Osteoporosis is a skeletal disease that involves micro-architectural deterioration of the bone matrix and depletion of bone mineral. Inadequate dietary calcium, especially in a vitamin D deficient environment, may predispose an individual to osteoporosis. Given that recommendations for daily intake (RDI) of dietary calcium differ between countries, and according to life-stages, understanding RDIs and how to achieve them is likely to be a complex process for many individuals. Health literacy, or the ability of individuals to gain access to, understand and use health-related information, will influence the capacity of individuals to meet RDIs. Furthermore, the lowest health literacy is observed in the same groups identified as having an increased risk of osteoporosis; older individuals, and those that are socially disadvantaged. It is imperative to consider the specific health literacy needs of at-risk populations when promoting recommendations for dietary calcium intake.Keywords: Health literacy; Dietary calcium intake; Osteoporosis; Recommended daily intake
Health LiteracyOsteoporosis, a common disease of the skeleton, involves microarchitectural deterioration of the bone matrix and depletion of bone mineral; this results in an increased susceptibility to fracture [1]. Postfracture, there is a plethora of financial, personal and psychosocial outcomes, including reduced mobility, impairment of daily activities, inability to work and loss of confidence [2,3]. A hip fracture has the most severe implications: one in five individuals die within the first year, while 60% of individuals who survive a hip fracture still require assistance to walk one year later, and 33% are totally dependent or are admitted to a nursing home [2,4]. Bone mass is an important predictor of osteoporosis, and future fracture risk [5], and calcium plays an important role in normal growth, development and maintenance of the skeleton [6], including providing a dynamic store to maintain the intra-and extra-cellular calcium pools [7]. Calcium homeostasis is regulated by an integrated hormonal system that involves calcitonin, parathyroid hormone (PTH) and the PTH receptor, and 1,25-dihydroxyvitamin D and the vitamin D receptor [7,8], along with serum ionized calcium, and the calcium-sensing receptor [9]. When plasma concentrations of ionized calcium fall below optimal levels, bone resorption increases in order to restore the mineral equilibrium.Clearly, adequate dietary calcium intake is an essential modifiable dietary factor for both achieving optimal peak bone mass in the second to third decade of life [10] and reducing age-related bone loss in later life [11]. However, recommendations for daily intake (RDI) of dietary calcium differ between countries; such discrepancies may likely arise from the rationale implemented by the governing bodies with responsibility for nutritional RDIs [12].
Life-stage RDI (mg)Babies 0-6 months~2 10 (if breastfed)
(if formula fed)Babies 7-12 months 270Children 1-3 years 500Children 4-8 years 700Children 9-11...