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Pubertal Girls Only Partially Adapt to Low Dietary Calcium Intakes

Abrams, Steven A, Griffin, Ian J, Hicks, Penni D, Gunn, Sheila K·2004·Journal of Bone and Mineral Research
DOI 10.1359/jbmr.040122
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Abstract

We evaluated the effects of low calcium in the diets of young adolescent girls. We measured calcium absorption and excretion using stable isotopes. We found partial adaptation to low intakes but a persistent large deficit relative to recommended intakes. Low calcium intakes pose a substantial risk of inadequate calcium retention. Introduction: A substantial number of adolescent girls in the United States have habitual calcium intakes <500 mg/day (about 40% of the current recommended intake). The ability to adapt to these very low intakes by increasing calcium absorption and decreasing calcium excretion is not known. We sought to determine the effects of recommended (REC-Ca) versus very low (LO-Ca) calcium intakes on calcium absorption and excretion in white and black girls. Materials and Methods: Pubertal, but premenarcheal girls, were adapted to low or recommended calcium intakes for at least 2 weeks before each study. Calcium absorption (n = 51) and endogenous fecal calcium excretion (n = 36 of the 51) were determined by dual-tracer stable isotope studies. Subjects were then switched to the other diet for at least 6 weeks, and the study was repeated. Results: Calcium intake was 389 ± 10 mg/day on LO-Ca and 1259 ± 35 mg/day on REC-Ca diets. Fractional absorption increased from 44.9 ± 1.9% on REC-Ca to 63.4 ± 1.7% on LO-Ca (p < 0.01), but the net calcium absorption remained less than one-half the value on LO-Ca as on REC-Ca. Despite decreases in both endogenous fecal calcium excretion and urinary calcium excretion, net calcium balance was much lower on LO-Ca compared with REC-Ca1 (131 ± 14 versus 349 ± 32 mg/day, respectively; p < 0.001). We found significantly lower urinary calcium excretion but not calcium absorption in black girls compared with white girls. Conclusions: Very low calcium intakes are only partially adapted to by increased absorption and decreased excretion. Very low calcium intakes place both white and black pubertal girls at substantial risk for inadequate calcium retention.

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Research works printed but not linked: 18

  1. Jackman, 1997, Calcium retention in relation to calcium intake and postmenarcheal age in adolescent females, Am J Clin Nutr, 66, 327, 10.1093/ajcn/66.2.327 · DOI
  2. Institute of Medicine, Food, and Nutrition Board, 1997, Dietary Reference Intakes
  3. O'Brien, 1996, Increased efficiency of calcium absorption during short periods of inadequate intake in girls, Am J Clin Nutr, 63, 579, 10.1093/ajcn/63.4.579 · DOI
  4. Matkovic, 1992, Calcium balance during human growth: Evidence for threshold behavior, Am J Clin Nutr, 55, 992, 10.1093/ajcn/55.5.992 · DOI · Paper page
  5. Wastney, 2000, Changes in calcium kinetics in adolescent girls induced by high calcium intake, J Clin Endocrinol Metab, 85, 4470
  6. Matkovic, 1991, Calcium metabolism and calcium requirements during skeletal modeling and consolidation of bone mass, Am J Clin Nutr, 54, 254S
  7. Abrams, 1999, Using stable isotopes to assess mineral absorption and utilization by children, Am J Clin Nutr, 70, 955, 10.1093/ajcn/70.6.955 · DOI
  8. Abrams, 1997, Calcium and magnesium balance in 9–14-year old children, Am J Clin Nutr, 66, 1172, 10.1093/ajcn/66.5.1172 · DOI
  9. Abrams, 1991, Stable isotopic measurement of endogenous fecal calcium excretion in children, J Pediatr Gastroenterol Nutr, 12, 469
  10. Heaney, 1994, Determinants of endogenous fecal calcium in healthy women, J Bone Miner Res, 9, 1621, 10.1002/jbmr.5650091016 · DOI
  11. Heaney, 1990, Influence of calcium load on absorption fraction, J Bone Miner Res, 5, 1135, 10.1002/jbmr.5650051107 · DOI
  12. Martin, 1997, Bone mineral and calcium accretion during puberty, Am J Clin Nutr, 66, 611, 10.1093/ajcn/66.3.611 · DOI
  13. McKay, 1998, Peak bone mineral accrual and age at menarche in adolescent girls: A 6-year longitudinal study, J Pediatr, 133, 682, 10.1016/S0022-3476(98)70112-X · DOI
  14. Abrams, 1995, Differences in calcium absorption and kinetics between black and white girls aged 5–16 years, J Bone Miner Res, 10, 829, 10.1002/jbmr.5650100521 · DOI
  15. Bryant, 2003, Racial differences in bone turnover and calcium metabolism in adolescent females, J Clin Endocrinol Metab, 88, 1043, 10.1210/jc.2002-021367 · DOI
  16. Bell, 1993, Demonstration of difference in urinary calcium, not calcium absorption, in white and black adolescents, J Bone Miner Res, 12, 676
  17. Blackwood, 2001, Urinary calcium excretion, sodium intake and blood pressure in a multi-ethnic population: Results of the Wandsworth Heart and Stroke Study, J Hum Hypertens, 15, 229, 10.1038/sj.jhh.1001171 · DOI
  18. Dawson-Hughes, 1993, Calcium retention and hormone levels in black and white women on high- and low-calcium diets, J Bone Miner Res, 8, 779, 10.1002/jbmr.5650080702 · DOI

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Metadata

Authors
Abrams, S. A., Griffin, I. J., Hicks, P. D., & Gunn, S. K.
Affiliations
  • U.S. Department of Agriculture/Agricultural Research Service, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA
  • Section of Endocrinology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA
Venue
Journal of Bone and Mineral Research
Publisher
Oxford University Press (OUP)
Published
2004-05-01
Volume
19
Issue
5
Pages
759-763
ISSN
  • 0884-0431
  • 1523-4681
DOI
10.1359/jbmr.040122
Cited by
60
References
0
Language
en
Licence
academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)

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