Dietary calcium and bone density among middle-aged and elderly women in China

Hu, Ji-Fan; Zhao, Xiaoqun; Jia, Jian-Bin; Parpia, Banoo; Campbell, T. C.

doi:10.1093/ajcn/58.2.219

Cited by 114 publications

(46 citation statements)

References 49 publications

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“…Details of the survey, including subject selection, dietary survey, health and lifestyle questionnaire, and blood collection techniques, have been described previously (Hu et al, 1993a(Hu et al, ,b, 1994a. In summary, ®ve counties were chosen from among the original 65 that participated in our 1983 ecological survey in rural China (Chen et al, 1991).…”

Section: Sampling Proceduresmentioning

confidence: 99%

“…The intake of foods and food ingredients was determined in the 3-day weighed food dietary survey (Hu et al, 1993a(Hu et al, , 1994b. Before each meal, investigators ®rst separated and weighed selected foods for each subject.…”

Section: Dietary Assessmentmentioning

confidence: 99%

“…These women were previously chosen for studies of diet and osteoporosis (Hu et al, 1993a(Hu et al, ,b, 1994 and of diet and vitamin A status (Root et al, 1997). The speci®c aims were to examine the relationship between dietary enhancers and inhibitors, menopausal status, and in¯ammatory status on several measures of iron status, and to evaluate the overall iron nutriture of rural Chinese premenopausal women.…”

Section: Introductionmentioning

confidence: 99%

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Iron status of middle-aged women in five counties of rural China

Root

Stephenson

et al. 1999

Eur J Clin Nutr

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Objective: To determine the relationships of dietary iron sources, other dietary factors, and lifestyle to iron status among premenopausal and recently postmenopausal Chinese women with widely varying regional dietary patterns. Design: Cross-sectional. Subjects were interviewed, blood samples were drawn, and dietary intakes were measured by a 3-day dietary survey for subjects in the ®ve survey counties. Setting: Rural China Subjects: About 80 randomly selected subjects per county among women aged 32 ± 66 y. Main outcome measures: Blood hemoglobin, plasma ferritin, and plasma iron. Results: Total iron intake was relatively high (15 ± 29 mgad) compared to developed counties. Heme iron intake was negligible in two of the study counties. Overall levels of iron de®ciency anemia were relatively low in these generally iron-stressed women. There was no clear statistical relationship between iron intake and physiological iron status. Although several measures of dietary intake (heme iron, dietary calcium, animal protein) were correlated with several measures of iron status before adjusting for survey county, only dietary animal protein was signi®cantly positively correlated with plasma ferritin after adjusting for the possibly confounding factor of the survey county (r 0.15, P 0.009). Intakes of potential inhibitors of iron absorption, such as tea, even in very high amounts, were not correlated to iron status. Plasma ferritin was positively correlated with plasma retinol (P 0.024) and cholesterol (P 0.007). Systemic in¯ammatory response, as indicated by high plasma Creactive protein levels, was shown to be raised in a group of subjects with apparently contradictory high levels of ferritin and low levels of hemoglobin (P 0.03). Conclusions: Iron nutriture in these areas of rural China seemed more related to physiological factors such as in¯ammatory response, menses, plasma vitamin A and cholesterol, than to dietary factors.

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Section: Sampling Proceduresmentioning

confidence: 99%

Section: Dietary Assessmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Iron status of middle-aged women in five counties of rural China

Root

Stephenson

et al. 1999

Eur J Clin Nutr

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“…2 Dairy consumption in Chinese populations is low but milk is potentially of benefit for bone health. 4 The recommended minimum daily requirement for calcium in Chinese women is set at 1000 mg/day 5 but several studies report intakes as low as 230-724 mg/day 1,6,7 and higher dietary calcium intake was associated with higher bone mass. 7 A study in Chinese women living in Hong Kong showed that bone loss can be reduced by supplementing with 800 mg calcium per day using fortified milk.…”

Section: Introductionmentioning

confidence: 99%

“…4 The recommended minimum daily requirement for calcium in Chinese women is set at 1000 mg/day 5 but several studies report intakes as low as 230-724 mg/day 1,6,7 and higher dietary calcium intake was associated with higher bone mass. 7 A study in Chinese women living in Hong Kong showed that bone loss can be reduced by supplementing with 800 mg calcium per day using fortified milk. 8,9 Similarly, a study in Chinese women in Malaysia showed that supplementing with 1200 mg calcium per day from fortified milk significantly reduced the percentage of total body bone loss compared to the control group.…”

