Young Adults’ Perceptions of Calcium Intake and Health: A Qualitative Study

Abstract

Many young Canadian adults are not meeting dietary calcium recommendations. This is concerning as adequate calcium is important throughout young adulthood to maximize peak bone mass for osteoporosis prevention. There are limited studies that have explored young adults' perceptions toward calcium and health. Our objectives were to determine young adults' (18-34 years) knowledge of calcium in relation to health, facilitators and barriers to adequate calcium intake, and to explore both their suggestions for individual strategies to increase calcium intake and ways to communicate calcium-related messaging to this population. Eight gender-specific focus groups (18 men; 35 women) were conducted using a semistructured interview guide, guided by social cognitive theory. Deductive thematic analysis was used to generate themes. Participants perceived adequate calcium intake to be important for children and older adults but were uncertain of the benefits for their own age group. Perceived positive outcomes (e.g., aesthetics such as strong nails) associated with adequate calcium intake were cited as a motivator to increase intake. Perceived barriers to achieving increased calcium intake included the high cost and inconvenience of milk products and negative practices of dairy farmers. Participants suggested planning healthy well-balanced meals and forming a habit of consuming calcium-rich foods as individual strategies to increase calcium intake. Strategies to convey calcium-related information to young adults included increasing awareness of the importance of calcium via credible sources of information and developing nutrition education curricula. Social media and advertising were perceived as ineffective. Our findings provide key information for nutrition education initiatives.

The barriers and enablers to achieving adequate calcium intake in young adults: a qualitative study using focus groups

“…Our findings are generally in agreement with a similar study reporting barriers and facilitators from adolescents that included personal knowledge gap, misconceptions related to benefits, taste, parental and peer influence, and the availability and convenience of dairy products . Although previous studies report a gap in young adults' knowledge of high calcium foods , a majority of the participants were able to identify the importance of calcium for bone health, which is consistent with a Canadian study and an older study in young women . Previous studies have identified that young adults perceive osteoporosis as an older woman's disease .…”

“…This concept is original and emphasises the need and importance of the present study. In addition, only one Canadian study has explored the perception of calcium in young men and women and so the present study conducted in Australian 18–25‐year‐old adults is novel.…”

A Review of Knowledge, Belief and Practice Regarding Osteoporosis among Adolescents and Young Adults

“…The studies were performed in various countries and regions. The majority of the studies are from Saudi Arabia [15,17,18,19], Sri Lanka [20], Canada [21,22,23,24], Thailand [25,26] and South Korea [27,28,29,30], Jordan [31,32], Malaysia [33,34], China [35,36] and the rest are from United States [35], Nigeria [4], Taiwan [37], Syria [38], India [39], Poland [40], Denmark [41], U.K. [42], Iran [43], Pakistan [44], Columbia [45], the Basque region (Spain) [46], Japan [47] and Australia [48]. Most of the studies included in this review used either self-designed or validated questionnaire to assess the knowledge, attitude and practice among subjects regarding bone health/osteoporosis.…”

“…In some studies, despite the high perceived seriousness of osteoporosis, perceived barriers to osteoprotective behaviours remained high [23,35,38]. Among the barriers to meet the daily recommendation of calcium intake were high cost and inconvenience of milk products (packaging), as well as negative practices of dairy farmers (hormones were given to cows to encourage milk production) [23].…”

“…Among the barriers to meet the daily recommendation of calcium intake were high cost and inconvenience of milk products (packaging), as well as negative practices of dairy farmers (hormones were given to cows to encourage milk production) [23]. Cultural differences, as demonstrated between US and Chinese university students, also contributed to discrepancies between dietary and physical activity habits [35].…”