Dietary Calcium Intake in Sample of School Age Children in City of Rabat, Morocco

Project Abstract

<p>                       <b>ABSTRACT&nbsp;</b><br></p><p> Calcium is an important mineral playing a vital role to maintain bone health. Calcium intake is considered as one of the most important determinants to assess the calcium status and to evaluate the calcium deficiency in the human body. Our study aims at estimating calcium intake in a sample of children and adolescent to be used in the global strategy to reduce calcium deficiency disorders in Morocco. Thus, 131 children and adolescents were recruited from public schools at Rabat and its regions in the framework of a descriptive cross-sectional study. For each participant, anthropometric parameters were measured. Calcium status was assessed by 24 h dietary recall. Food frequency questionnaire was used to evaluate children’s nutritional habits and to assess the consumption of calcium-rich food. Overall, the mean calcium intake was 522.0 ± 297.0 mg/day, and 85.5% of subjects highlighted calcium deficiency, with no significant difference between boys and girls. Calcium intake was significantly different according to age groups, and high consumption of calcium was found in subjects aged from 14 to 18 years (776.86 ±290.07 mg/day), giving evidence of the low calcium status of the studied population. Daily food intake and food frequency analysis showed that bread, vegetables, and fruits are the most consumed food and the main source of daily calcium intake. Consumption of dairy products, considered as the best source of calcium, is lower and represents only 14% of total calcium intake. Our study clearly showed that calcium status is very lower in Moroccan children and adolescents and a large proportion of this population have inadequate calcium intake. Hence, there’s an urgent need of specific strategies, including children sensitisation and nutritional education, to increase calcium intake and therefore reduce calcium deficiency disorders impacting the whole body during childhood and in adult age. <br></p>

Project Overview

<p> </p><p><b>1.1 INTRODUCTION</b><br></p><p>Calcium is the most abundant mineral element in the body, representing 1–2% of total body weight [<a target="_blank" rel="nofollow">1</a>]. Overall, 99% of calcium is found in the skeleton and teeth, as calcium phosphate, providing rigidity by virtue of the insoluble salts it forms with phosphoric acid, the remaining 1% of calcium is freely exchangeable with the extracellular fluid [<a target="_blank" rel="nofollow">2</a>]. The concentration of calcium in the organism is systematically regulated by parathyroid hormones, vitamin D, and calcitonin [<a target="_blank" rel="nofollow">3</a>], and calcium deposition is depending on many factors, especially age, sodium status, and the presence of some animal proteins [<a target="_blank" rel="nofollow">4</a>].</p><p>Indeed, calcium deposition on bones is dependent on the growth rate: from birth until the age of 30 years, about 150 mg of calcium per day is accumulated in the skeleton [<a target="_blank" rel="nofollow">5</a>], during maturity (30–50 years) calcium absorption is variable and depends on calcium intake, and at elderly age (more than 50 years), the calcium balance becomes negative and bones are more likely to loss calcium [<a target="_blank" rel="nofollow">6</a>]. Therefore, there’s evidence that calcium intake during childhood and adolescence is critical, and adequate calcium intake during this period of life cycle is of a great interest to have a positive calcium balance, good bone density necessary for the skeletal consolidation [<a target="_blank" rel="nofollow">7</a>], and reducing the risk of fractures and osteoporosis later [<a target="_blank" rel="nofollow">8</a>].</p> <p>In childhood, one of the most important nutritional risks is poor eating habits, including skipping meals, eating lots of processed food, and following fad diets [<a target="_blank" rel="nofollow">9</a>], factors that promote an inadequate calcium intake and consequently growth problems in children and adolescents [<a target="_blank" rel="nofollow">10</a>]. Calcium is present in many foods, but milk and dairy products, such as yogurt, cheeses, and buttermilk, are the best source of calcium (∼1150 mg/l), which is more available and easily absorbed in the organism. Calcium is also present in some vegetables like flour, beans, eggs, and fish. Mineral drinking water represents an alternative source of calcium for some groups of the population [<a target="_blank" rel="nofollow">11</a>].</p><p>Worldwide recommendations for calcium intake vary depending on age, gender, and according to some genetic and environmental factors. Accordingly, IOM, FAO, and FNB recommendations outline the importance of high calcium intake to improve bone mineral density. The adequate intake of calcium is about 1000 mg/day for children aged from 6 to 8 and about 1300 mg/day for those aged&nbsp; from 9 to 18 and for adolescents [<a target="_blank" rel="nofollow">12</a>].</p><p>The Moroccan diet, basically Mediterranean, is based on a large consumption of cereals, fruits, and vegetables [<a target="_blank" rel="nofollow">13</a>]. However, the consumption of dairy products is still limited [<a target="_blank" rel="nofollow">14</a>]. In Morocco, the prevalence of osteoporosis is quite higher. In 2013, more than 35% of women over 50 years and about 60% of women over 60 years have been reported developing osteoporosis [<a target="_blank" rel="nofollow">15</a>]. Moreover, more than 4300 hip fractures were recorded in 2010 giving an incidence of 60.6 per 100,000 women (95% CI: 55.1–65.6) [<a target="_blank" rel="nofollow">16</a>].</p><p>In Morocco, the Ministry of Health has adopted a global strategy to prevent health problems related to micronutrient deficiencies [<a target="_blank" rel="nofollow">17</a>]. However, limited information is available regarding calcium intake. Owing to the importance of calcium for both children and adults, the evaluation of the dietary intake of this mineral, especially during childhood, is very important. Therefore, we have planned to evaluate the calcium intake in Moroccan children and adolescents aged from 6 to 18 years, living in Rabat and regions, to adapt the national strategy and to prevent all calcium deficiency associated diseases.</p> <p></p> <br><p></p>