Section: Introductionmentioning

confidence: 99%

High-calcium, vitamin D fortified milk is effective in improving bone turnover markers and vitamin D status in healthy postmenopausal Chinese women

Kruger

Todd

et al. 2012

Eur J Clin Nutr

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BACKGROUND/OBJECTIVES: Risk for developing osteoporosis increases in Asia. The purpose of the study was to evaluate the impact of a high-calcium vitamin D fortified milk (HCM) intervention on parathyroid hormone (PTH) levels, vitamin D status and markers of bone turnover in postmenopausal Chinese women. SUBJECTS/METHODS: Sixty three women (455 years) were assigned to receive two servings of either a calcium/vitamin D fortified milk or a control drink for 12 weeks. PTH, serum 25 (OH)D levels, C-telopeptide of type I collagen (CTX) levels and procollagen type I N-terminal propeptide (PINP) were measured at baseline, 2, 8 and 12 weeks of supplementation. RESULTS: Daily calcium intake at baseline ranged between 260 and 482 mg for the HCM, and 252 and 692 mg for the control group. HCM improved serum 25 (OH)D levels significantly (33.13-39.49 nmol/l), while remaining similar in the control group (29.27-28.21 nmol/l). The difference between the groups were significant at week 2, 8 and 12. The percentage change in PTH levels in the HCM group was significant from week 2 onwards compared to the control drink (Po0.017, Po0.05 and Po0.001 at weeks 2, 8 and 12, respectively). Plasma CTX of the HCM group reduced by 25% between weeks 0 and 2, remaining significantly lower and at similar levels up to week 12. The difference between the HCM and control group for PINP reached significance at weeks 8 (P ¼ 0.011) and 12 (P ¼ 0.003). CONCLUSIONS: The HCM intervention significantly improved vitamin D status and reduced bone turnover over 12 weeks in postmenopausal Chinese women.

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Milk Consumption and Bone Health

Weaver

2014

JAMA Pediatr

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Increasing peak bone mass early in life and reducing bone loss later in life are 2 approaches for reducing risk of osteoporosis. This disease of low bone mass and fragility fracture affects a large portion of the elderly population. Milk consumption has long been held as an important strategy for building optimal peak bone mass. Therefore, it is assumed that milk consumption, especially during development of peak bone mass, reduces risk for osteoporosis.There is substantive mechanistic evidence for this inference from a variety of physiological perspectives, including structure-function relationships, homeostatic regulation of serum cations, and bone balance. Bone mineral composition in many respects reflects the mineral composition of milk. The most abundant mineral in bone is calcium, which composes approximately 32% of bone mineral content. Milk and other dairy products provide the majority of dietary calcium in the diets of most populations. Bone mineral acquisition during growth and retention in later life directly relate to calcium intake up to a threshold intake. 1 Other minerals, notably phosphorus and magnesium, are also important constituents in bone. Milk is a major dietary contributor of these minerals, although to a lesser extent than it is for calcium. Maintaining appropriate electrolyte concentrations in the blood and extracellular fluid compartments is essential to support myriad biological functions. If the serum calcium level decreases owing to inadequate calcium intake, parathyroid hormone is released to stimulate bone resorption to return blood calcium levels to the normal range. Long-term low calcium intakes lead to negative bone balance. Bone balance is a net result of bone formation and bone resorption. Increased dietary calcium suppresses bone resorption without altering bone formation rates, thereby improving bone balance. 2 It is not only the calcium in milk that influences bone health. Growing rats fed equal and adequate calcium intakes from milk or calcium carbonate with all of the recommended levels of other nutrients achieved larger, denser, stronger bones on the milk diet, and most of these advantages were retained through adulthood after switching both groups to an inadequate calcium intake provided by calcium carbonate. 3 Feskanich et al 4 report that milk intake during teenage years was associated with an increased risk of adult hip fracture in men (albeit borderline), but not women, in 2 prospective cohort studies. This observation is consistent with some reports of current milk consumption but not typically retrospective studies of milk consumption during growth. In a metaanalysis of prospective cohort studies by many of the same au-

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Dietary calcium and bone density among middle-aged and elderly women in China

Cited by 114 publications

References 49 publications

Iron status of middle-aged women in five counties of rural China

Iron status of middle-aged women in five counties of rural China

High-calcium, vitamin D fortified milk is effective in improving bone turnover markers and vitamin D status in healthy postmenopausal Chinese women

Milk Consumption and Bone Health

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