Interaction Between Calcium and Phosphorus and the Relationship to Bone Health

Lamberg‐Allardt, Christel; Kemi, Virpi

doi:10.1007/978-1-4939-6566-3_10

Cited by 6 publications

(6 citation statements)

References 73 publications

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“…Aggravated by the country’s current Westernisation, this unbalanced diet has progressively deteriorated to include high amounts of carbonated drinks (such as soda) and processed foods which, as mentioned, are high in Pi content ( 37 ). Despite the well-known inverse association between Ca and Pi in bone health (high Pi intake may decrease Ca absorption and high Ca may inhibit Pi uptake in the gut) ( 38 ), the elevated dietary Pi intake in our cohort did not protect from developing biochemical OM as the Ca-P product remained low in the OM group independent of Pi intake, indicating that association alone does not imply causation. The significant association of dietary vitamin D intake with serum 25(OH)D among only those without biochemical OM is worth noting since this association, while significant, was very small ( r 2 < 1%) in terms of affecting the participants’ vitamin D status, suggesting that other major factors (i.e., sun exposure, outdoor physical activity, vitamin D supplements) not assessed in the present study are largely influencing the vitamin D status of this population.…”

Section: Discussioncontrasting

confidence: 76%

Association of bone mineralization markers with dietary nutrient intake in adolescents with and without biochemical osteomalacia

et al. 2023

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BackgroundDietary intake is widely known to play a crucial role in achieving peak bone mass among children and adolescents. Unfortunately, this information is lacking among Arab adolescents, an understudied demographic that has recently been observed to have a high prevalence of abnormal mineralization markers [low serum 25(OH)D, high serum alkaline phosphatase (ALP), low calcium (Ca) and/or inorganic phosphate (Pi)] suggestive of biochemical osteomalacia (OM, defined as any 2 of the 4 parameters). In order to fill this gap, we aimed to evaluate the associations of serum markers of biochemical OM with dietary intake of macronutrients, vitamins and trace minerals.MethodsSaudi adolescents (N = 2,938, 57.8% girls), aged 12–17 years from 60 different schools in Riyadh, Saudi Arabia were included. Dietary intake of nutrients was calculated following a semi-quantitative 24 h dietary recall over 3 weekdays and 1 weekend-day using a validated food frequency questionnaire. Compliance to reference daily intake (RDI) of macronutrients, vitamins and trace minerals were calculated. Fasting blood samples were collected and circulating levels of 25(OH)D, ALP, Ca, and Pi were analyzed.ResultsA total of 1819 (1,083 girls and 736 boys) adolescents provided the dietary recall data. Biochemical OM was identified in 175 (9.6%) participants (13.5% in girls, 3.9% in boys, p < 0.01) while the rest served as controls (N = 1,644). All participants had serum 25(OH)D levels <50 nmoL/L. Most participants had very low dietary intakes of Ca (median ~ 290 mg) and vitamin D (median ~ 4 μg) which are far below the RDI of 1,300 mg/day and 20 μg/day, respectively. In contrast, excess dietary intakes of Pi, Na, K, and Fe were observed in all participants. In the biochemical OM group, thiamine and protein intake were significant predictors of serum 25(OH)D, explaining 4.3% of the variance perceived (r = 0.23, adjusted r2 = 4.3%, p = 0.01). Among controls, dietary vitamin C and vitamin D explained 0.6% of the total variation in serum 25(OH)D (r = 0.09, adjusted r2 = 0.6%, p = 0.004).ConclusionArab adolescents do not meet the RDI for dietary Ca and vitamin D, and none have sufficient vitamin D status (25(OH)D levels >50 nmol/L) but they exceed the RDI for dietary Pi. Interpreting these data in the light of the increased prevalence of rickets in Arab countries, food fortification to optimise vitamin D and Ca intake in Saudi adolescents should be considered.

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Section: Discussioncontrasting

confidence: 76%

Association of bone mineralization markers with dietary nutrient intake in adolescents with and without biochemical osteomalacia

et al. 2023

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“…Notably, these discrepancies may be related to study population characteristics, including the inclusion of adults younger than 35 years old in most comparative studies. Both serum calcium and phosphate are known to be affected by PTH and vitamin D concentrations 18 . Thus, an assessment and comparison of PTH and vitamin D reference value distributions for each of these regions is necessary.…”

Section: Discussionmentioning

confidence: 99%

“…Both serum calcium and phosphate are known to be affected by PTH and vitamin D concentrations. 18 Thus, an assessment and comparison of PTH and vitamin D reference value distributions for each of these regions is necessary. In addition, kidney function, evaluated by creatinine (Cr) level and glomerular filtration rate (GFR), 39 influences the levels of calcium and phosphate.…”

