
 
4.
Cumming RG, Nevitt MC. Calcium for prevention of osteoporotic fractures in postmenopausal women. J Bone Miner Res. 1997; 12: 1321–1329.
 
5.
Jarosz M, Bułhak-Jachymczyk B. (Ed.): Standards of human nutrition. Principles of Prevention of obesity and non-communicable diseases [In Polish], PZWL, Warszaw 2008 [In Polish].
 
6.
Bischoff-Ferrari HA, Kiel DP, Dawson-Hughes B, Orav JE, Li R, Spiegelman D, et al.Dietary calcium and serum 25-hydroxyvitamin D status in relation to BMD among U.S. adults. J Bone Miner Res. 2009; 24: 935–942.
 
7.
Cumming RG, Cummings SR, Nevitt MC, Scott J. Ensrud KE, Vogt TM, Fox Kl. Calcium intake and fracture risk: results from the study of osteoporotic fractures. Am J Epidemiol. 1997; 15: 926–934.
 
8.
Jackson RD, LaCroix AZ, Gass M, Wallace RB, Robbins J, Lewis CE, et al. Women’s Health Initiative Investigators.Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med. 2006; 354: 669–683.
 
9.
Warensjö E, Byberg L, Melhus H, Gedeborg R, Mallmin H, Wolk A, Michaëlsson K. Dietary calcium intake and risk of fracture and osteoporosis: prospective longitudinal cohort study. British Med J. 2011; 342: 1473.
 
10.
Bolland MJ, Avenell A, Baron JA, Grey A, MacLennan GS, Gamble GD, Reid IR. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. British Med J. 2010; 341: c3691.
 
11.
Kanis JA, Melton LJ III, Christiansen C, Johnston CC, Khaltaev N. The diagnosis of osteoporosis. J Bone Miner Res. 1994; 9: 1137–1141.
 
12.
Cummings SR, Karpf DB, Harris F, Genant HK, EnsrudK, LaCroix AZ, Black DM. Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs. Am J Med. 2002; 112: 281–289.
 
13.
Njeh CF, Fuerst T, Diessel E, Genant HK. Is quantitative ultrasound dependent on bone structure? A reflection. Osteoporosis Int. 2001; 12: 1–15.
 
14.
Bouxsein ML, Radloff SE. Quantitative ultrasound of the calcaneus reflects the mechanical properties of calcaneal trabecular bone. J Bone Miner Res. 1997; 12: 839–846.
 
15.
Gonnelli S, Rossi S, Montomoli M, Caffarelli C, Cuda C, Lazzeri G, et al. Accuracy of different reduced versions of a validated food-frequency questionnaire in Italian men and women. Calcif Tissue Int. 2009; 85: 221–227.
 
16.
Szymelfejnik EJ, Wądołowska L, Cichon R, Przysławski J, Bolesławska I. Dairy products frequency questionnaire (ADOS-Ca) calibration for calcium intake evaluation. Pol J Food Nutr Sci. 2006; 15: 229–236.
 
17.
Kunachowicz H, Nadolna I, Przygoda B, Iwanow K. Food Composition Tables. Warsaw: PZWL, 2005 [in Polish].
 
18.
Jaworski M, Matusik H, Biliński P, Czerwiński E, Lewiński A, Marcinowska-Suchowierska E, et al. Stability and consistency of DPX devices in a multi center cohort study – The EPOLOS study. Osteoporosis Int. 2003; 14: Suppl 6: S9.
 
19.
Schousboe JT, Shepherd JA, Bilezikian JP, Baim S. Executive summary of the 2013 ISCD position development conference on bone densitometry. J Clin Densitom. 2013; 16: 455–467.
 
20.
Njeh CF, Saeed I, Grigorian M, Kendler DL, Fan B, Shepherd J, et al. Assessment of bone status using speed of sound at multiple anatomical sites, Ultrasound Med Biol. 2001; 27: 1337–1345.
 
21.
Jaworski M, Lorenc RS. Crosscalibration of Achilles apparatuses – in vitro and in vivo study. Acta Orthopaedica Scand. 2002; 73; supp. 304: 58.
 
22.
Ma J, Johns RA, Stafford RS. Americans are not meeting current calcium recommendations. Am J Clin Nutr. 2007; 85: 1361–1366.
 
