Calcium-enriched foods and bone mass growth in prepubertal girls: a randomized, double-blind, placebo-controlled trial.

Bonjour, J. P.; Carrié, Anne-Lise; Ferrari, Serge; Clavien, H; Slosman, Daniel O.; Theintz, G; Rizzoli, René

doi:10.1172/jci119287

Cited by 512 publications

(381 citation statements)

References 43 publications

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“…There is evidence that increased intake of dairy foods and calcium may play a significant role in maintaining a healthful weight and moderating body fat (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). However, results across studies have been inconsistent (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28), and this may be attributable to major challenges in using self-reported dietary intake data. Self-reported intakes tend to be subject to underreporting bias and the underreporting of energy intake tends to be positively related to weight status.…”

mentioning

confidence: 99%

Girls’ Dairy Intake, Energy Intake, and Weight Status

Fiorito¹,

Ventura²,

Mitchell³

et al. 2006

Journal of the American Dietetic Association

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We explored the relationships among girls' weight status, dairy servings, and total energy intake. The hypothesis that consuming dairy could reduce risk for overweight was evaluated by comparing energy intake and weight status of girls who met or consumed less than the recommended three servings of dairy per day. Participants included 172 11-year-old non-Hispanic white girls, assessed cross-sectionally. Intakes of dairy, calcium, and energy were measured using three 24-hour recalls. Body mass index and body fat measures from dual-energy x-ray absorptiometry were obtained. Because preliminary analyses suggested systematic underreporting of energy intake, the relationships among dairy servings and measures of weight status were examined for the total sample and for subsamples of under-, plausible, and overreporters. Data for the total sample provided support for the hypothesized relationship among weight status, dairy servings, and energy intake. Thirty-nine percent of girls reported consuming the recommended ≥3 servings of dairy per day; these girls also reported higher energy intake but had lower body mass index z scores and body fat than the girls who consumed fewer than three dairy servings each day. Among plausible reporters, no relationship between dairy intake and weight status was noted. This discrepancy may be attributable to a high percentage (45%) of overweight underreporters in the total sample. Our findings reveal that reporting bias, resulting from the presence of a substantial proportion of underreporters of higher weight status, can contribute to obtaining spurious associations between dairy intake and weight status. These findings underscore the need for randomly controlled trials to assess the role of dairy in weight management.The prevalence of pediatric obesity has been rising for more than 20 years (1). There is evidence that increased intake of dairy foods and calcium may play a significant role in maintaining a healthful weight and moderating body fat (2-15). However, results across studies have been inconsistent (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28), and this may be attributable to major challenges in using self-reported dietary intake data. Self-reported intakes tend to be subject to underreporting bias and the underreporting of energy intake tends to be positively related to weight status. Underreporters also tend to weigh more (29,30). Doubly labeled water techniques assessing energy expenditure suggest underreporting results in a 10% to 50% underestimation of actual energy intake and is a significant problem in older children (31). Doubly labeled water techniques are expensive and not feasible for large samples; thus, several methods have been developed that use estimated energy requirements to assess reporting bias (29,32). Therefore, in this study the method suggested by Huang and colleagues (29) was used to classify children as under-,

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confidence: 99%

Girls’ Dairy Intake, Energy Intake, and Weight Status

Fiorito¹,

Ventura²,

Mitchell³

et al. 2006

Journal of the American Dietetic Association

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“…9 -12 Although it is expected that children of different genders and socioeconomic background would have different lifestyles (exercise, sunlight exposure, and nutrition), the few studies evaluating vitamin D levels in children and adolescents have mostly done so in boys and have not systematically examined the impact of socioeconomic status (SES) on vitamin D levels. An increasing body of evidence confirms a key role of calcium in bone mass accretion in children and adolescents [13][14][15] ; however, the impact of vitamin D insufficiency and, therefore, repletion on skeletal integrity in this age group is yet to be determined. …”

