Calcium intake

1
Calcium intake

• Recommendations and reality
• V Bhatia
• Sanjay Gandhi PGIMS
• Lucknow

2
Clinical implications of calcium deficiency

• Impaired bone mass accrual in fetus, metabolic
  consequences, programming
• Metabolic bone disease of prematurity
• Childhood rickets
• Possible secondary vitamin D deficiency
• Impaired peak bone mass accrual
• Osteoporosis postmenopausal, elderly

3
(No Transcript)
4
(No Transcript)
5
Urinary/fecal and insensible loss

• Urinary loss
• About 140 mg/day
• Increased by protein (esp animal) intake (1 g 1
  mg Ca loss (complex urinary calcium and remove)
• Increased by sodium loss (1 gm inake 15 mg
  loss)(compete for tubular reabsorption)

6
Protein intake in various regions
7
(No Transcript)
8
(No Transcript)
9
(No Transcript)
10
Vitamin D deficiency in adolescent girls and
pregnant women from rural northern India
Sahu M, Bhatia V, Das V, Agarwal A
11
Clinical and biochemical features
12
Exposure to sun shine in rural population
13
Prevalence of osteomalacia and hypovitaminosis D
14
Effect of seasonality on 25OHD levels
15
Co relations of possible factors with Vitamin D
status
16
Hypovitaminosis D comparison between boys and
girls
17
Summary of results

• High prevalence of 25(OH) D deficiency in rural
  adolescent and pregnant females
• Very low calcium intake present in both groups
  studied
• Sun shine exposure positively correlates with
  vitamin D status
• Marked seasonal effect on circulating 25(OH) D
  levels
• Girls more vulnerable than boys

18
Conclusions

• Calcium deficiency has numerous implications from
  fetal through adult life
• Calcium balance studies in different age groups,
  in different geographical regions, are pending
• Scope for rationalisation of Indian guidelines
  exists

Thank you
19
Absorption of dietary calcium 35 of
intake(higher at low intakes, lower at high
intakes)

• 75 of daily needs from milk and milk products
• Smaller amounts from vegetable sources
• (not possible to maintain from veg sources
  without fortification)

• Impede absorption
• Low calcium phosphate
• ratio
• Phytate, oxalate present
• Vitamin D deficiency

• Favour absorption
• Infancy, adolescence,
• pregnancy
• High calcium phosphate
• ratio (breast vs cow milk)