Calcium Intake from Food and Supplemental Sources Decreased in the Canadian Population from 2004 to 2015

Abstract

Background In light of the publications (2008–2014) linking calcium intake, mainly from supplements, to the elevated risk of cardiovascular events, there is a need to determine if there have been any changes in usual intakes of calcium among Canadians. Objective We aimed to examine changes in dietary and total usual intake of calcium among Canadians aged ≥1 y over the period 2004–2015. Methods We used nutrition data from 2 nationally representative surveys conducted in 2004 and 2015 (CCHS 2004 Cycle 2.2 and CCHS-Nutrition 2015). This study included all the Canadians across 10 provinces, and the analyses were performed across different age/sex groups. We used the National Cancer Institute (NCI) method to estimate the usual intake of calcium and the prevalence of calcium inadequacy. Multiple logistic regression was performed to assess the relation between supplement uses and sociodemographic variables. Results From 2004 to 2015, the usual intake of calcium from food sources significantly decreased in calcium supplement nonusers (from 872 ± 18.2 mg/d to 754 ± 18.0 mg/d), but not in calcium supplement users. The contribution of calcium from the Milk and alternatives food group significantly decreased by 7.5% and 6.1% in calcium supplement users and nonusers, respectively. The prevalence of calcium supplement use significantly decreased from 2004 to 2015 in the Canadian population, from 27.5% to 22.0%. During this time, the percentage contribution of calcium from supplemental sources significantly decreased among Canadians, especially women. The prevalence of calcium inadequacy increased from 58.0% to 68.0% in supplement nonusers; however, among users of calcium supplements, the prevalence of calcium inadequacy remained at ∼31%. Conclusions Calcium intake from both food and supplemental sources decreased in the Canadian population over an 11-y period, which must be addressed by policy-makers in their efforts to decrease the high prevalence of calcium inadequacy.

Consumption of Milk and alternatives decreased among Canadians from 2004 to 2015: evidence from the Canadian community health surveys

“…Further, in efforts to decrease saturated fat consumption, the new 2019 Canada's Food Guide has eliminated the "Milk & Alternatives" food category and recommended only lower-fat dairy products as a subgroup of protein foods [4]. However, this may accelerate the previously observed downward trend in dietary intakes of calcium and vitamin D [43,44], and alter the nutritional profile of the diet of Canadians.…”

Canadian Adults with Moderate Intakes of Total Sugars have Greater Intakes of Fibre and Key Micronutrients: Results from the Canadian Community Health Survey 2015 Public Use Microdata File

“…The low intakes of calcium and vitamin D in Q1 may be explained by the corresponding low intakes of dairy products such as milk and yogurt, which are the most readily available dietary sources of calcium and vitamin D. Adequate calcium intake has many health benefits including prevention of osteoporosis and colorectal adenomas, lower cholesterol values, and a reduction in hypertensive disorders in pregnancy [76][77][78][79][80], whereas vitamin D has been shown to have important skeletal and non-skeletal effects, including on cardiovascular function, glucose homeostasis and immune function [81][82][83][84]. The mean intake of calcium in Canadian adults is below recommendations for most age and sex groups, and has shown a declining trend between 2004 and 2015 [85,86]. Similarly, the majority of Canadians do not meet the adequate intake level for potassium or vitamin D [74,75], and low vitamin D intake may further reduce calcium absorption, exacerbating the challenge of meeting calcium recommendations.…”

Trends in the consumption of conventional dairy milk and plant‐based beverages and their contribution to nutrient intake among Canadians

“…As we have shown previously, enriched beverages contribute approximately 2% of calcium intakes. 7 Furthermore, the transition of milk from a subgroup of Milk and Alternatives food group in 2007 Canada's Food Guide to a source of protein in the new Canada's Food Guide (2019) may further exacerbate the observed downward trend in the consumption of plain milk. Consequently, as we have shown earlier, 7 this may adversely affect the dietary intake of calcium and increase the prevalence of calcium inadequacy among Canadians even further.…”

“…Consequently, this may adversely affect the dietary intake of calcium and increase the prevalence of calcium inadequacy because milk and milk products are major sources of calcium in the diet of Canadians. 7 Although new Canada's Food Guide has recommended consuming fortified-soy beverages, it should be noted that PBBs have generally lower bioavailability of calcium and higher glycaemic index compared to conventional dairy milk. 8 Thus, it is important to examine trends in the consumption of conventional dairy milk and PBBs before the introduction of the new Canada's Food Guide.…”