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confidence: 99%

Hypovitaminosis D in Healthy Schoolchildren

G¹,

Nabulsi

Choucair³

et al. 2001

Pediatrics

300

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ABSTRACT. Background. Vitamin D is essential for skeletal growth, but there are currently no guidelines for vitamin D supplementation after infancy. This study investigates vitamin D insufficiency in healthy children.Methods. Children ages 10 to 16 years from 3 private schools in Beirut, Lebanon, with differing socioeconomic status (SES) were studied: 169 in the spring of 1999 and 177 in the following fall; 83 students participated in both study phases. They had a physical examination, answered a dietary questionnaire, and blood was drawn for calciotropic hormones and indices of bone turnover.Results. Overall, 52% of the students were vitamin D-insufficient; the proportion of insufficiency was 65% in the winter and 40% at the end of the summer. During both seasons, girls had lower vitamin D levels than did boys; those who followed the dress code of covered head, arms, and legs had the lowest levels. Students in the mid-SES school had lower 25-hydroxyvitamin D (25-OHD) levels than did the ones from the high-SES school. After adjusting for confounders, gender, SES, and body mass index remained the significant predictors of vitamin D levels in both seasons (R 2 ‫؍‬ 0.53, for spring and 0.28 for fall). There was a significant inverse correlation between 25-OHD levels and parathyroid hormone levels that was best fitted by a curvilinear model (R 2 ‫؍‬ 0.19). V itamin D, the precursor of the active metabolite calcitriol, 1,25(OH) 2 vitamin D, is a steroid hormone that is essential for bone growth and development in children and skeletal health in adults. 1 Although nutritional rickets caused by severe vitamin D deficiency is almost eradicated from developed countries, it is still ranked among the 5 most prevalent diseases in developing countries. 2 It is recognized that less severe vitamin D deficiency (otherwise called insufficiency) has a deleterious effect on skeletal health in adults and elderly 3-6 ; however, its impact on bone metabolism in children and adolescents is less clear. The consensus has been that most adolescents should be able to synthesize sufficient vitamin D by brief exposure to sunlight and that only children living in extreme northern or southern latitudes may require supplementation with D 7,8 ; examination of the recent evidence leads to different conclusions. Indeed, 80% of children and adolescents had insufficient vitamin D levels (25-hydroxyvitamin D [25-OHD] levels Ͻ20 ng/mL) in the winter in 4 studies conducted in Spain, France, and Finland. 9 -12 Although it is expected that children of different genders and socioeconomic background would have different lifestyles (exercise, sunlight exposure, and nutrition), the few studies evaluating vitamin D levels in children and adolescents have mostly done so in boys and have not systematically examined the impact of socioeconomic status (SES) on vitamin D levels. An increasing body of evidence confirms a key role of calcium in bone mass accretion in children and adolescents [13][14][15] ; however, the impact of vitamin D insufficiency and, theref...

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“…Even after adjusting for height, calcium intake, vitamin D status and TBLH BA, the gain in TBLH BMC remained significantly greater in the group who were administered calcium fortified laddoos. Calcium supplementation resulted in significantly higher serum concentrations of iCa and a decrease in the serum concentrations of intact parathyroid hormone in the study group than the control group toddlers who received only vitamin D. Toddlers from the study group showed a significant increase in TBLH BMC of 35% as against 28% in the control group, which is higher than the increase observed in other calcium supplementation studies (Johnston et al, 1992;Lee et al, 1994a, b;Bonjour et al, 1997;Cadogan et al, 1997;Specker et al, 2001;Specker and Binkley, 2003;Lambert et al, 2008). Calcium supplementation with pharmacologic preparations in children has been studied by various researchers, although studies in toddlers and preschool children are scant.…”

Section: Discussionmentioning

confidence: 61%

“…Calcium fortification of fruit juice was used by Lambert et al (2008) in 12-yearold girls and a significantly greater increase in TBLH BMC was observed in the supplemented group than the placebo. Fortification of several foods with milk extracts has shown to bring about greater increase in BMD in prepubertal girls with low calcium intakes (Bonjour et al, 1997).…”

Section: Discussionmentioning

confidence: 99%

A pilot randomized controlled trial of oral calcium and vitamin D supplementation using fortified laddoos in underprivileged Indian toddlers

et al. 2011

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Background/Objectives: Low habitual dietary calcium intake and vitamin D deficiency are common among Indian children. Using 'laddoo', an Indian snack, as a vehicle for administering calcium and vitamin D supplements, a randomized double-blind controlled trial was conducted for 12 months to assess its efficacy on total body less head (TBLH) bone mineral content (BMC) in underprivileged toddlers. Subjects/Methods: A total of 60 toddlers (mean age 2.7 ± 0.52 years, boys ¼ 31) were randomized to two groups, (i) study group receiving one calcium fortified laddoo (cereal-legume snack) containing 405 mg calcium per day and (ii) control receiving a non-fortified laddoo, containing 156 mg of indigenous calcium. Both groups also received a laddoo fortified with 30 000 IU of vitamin D 3 per month. Outcome measures included TBLH bone area (BA) and TBLH BMC by GE-Lunar DPX Pro Pencil Beam Dual-Energy X-ray absorptiometry. Results: At baseline, mean energy, protein and calcium intakes were 71, 72 and 47% of Indian Recommended Dietary allowances. In all, 87 and 83% toddlers were hypocalcaemia and vitamin D deficient, respectively. Mean TBLH BMC was 289.5 ± 45.8 g. Post supplementation, mean TBLH BMC of study group showed a significantly greater (Po0.01) increase of 35% as against 28% in controls and the difference remained significant after adjusting for vitamin D status, calcium intake, height and TBLH BA. Conclusions: Daily supplementation with calcium fortified laddoo, and monthly vitamin D supplement resulted in a significant increase in TBLH BMC of underprivileged toddlers. We believe that such strategies have the potential of addressing nutritional problems in developing countries.

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Calcium-enriched foods and bone mass growth in prepubertal girls: a randomized, double-blind, placebo-controlled trial.

Cited by 512 publications

References 43 publications

Girls’ Dairy Intake, Energy Intake, and Weight Status

Girls’ Dairy Intake, Energy Intake, and Weight Status

Hypovitaminosis D in Healthy Schoolchildren

A pilot randomized controlled trial of oral calcium and vitamin D supplementation using fortified laddoos in underprivileged Indian toddlers

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