23.
Bruyere O, De Cock C, Mottet C, Neuprez A, Malaise O, Reginster JY. Low dietary calcium in European postmenopausal osteoporotic women. Public Health Nutr 2009; 12: 111–114.
 
24.
Boylan S, Welch A, Pikhart H, Malyutina S, Pajak A, Kubinova R, et al. Dietary habits in three Central and Eastern European countries: the HAPIEE study. BMC Public Health 2009; 9: 439.
 
25.
Wadolowska L, Sobas K, Szczepanska JW, Slowinska MA, Czlapka-Matyasik M, Niedzwiedzka E. Dairy products, dietary calcium and bone health: possibility of prevention of osteoporosis in women: the Polish experience. Nutrients 2013; 5: 2684–2707.
 
26.
Skowrońska-Jóźwiak E, Jaworski M, Grzywa A, Lorenc R, Lewiński A. Influence of calcium intake on bone mineral density and fractures incidence in the treatment-naive women from Lodz urban area – part of EPOLOS study. Ann Agric Environ Med. 2014; 21: 201–204.
 
27.
Włodarek D, Głąbska D, Kołota A, Adamczyk P, Czekajło A, Grzeszczak W, et al. Calcium intake and osteoporosis: the influence of calcium intake from dairy products on hip bone mineral density and fracture incidence – a population-based study in women over 55 years of age. Public Health Nutr. 2014; 17: 383–389.
 
28.
McKenna MJ, McKenna MC, van der Kamp S. Should dual-energy X-ray absorptiometry technologists estimate dietary calcium intake at the time of DXA? J Clin Densitom. 2015; 28. pii: S1094–6950(15)00022–0.
 
29.
Saw SM, Hong CY, Lee J, Wong ML, Chan MF, Cheng A, Leong KH. Awareness and health beliefs of women towards osteoporosis. Osteoporosis Int. 2003; 14: 595–601.
 
30.
Ilow R, Regulska-Ilow B, Różańska D, Zatońska K, Dehghan M, Zhang X, et al. Evaluation of mineral and vitamin intake in the diet of a sample of Polish population – baseline assessment from the prospective cohort “PONS” study. Ann Agric Environ Med. 2011; 18: 235–240.
 
31.
Adami S, Giannini S, Giorgino R, Isaia GC, Maggi S, Sinigaglia L, et al. Effect of age, weight and lifestyle factors on calcaneal quantitative ultrasound in premenopausal women: the ESOPO study. Calcif Tissue Int. 2004; 74: 317–321.
 
32.
Robinson ML, Winters-Stone K, Gabel K, Dolny D. Modifiable lifestyle factors affecting bone health using calcaneus quantitative ultrasound in adolescent girls. Osteoporosis Int. 2007; 18: 1101–1107.
 
33.
Zhang Y, Aoyagi K, Honda S, Yahata Y, Yoshimi I, Kusano Y, et al. Effects of lifestyle factors on stiffness index of calcaneus measured by quantitative ultrasound system among Japanese women aged 40 years and over: the Hizen-Oshima Study. Tohoku J Exp Med. 2003; 201: 97–107.
 
34.
Nuzzo V, Zuccoli A, de Terlizzi F, Colao A, Tauchmanova L. Low 25-Hydroxyvitamin D Levels and Low Bone Density Assessed by Quantitative Ultrasonometry in a Cohort of Postmenopausal Italian Nuns. J Clin Densitom. 2013; 16: 308–312.
 
35.
Kim KM, Choi SH, Lim S, Moon JH, Kim JH, Kim SW, et al. Interactions between dietary calcium intake and bone mineral density or bone geometry in a low calcium intake population (KNHANES IV 2008–2010). J Clin Endocrinol Metab. 2014; 99: 2409–2417.
 
36.
Napiórkowska L, Budlewski T, Jakubas-Kwiatkowska W, Hamzy V, Gozdowski D, Franek E. Prevalence of low serum vitamin D concentration in an urban population of elderly women in Poland. Pol Arch Med Wewn. 2009; 119: 699–703.
 
37.
Specker BL. Evidence for an interaction between calcium intake and physical activity on changes in bone mineral density. J Bone Miner Res. 1996; 11: 1539–1544.
 
eISSN:1898-2263
ISSN:1232-1966
Journals System - logo
Scroll to top