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Calcium intake below the recommended dietary allowance is associated with lower tibia bone mineral content and strength in young adults entering initial military training
Author(s) -
Nakayama Anna,
Lutz Laura J,
McClung James P,
GaffneyStomberg Erin
Publication year - 2017
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.31.1_supplement.967.7
Subject(s) - medicine , dietary reference intake , reference daily intake , micronutrient , bone mineral , calcium , tibia , metaphysis , osteoporosis , surgery , environmental health , nutrient , chemistry , organic chemistry , pathology
Background Calcium (Ca), a critical micronutrient for bone health, has been deemed a nutrient of public health concern due to consumption at levels below the recommended dietary allowance (RDA). Stress fracture risk is elevated during initial military training (IMT) and supplemental Ca during IMT reduces stress fracture incidence. Objective To assess dietary Ca in young adults entering IMT and to determine whether habitual Ca intake is associated with indices of bone health at the tibia, a commonly fractured site. Methods A retrospective analysis was performed using baseline data from 3 randomized control trials that assessed the efficacy of Ca and vitamin D supplementation for optimizing bone health during IMT in Army, Air Force, and Marine recruits. Ca intake was estimated from a semi‐quantitative food frequency questionnaire and adequacy was based on the age‐specific RDAs. Bone health was evaluated by peripheral quantitative computed tomography (pQCT) of the tibia at the metaphysis and diaphysis. The associations between pQCT parameters and Ca intake adequacy were assessed by multivariate regression (SPSS, v21) controlling for age, sex, race, self‐reported physical activity, BMI, smoking, education level, and use of Depo Provera. Results Of the 399 study participants (n=223 females, n=180 males), 251 (62%) did not meet the RDA for Ca. Adequate Ca intake was positively associated with total bone mineral content (BMC; B=.091, p=.005) and strength (B=.084, p=.020) at the metaphysis. When participants were stratified by sex, 70% of females and 52% of the males did not meet the RDA. In the female cohort, adequate Ca intake was positively associated with BMC (B=.169, p=.011) and strength (B=.142, p=.033) at the metaphysis and cortical BMC (B=.134, p=.042) at the diaphysis. There were no associations in the male cohort. Conclusion Adequate Ca intake in young adults is positively associated with measures of tibia BMC and strength. As recruits with Ca intake below the RDA at the start of training may experience diminished bone health potentially leading to greater injury susceptibility, adequate Ca intake should be emphasized prior to initiating military training. Disclaimer: The views expressed in this abstract are those of the authors and do not reflect the official policy of the Department of Army, Department of Defense, or the U.S. Government. Support or Funding Information Research supported by USAMRMC, DHP, and in part by an appointment to the Postgraduate Research Participation Program administered by the Oak Ridge Institute for Science and Education.