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Calcium intake

Calcium intake. Recommendations and reality V Bhatia Sanjay Gandhi PGIMS Lucknow. Clinical implications of calcium deficiency. Impaired bone mass accrual in fetus, metabolic consequences, programming Metabolic bone disease of prematurity Childhood rickets

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Calcium intake

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  1. Calcium intake Recommendations and reality V Bhatia Sanjay Gandhi PGIMS Lucknow

  2. Clinical implications of calcium deficiency • Impaired bone mass accrual in fetus, metabolic consequences, programming • Metabolic bone disease of prematurity • Childhood rickets • Possible secondary vitamin D deficiency • Impaired peak bone mass accrual • Osteoporosis: postmenopausal, elderly

  3. Urinary/fecal and insensible loss Urinary loss: • About 140 mg/day • Increased by protein (esp animal) intake (1 g = 1 mg Ca loss (complex urinary calcium and remove) • Increased by sodium loss (1 gm inake = 15 mg loss)(compete for tubular reabsorption)

  4. Protein intake in various regions

  5. Vitamin D deficiency in adolescent girls and pregnant women from rural northern India Sahu M, Bhatia V, Das V, Agarwal A

  6. Clinical and biochemical features

  7. Exposure to sun shine in rural population

  8. Prevalence of osteomalacia and hypovitaminosis D

  9. Effect of seasonality on 25OHD levels

  10. Co relations of possible factors with Vitamin D status

  11. Hypovitaminosis D: comparison between boys and girls

  12. Summary of results • High prevalence of 25(OH) D deficiency in rural adolescent and pregnant females • Very low calcium intake present in both groups studied • Sun shine exposure positively correlates with vitamin D status • Marked seasonal effect on circulating 25(OH) D levels • Girls more vulnerable than boys

  13. Conclusions • Calcium deficiency has numerous implications from fetal through adult life • Calcium balance studies in different age groups, in different geographical regions, are pending • Scope for rationalisation of Indian guidelines exists Thank you

  14. Absorption of dietary calcium = 35% of intake(higher at low intakes, lower at high intakes) 75% of daily needs from milk and milk products Smaller amounts from vegetable sources (not possible to maintain from veg sources without fortification) • Impede absorption: • Low calcium phosphate • ratio • Phytate, oxalate present • Vitamin D deficiency • Favour absorption: • Infancy, adolescence, • pregnancy • High calcium phosphate • ratio (breast vs cow milk)

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