Section: Ris For Macro-mineralsmentioning

confidence: 99%

“…For example, zinc and copper have effects on growth, neuronal development, immunity, bone and blood health, and cell apoptosis, 13,14 while magnesium plays an important role in carbohydrate metabolism, acting as a cofactor in several enzymatic reactions. 15 Calcium and phosphate form the main contents of the bone structure 16 in the form of hydroxyapatite [Ca 10 (PO 4 ) 6 (OH) 2 ] crystals, 17 playing a role in the formation of the bone by their effects on parathyroid hormone (PTH) and 1,25-dihydroxyvitamin D. 18 Finally, copper and zinc are involved in the structure of SOD, an enzyme with the role of reducing oxidative stress by converting the superoxide to oxygen and hydrogen peroxide. 19 Copper and zinc form the part of the active site of this enzyme.…”

Section: Introductionmentioning

confidence: 99%

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Age‐ and sex‐specific reference intervals for superoxide dismutase enzyme and several minerals in a healthy adult cohort

Ghazizadeh

Bohn

Yaghooti‐Khorasani

et al. 2021

Clinical Laboratory Analysis

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Introduction The aim of this study was to establish RIs for clinically important markers including superoxide dismutase (SOD), serum copper, zinc, calcium, magnesium, and phosphate in a cohort of healthy Iranian adults. Materials A subsample from MASHAD cohort study was used to assess serum SOD, copper, zinc, calcium, magnesium and phosphate. Serum SOD was measured according to its inhibitory potential of pyrogallol oxidation. Micro‐ and macro‐minerals were measured using flame atomic absorption spectrometry and a BT3000 autoanalyzer, respectively. Sex‐ and age‐specific RIs were then calculated based on CLSI Ep28‐A3 guidelines. Results Reference value distributions for studied parameters did not demonstrate any age‐specific differences that were statistically significant. In addition, sex partitioning was not required for all parameters, apart from serum magnesium, which showed a wider range in females (0.81–1.26 mg/dl) compared with males (0.82–1.23 mg/dl). Conclusion The RIs established in this study can be expected to improve mineral assessment and clinical decision‐making in the Iranian adult population.

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“…Vitamin A, iron, zinc, and calcium were selected because of their public health importance (Stevens et al, 2013;WHO, 2020). Although phosphorous and magnesium are largely not considered among micronutrients of public health importance, they were included in the study due to the fact that high concentration of phosphorous in the diet impairs calcium metabolism whereas high concentration of magnesium impacts negatively on iron absorption (Lamberg-Allardt & Kemi, 2017;Sugimoto & Yamada, 2019), thus indirectly making them significant in micronutrient nutrition in developing countries. Vitamin A was analyzed through detection of beta carotene using high-performance liquid chromatography according to Fatimah et al (2014) and expressed as retinol equivalent (RE).…”

Section: Analysis Of Micronutrientsmentioning

confidence: 99%

Traditional vegetable preservation technologies practiced in Acholi subregion of Uganda improves mineral bioavailability but impacts negatively on the contribution of vegetables to household needs for micronutrients

Bighaghire

Okidi

Muggaga

et al. 2021

Food Science & Nutrition

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The impact of traditional African preservation methods on the contribution of vegetables to household micronutrient needs (Recommended Dietary Allowance: RDA) has largely remained unquantified. Using Acholi subregion of Uganda as a case area, this study examined using the predominant vegetables consumed in fresh and preserved forms (cowpeas—Vigna unguicullata, okra/lady fingers—Abelmoschus esculentus, Malakwang—Hibscus cannabinus, and eggplants—Solanum melongena), the effect of major traditional vegetable preservation methods (sun drying, boiling and sun drying, and salting and sun drying) on the contents of micronutrients (vitamin A, iron, zinc, calcium, magnesium, and phosphorus), the levels of antinutritional factors (total polyphenols, oxalate, tannins, and phytate), bioavailability of iron and zinc, and the contribution of vegetables to the cumulative annual household RDA for micronutrients. Laboratory analysis showed that all the preservation methods, except the sun drying method reduced the contents of micronutrients by 20%–82% (p ≤ .05). The contents of antinutritional factors reduced by 1%–80% while in vitro bioavailability of iron and zinc increased by 21%–296% (p ≤ .05). Nutritional computation revealed that except for calcium, the preservation methods combined, reduced the contribution of the vegetables to cumulative annual RDA for other micronutrients by 28%–60%. These results demonstrate that improvements in bioavailability of essential nutrients (iron and zinc) by traditional preservation methods investigated are associated with significant loss of micronutrients which culminates in significant reduction in the contribution of cultivated vegetables to household RDA for micronutrients. Traditional African preservation methods should be optimized for nutrient retention.

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Interaction Between Calcium and Phosphorus and the Relationship to Bone Health

Cited by 6 publications

References 73 publications

Association of bone mineralization markers with dietary nutrient intake in adolescents with and without biochemical osteomalacia

Association of bone mineralization markers with dietary nutrient intake in adolescents with and without biochemical osteomalacia

Age‐ and sex‐specific reference intervals for superoxide dismutase enzyme and several minerals in a healthy adult cohort

Traditional vegetable preservation technologies practiced in Acholi subregion of Uganda improves mineral bioavailability but impacts negatively on the contribution of vegetables to household needs for micronutrients

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